Science.gov

Sample records for decremental open lung

  1. OZONE-INDUCED RESPIRATORY SYMPTOMS AND LUNG FUNCTION DECREMENTS IN HUMANS: EXPOSURE-RESPONSE MODELS

    EPA Science Inventory

    Short duration exposure to ozone (<8 hr) is known to result in lung function decrements and respiratory symptoms in humans. The magnitudes of these responses are functions of ozone concentration (C), activity level measured by minute ventilation (Ve), duration of exposure (T), a...

  2. OZONE-INDUCED RESPIRATORY SYMPTOMS AND LUNG FUNCTION DECREMENTS IN HUMANS: EXPOSURE-RESPONSE MODELS

    EPA Science Inventory

    Short duration exposure to ozone (<8 hr) is known to result in lung function decrements and respiratory symptoms in humans. The magnitudes of these responses are functions of ozone concentration (C), activity level measured by minute ventilation (Ve), duration of exposure (T), a...

  3. Transpulmonary Pressure Describes Lung Morphology During Decremental Positive End-Expiratory Pressure Trials in Obesity.

    PubMed

    Fumagalli, Jacopo; Berra, Lorenzo; Zhang, Changsheng; Pirrone, Massimiliano; Santiago, Roberta R De Santis; Gomes, Susimeire; Magni, Federico; Dos Santos, Glaucia A B; Bennett, Desmond; Torsani, Vinicius; Fisher, Daniel; Morais, Caio; Amato, Marcelo B P; Kacmarek, Robert M

    2017-08-01

    Atelectasis develops in critically ill obese patients when undergoing mechanical ventilation due to increased pleural pressure. The current study aimed to determine the relationship between transpulmonary pressure, lung mechanics, and lung morphology and to quantify the benefits of a decremental positive end-expiratory pressure trial preceded by a recruitment maneuver. Prospective, crossover, nonrandomized interventional study. Medical and Surgical Intensive Care Units at Massachusetts General Hospital (Boston, MA) and University Animal Research Laboratory (São Paulo, Brazil). Critically ill obese patients with acute respiratory failure and anesthetized swine. Clinical data from 16 mechanically ventilated critically ill obese patients were analyzed. An animal model of obesity with reversible atelectasis was developed by placing fluid filled bags on the abdomen to describe changes of lung mechanics, lung morphology, and pulmonary hemodynamics in 10 swine. In obese patients (body mass index, 48 ± 11 kg/m), 21.7 ± 3.7 cm H2O of positive end-expiratory pressure resulted in the lowest elastance of the respiratory system (18.6 ± 6.1 cm H2O/L) after a recruitment maneuver and decremental positive end-expiratory pressure and corresponded to a positive (2.1 ± 2.2 cm H2O) end-expiratory transpulmonary pressure. Ventilation at lowest elastance positive end-expiratory pressure preceded by a recruitment maneuver restored end-expiratory lung volume (30.4 ± 9.1 mL/kg ideal body weight) and oxygenation (273.4 ± 72.1 mm Hg). In the swine model, lung collapse and intratidal recruitment/derecruitment occurred when the positive end-expiratory transpulmonary pressure decreased below 2-4 cm H2O. After the development of atelectasis, a decremental positive end-expiratory pressure trial preceded by lung recruitment identified the positive end-expiratory pressure level (17.4 ± 2.1 cm H2O) needed to restore poorly and nonaerated lung tissue

  4. Accelerated structural decrements in the aging female rhesus macaque lung compared with males

    PubMed Central

    Herring, Matt J.; Avdalovic, Mark V.; Quesenberry, Cheryl L.; Putney, Lei F.; Tyler, Nancy K.; Ventimiglia, Frank F.; St. George, Judith A.

    2013-01-01

    Aging is associated with morphometric changes in the lung that lead to decreased lung function. The nonhuman primate lung has been shown to have similar architectural, morphological, and developmental patterns to that of humans. We hypothesized that the lungs of rhesus monkeys age in a pattern similar to human lungs. Thirty-four rhesus monkeys from the California National Primate Research Center were euthanized, necropsied, and the whole lungs sampled. Stereological analysis was performed to assess the morphological changes associated with age. The number of alveoli declined significantly from age 9 to 33 yr with a greater decline in females compared with males. Lungs of females contained roughly 20% more alveoli at age 9 yr than males, but by ∼30 yr of age, females had 30% fewer alveoli than males. The volume of alveolar air also showed a significant linear decrease in females relative to age, while males did not. The number-weighted mean volume of alveoli showed a significant positive correlation with age in females but not in males. The volume of alveolar duct showed a significant positive correlation with age in females, but not in males. Structural decrements due to aging in the lung were increased in the female compared with male rhesus monkey. PMID:23144321

  5. Diesel exhaust modulates ozone-induced lung function decrements in healthy human volunteers

    PubMed Central

    2014-01-01

    The potential effects of combinations of dilute whole diesel exhaust (DE) and ozone (O3), each a common component of ambient airborne pollutant mixtures, on lung function were examined. Healthy young human volunteers were exposed for 2 hr to pollutants while exercising (~50 L/min) intermittently on two consecutive days. Day 1 exposures were either to filtered air, DE (300 μg/m3), O3 (0.300 ppm), or the combination of both pollutants. On Day 2 all exposures were to O3 (0.300 ppm), and Day 3 served as a followup observation day. Lung function was assessed by spirometry just prior to, immediately after, and up to 4 hr post-exposure on each exposure day. Functional pulmonary responses to the pollutants were also characterized based on stratification by glutathione S-transferase mu 1 (GSTM1) genotype. On Day 1, exposure to air or DE did not change FEV1 or FVC in the subject population (n = 15). The co-exposure to O3 and DE decreased FEV1 (17.6%) to a greater extent than O3 alone (9.9%). To test for synergistic exposure effects, i.e., in a greater than additive fashion, FEV1 changes post individual O3 and DE exposures were summed together and compared to the combined DE and O3 exposure; the p value was 0.057. On Day 2, subjects who received DE exposure on Day 1 had a larger FEV1 decrement (14.7%) immediately after the O3 exposure than the individuals’ matched response following a Day 1 air exposure (10.9%). GSTM1 genotype did not affect the magnitude of lung function changes in a significant fashion. These data suggest that altered respiratory responses to the combination of O3 and DE exposure can be observed showing a greater than additive manner. In addition, O3-induced lung function decrements are greater with a prior exposure to DE compared to a prior exposure to filtered air. Based on the joint occurrence of these pollutants in the ambient environment, the potential exists for interactions in more than an additive fashion affecting lung physiological

  6. Personal and Ambient Air Pollution Exposures and Lung Function Decrements in Children with Asthma

    PubMed Central

    Delfino, Ralph J.; Staimer, Norbert; Tjoa, Thomas; Gillen, Dan; Kleinman, Michael T.; Sioutas, Constantinos; Cooper, Dan

    2008-01-01

    Background Epidemiologic studies have shown associations between asthma outcomes and outdoor air pollutants such as nitrogen dioxide and particulate matter mass < 2.5 μm in diameter (PM2.5). Independent effects of specific pollutants have been difficult to detect because most studies have relied on highly correlated central-site measurements. Objectives This study was designed to evaluate the relationship of daily changes in percent-predicted forced expiratory volume in 1 sec (FEV1) with personal and ambient air pollutant exposures. Methods For 10 days each, we followed 53 subjects with asthma who were 9–18 years of age and living in the Los Angeles, California, air basin. Subjects self-administered home spirometry in themorning, afternoon, and evening. We measured personal hourly PM2.5 mass, 24-hr PM2.5 elemental and organic carbon (EC–OC), and 24-hr NO2, and the same 24-hr average outdoor central-site(ambient) exposures. We analyzed data with transitional mixed models controlling for personal temperature and humidity, and as-needed β2-agonist inhaler use. Results FEV1 decrements were significantly associated with increasing hourly peak and daily average personal PM2.5, but not ambient PM2.5. Personal NO2 was also inversely associated with FEV1. Ambient NO2 was more weakly associated. We found stronger associations among 37 subjects not taking controller bronchodilators as follows: Personal EC–OC was inversely associated with morning FEV1; for an interquartile increase of 71 μg/m3 1-hr maximum personal PM2.5, overall percent-predicted FEV1 decreased by 1.32% [95% confidence interval (CI), −2.00 to −0.65%]; and for an interquartile increase of 16.8 ppb 2-day average personal NO2, overall percent-predicted FEV1 decreased by 2.45% (95% CI, −3.57 to −1.33%). Associations of both personal PM2.5 and NO2 with FEV1 remained when co-regressed, and both confounded ambient NO2. Conclusions Independent pollutant associations with lung function might be missed

  7. Lung function decrement with arsenic exposure to drinking groundwater along River Indus: a comparative cross-sectional study.

    PubMed

    Nafees, Asaad Ahmed; Kazi, Ambreen; Fatmi, Zafar; Irfan, Muhammad; Ali, Arif; Kayama, Fujio

    2011-04-01

    This study was designed to determine the association between chronic arsenic exposure through drinking groundwater and decrement in lung function, particularly among individuals who do not have signs of arsenic lesions, among an adult population. This was a comparative cross-sectional study conducted during the months of January to March 2009. One hundred participants ≥15 years of age in each group, i.e. exposed (≥100 μg/l) and unexposed (≤10 μg/l) to arsenic, determined by testing drinking water samples (using portable kits), were compared for effects on lung function using spirometry. A structured and validated questionnaire was administered. Examination for arsenic skin lesions was also done. There was a decline in the mean adjusted FEV1 of 154.3 ml (95% CI: -324.7, 16.0; p = 0.076), in mean adjusted FVC of 221.9 ml (95% CI: -419.5, -24.3; p = 0.028), and in FEV1/FVC ratio of 2.0 (95% CI: -25.3, 29.4; p = 0.884) among participants who were exposed to arsenic compared to those unexposed. A separate model comprising a total of 160 participants, 60 exposed to arsenic concentrations ≥250 μg/l and 100 unexposed at arsenic concentrations of ≤10 μg/l, showed a decrement in mean adjusted FEV1 of 226.4 ml (95% CI: -430.4, -22.4; p = 0.030), in mean adjusted FVC of 354.8 ml (95% CI: -583.6, -126.0; p = 0.003), and in FEV1/FVC ratio of 9.9 (95% CI: -21.8, 41.6; p = 0.539) among participants who were exposed to arsenic in drinking groundwater. This study demonstrated that decrement in lung function is associated with chronic exposure to arsenic in drinking groundwater, occurring independently, and even before any manifestation, of arsenic skin lesions or respiratory symptoms. The study also demonstrated a dose-response effect of arsenic exposure and lung function decrement.

  8. Open lung biopsy

    MedlinePlus

    ... tissues) Granulomatosis with polyangiitis (inflammation of the blood vessels) Pulmonary hypertension (high blood pressure in the arteries of the lungs) Risks There is a slight chance of: Air leak Excess blood loss Infection Injury to the ...

  9. Aerobic Exercise Decreases Lung Inflammation by IgE Decrement in an OVA Mice Model.

    PubMed

    Camargo Hizume-Kunzler, Deborah; Greiffo, Flavia R; Fortkamp, Bárbara; Ribeiro Freitas, Gabriel; Keller Nascimento, Juliana; Regina Bruggemann, Thayse; Melo Avila, Leonardo; Perini, Adenir; Bobinski, Franciane; Duarte Silva, Morgana; Rocha Lapa, Fernanda; Paula Vieira, Rodolfo; Vargas Horewicz, Verônica; Soares Dos Santos, Adair Roberto; Cattelan Bonorino, Kelly

    2017-06-01

    Aerobic exercise (AE) reduces lung function decline and risk of exacerbations in asthmatic patients. However, the inflammatory lung response involved in exercise during the sensitization remains unclear. Therefore, we evaluated the effects of exercise for 2 weeks in an experimental model of sensitization and single ovalbumin-challenge. Mice were divided into 4 groups: mice non-sensitized and not submitted to exercise (Sedentary, n=10); mice non-sensitized and submitted to exercise (Exercise, n=10); mice sensitized and exposed to ovalbumin (OVA, n=10); and mice sensitized, submitted to exercise and exposed to OVA (OVA+Exercise, n=10). 24 h after the OVA/saline exposure, we counted inflammatory cells from bronchoalveolar fluid (BALF), lung levels of total IgE, IL-4, IL-5, IL-10 and IL-1ra, measurements of OVA-specific IgG1 and IgE, and VEGF and NOS-2 expression via western blotting. AE reduced cell counts from BALF in the OVA group (p<0.05), total IgE, IL-4 and IL-5 lung levels and OVA-specific IgE and IgG1 titers (p<0.05). There was an increase of NOS-2 expression, IL-10 and IL-1ra lung levels in the OVA groups (p<0.05). Our results showed that AE attenuated the acute lung inflammation, suggesting immunomodulatory properties on the sensitization process in the early phases of antigen presentation in asthma. © Georg Thieme Verlag KG Stuttgart · New York.

  10. Diesel Exhaust Modulates Ozone-induced Lung Function Decrements in Healthy Human Volunteers

    EPA Science Inventory

    The potential effects of combinations of dilute whole diesel exhaust (DE) and ozone (03), each a common component of ambient airborne pollutant mixtures, on lung function were examined. Healthy young human volunteers were exposed for 2 hr to pollutants while exercising (~50 L/min...

  11. Diesel Exhaust Modulates Ozone-induced Lung Function Decrements in Healthy Human Volunteers

    EPA Science Inventory

    The potential effects of combinations of dilute whole diesel exhaust (DE) and ozone (03), each a common component of ambient airborne pollutant mixtures, on lung function were examined. Healthy young human volunteers were exposed for 2 hr to pollutants while exercising (~50 L/min...

  12. Early Life Wildfire Smoke Exposure Is Associated with Immune Dysregulation and Lung Function Decrements in Adolescence.

    PubMed

    Black, Carolyn; Gerriets, Joan E; Fontaine, Justin H; Harper, Richart W; Kenyon, Nicholas J; Tablin, Fern; Schelegle, Edward S; Miller, Lisa A

    2017-05-01

    The long-term health effects of wildfire smoke exposure in pediatric populations are not known. The objectives of this study were to determine if early life exposure to wildfire smoke can affect parameters of immunity and airway physiology that are detectable with maturity. We studied a mixed-sex cohort of rhesus macaque monkeys that were exposed as infants to ambient wood smoke from a series of Northern California wildfires in the summer of 2008. Peripheral blood mononuclear cells (PBMCs) and pulmonary function measures were obtained when animals were approximately 3 years of age. PBMCs were cultured with either LPS or flagellin, followed by measurement of secreted IL-8 and IL-6 protein. PBMCs from a subset of female animals were also evaluated by Toll-like receptor (TLR) pathway mRNA analysis. Induction of IL-8 protein synthesis with either LPS or flagellin was significantly reduced in PBMC cultures from wildfire smoke-exposed female monkeys. In contrast, LPS- or flagellin-induced IL-6 protein synthesis was significantly reduced in PBMC cultures from wildfire smoke-exposed male monkeys. Baseline and TLR ligand-induced expression of the transcription factor, RelB, was globally modulated in PBMCs from wildfire smoke-exposed monkeys, with additional TLR pathway genes affected in a ligand-dependent manner. Wildfire smoke-exposed monkeys displayed significantly reduced inspiratory capacity, residual volume, vital capacity, functional residual capacity, and total lung capacity per unit of body weight relative to control animals. Our findings suggest that ambient wildfire smoke exposure during infancy results in sex-dependent attenuation of systemic TLR responses and reduced lung volume in adolescence.

  13. Decrements in lung function related to arsenic in drinking water in West Bengal, India.

    PubMed

    von Ehrenstein, Ondine S; Mazumder, D N Guha; Yuan, Yan; Samanta, Sambit; Balmes, John; Sil, Arabinda; Ghosh, Nilima; Hira-Smith, Meera; Haque, Reina; Purushothamam, Radhika; Lahiri, Sarbari; Das, Subhankar; Smith, Allan H

    2005-09-15

    During 1998-2000, the authors investigated relations between lung function, respiratory symptoms, and arsenic in drinking water among 287 study participants, including 132 with arsenic-caused skin lesions, in West Bengal, India. The source population involved 7,683 participants who had been surveyed for arsenic-related skin lesions in 1995-1996. Respiratory symptoms were increased among men with arsenic-caused skin lesions (versus those without lesions), particularly "shortness of breath at night" (odds ratio (OR) = 2.8, 95% confidence interval (CI): 1.1, 7.6) and "morning cough" (OR = 2.8, 95% CI: 1.2, 6.6) in smokers and "shortness of breath ever" (OR = 3.8, 95% CI: 0.7, 20.6) in nonsmokers. Among men with skin lesions, the average adjusted forced expiratory volume in 1 second (FEV1) was reduced by 256.2 ml (95% CI: 113.9, 398.4; p < 0.001) and the average adjusted forced vital capacity (FVC) was reduced by 287.8 ml (95% CI: 134.9, 440.8; p < 0.001). In men, a 100-microg/liter increase in arsenic level was associated with a 45.0-ml decrease (95% CI: 6.2, 83.9) in FEV1 (p = 0.02) and a 41.4-ml decrease (95% CI: -0.7, 83.5) in FVC (p = 0.054). Women had lower risks than men of developing skin lesions and showed little evidence of respiratory effects. In this study, consumption of arsenic-contaminated water was associated with respiratory symptoms and reduced lung function in men, especially among those with arsenic-related skin lesions.

  14. Early detection of lung function decrements in children and adolescents with cystic fibrosis using new reference values.

    PubMed

    Zacharasiewicz, Angela; Renner, Sabine; Haderer, Flora; Weber, Michael; Dehlink, Eleonore; Szepfalusi, Zsolt; Frischer, Thomas

    2017-03-09

    Interpretation of lung function values in children with cystic fibrosis (CF) depends on the applied reference values. We hypothesize that differences between the new global lung function initiative (GLI) values and the formerly used Zapletal et al. values produce significantly different clinical results. We analyzed 3719 lung function measurements of 108 children and adolescents (n = 54 male; aged 6-18 years) with CF treated between September 1991 and July 2009. Data were analyzed in milliliters (ml) and % predicted (pred.) and interpreted using Zapletal and GLI reference values. Applying GLI compared to Zapletal resulted in significantly lower mean forced expiratory volume in 1s (FEV1)% pred. Zapletal 86.6% (SD 20.6), GLI 79.9% (SD 20.3) and 32% (n = 497/1543) were misclassified as normal when using Zapletal. Despite showing no overall differences in FEV1 and forced vital capacity (FVC) between concomitant Pseudomonas detection (PA+) in n = 938 and Pseudomonas negative (PA-) (n = 2781) using either reference PA+ resulted in lower FEV1 and FVC values with increasing age; however, measurement of small airway obstruction with forced expiratory flow at 75% of FVC (FEF75) values - available for Zapletal -showed significant differences. Reassurance regarding lung function when using old reference values may occur with potential clinical significance. Discrepancies in lung function interpretation underline the importance of using uniform and best available reference values.

  15. Open Lung Approach for the Acute Respiratory Distress Syndrome: A Pilot, Randomized Controlled Trial.

    PubMed

    Kacmarek, Robert M; Villar, Jesús; Sulemanji, Demet; Montiel, Raquel; Ferrando, Carlos; Blanco, Jesús; Koh, Younsuck; Soler, Juan Alfonso; Martínez, Domingo; Hernández, Marianela; Tucci, Mauro; Borges, Joao Batista; Lubillo, Santiago; Santos, Arnoldo; Araujo, Juan B; Amato, Marcelo B P; Suárez-Sipmann, Fernando

    2016-01-01

    The open lung approach is a mechanical ventilation strategy involving lung recruitment and a decremental positive end-expiratory pressure trial. We compared the Acute Respiratory Distress Syndrome network protocol using low levels of positive end-expiratory pressure with open lung approach resulting in moderate to high levels of positive end-expiratory pressure for the management of established moderate/severe acute respiratory distress syndrome. A prospective, multicenter, pilot, randomized controlled trial. A network of 20 multidisciplinary ICUs. Patients meeting the American-European Consensus Conference definition for acute respiratory distress syndrome were considered for the study. At 12-36 hours after acute respiratory distress syndrome onset, patients were assessed under standardized ventilator settings (FIO2≥0.5, positive end-expiratory pressure ≥10 cm H2O). If Pao2/FIO2 ratio remained less than or equal to 200 mm Hg, patients were randomized to open lung approach or Acute Respiratory Distress Syndrome network protocol. All patients were ventilated with a tidal volume of 4 to 8 ml/kg predicted body weight. From 1,874 screened patients with acute respiratory distress syndrome, 200 were randomized: 99 to open lung approach and 101 to Acute Respiratory Distress Syndrome network protocol. Main outcome measures were 60-day and ICU mortalities, and ventilator-free days. Mortality at day-60 (29% open lung approach vs. 33% Acute Respiratory Distress Syndrome Network protocol, p = 0.18, log rank test), ICU mortality (25% open lung approach vs. 30% Acute Respiratory Distress Syndrome network protocol, p = 0.53 Fisher's exact test), and ventilator-free days (8 [0-20] open lung approach vs. 7 [0-20] d Acute Respiratory Distress Syndrome network protocol, p = 0.53 Wilcoxon rank test) were not significantly different. Airway driving pressure (plateau pressure - positive end-expiratory pressure) and PaO2/FIO2 improved significantly at 24, 48 and 72 hours in patients

  16. "Open lung ventilation optimizes pulmonary function during lung surgery".

    PubMed

    Downs, John B; Robinson, Lary A; Steighner, Michael L; Thrush, David; Reich, Richard R; Räsänen, Jukka O

    2014-12-01

    We evaluated an "open lung" ventilation (OV) strategy using low tidal volumes, low respiratory rate, low FiO2, and high continuous positive airway pressure in patients undergoing major lung resections. In this phase I pilot study, twelve consecutive patients were anesthetized using conventional ventilator settings (CV) and then OV strategy during which oxygenation and lung compliance were noted. Subsequently, a lung resection was performed. Data were collected during both modes of ventilation in each patient, with each patient acting as his own control. The postoperative course was monitored for complications. Twelve patients underwent open thoracotomies for seven lobectomies and five segmentectomies. The OV strategy provided consistent one-lung anesthesia and improved static compliance (40 ± 7 versus 25 ± 4 mL/cm H2O, P = 0.002) with airway pressures similar to CV. Postresection oxygenation (SpO2/FiO2) was better during OV (433 ± 11 versus 386 ± 15, P = 0.008). All postoperative chest x-rays were free of atelectasis or infiltrates. No patient required supplemental oxygen at any time postoperatively or on discharge. The mean hospital stay was 4 ± 1 d. There were no complications or mortality. The OV strategy, previously shown to have benefits during mechanical ventilation of patients with respiratory failure, proved safe and effective in lung resection patients. Because postoperative pulmonary complications may be directly attributable to the anesthetic management, adopting an OV strategy that optimizes lung mechanics and gas exchange may help reduce postoperative problems and improve overall surgical results. A randomized trial is planned to ascertain whether this technique will reduce postoperative pulmonary complications. Copyright © 2014 Elsevier Inc. All rights reserved.

  17. [Evaluating the effectiveness of "open lung" maneuvre].

    PubMed

    Eremenko, A A; Borisov, R Iu; Egorov, V M

    2011-01-01

    The purpose of this study--a comparative evaluation of the treatment of postoperative acute respiratory insufficiency in cardio surgical patients with lung opening maneuver and conventional mechanical ventilation. The study included 81 patients operated on the heart and magistral vessels in which the immediate postoperative period was complicated by the development of acute lung injury. Patients were divided into 2 groups: 1 (main) group (48 patients), on which the open lung technique was used, 2 (control) group (33 patients) who underwent a standard respiratory support. The initial values of the partial oxygen pressure in arterial blood and the oxygenation index in patients of both groups were significantly reduced, and the fraction of intrapulmonary shunting - significantly increased. Starting with 1 day sharp increase in PaO2 and IE in patients with the first group was noticed, which coincides with the beginning of the opening of the alveoli. At the same time, the dynamics of these indicators in the second group had the reverse tendency. After the recruiting maneuver in all patients significant improvements in the mechanics of breathing were noticed. As a result of the recruiting maneuver in the first group sustained improvement of arterial oxygenation was achieved in 35 patients. In patients with acute postoperative respiratory failure recruiting maneuver led to a significant increase in arterial oxygenation and reduce the fraction of intrapulmonary shunt. Application of "open lung" maneuver leads to the resolution of respiratory failure, which greatly reduces the timing of mechanical ventilation and length of stay of patients in intensive care units in comparison with traditional methods of respiratory therapy.

  18. Open lung biopsy: a safe, reliable and accurate method for diagnosis in diffuse lung disease.

    PubMed

    Shah, S S; Tsang, V; Goldstraw, P

    1992-01-01

    The ideal method for obtaining lung tissue for diagnosis should provide high diagnostic yield with low morbidity and mortality. We reviewed all 432 patients (mean age 55 years) who underwent an open lung biopsy at this hospital over a 10-year period. Twenty-four patients (5.5%) were immunocompromised. One hundred and twenty-five patients were on steroid therapy at the time of operation. Open lung biopsy provided a firm diagnosis in 410 cases overall (94.9%) and in 20 out of 24 patients in the immunocompromised group (83.3%). The commonest diagnosis was cryptogenic fibrosing alveolitis (173 patients). Twenty-two patients (5.1%) suffered complications following the procedure: wound infection 11 patients, pneumothorax 9 patients and haemothorax 1 patient. Thirteen patients (3.0%) died following open lung biopsy, but in only 1 patient was the death attributable to the procedure itself. We conclude that open lung biopsy is an accurate and safe method for establishing a diagnosis in diffuse lung disease with a high yield and minimal risk.

  19. Volume-independent elastance: a useful parameter for open-lung positive end-expiratory pressure adjustment.

    PubMed

    Carvalho, Alysson Roncally; Bergamini, Bruno Curty; Carvalho, Niedja S; Cagido, Viviane R; Neto, Alcendino C; Jandre, Frederico C; Zin, Walter A; Giannella-Neto, Antonio

    2013-03-01

    A decremental positive end-expiratory pressure (PEEP) trial after full lung recruitment allows for the adjustment of the lowest PEEP that prevents end-expiratory collapse (open-lung PEEP). For a tidal volume (Vt) approaching zero, the PEEP of minimum respiratory system elastance (PEEP(minErs)) is theoretically equal to the pressure at the mathematical inflection point (MIP) of the pressure-volume curve, and seems to correspond to the open-lung PEEP in a decremental PEEP trial. Nevertheless, the PEEP(minErs) is dependent on Vt and decreases as Vt increases. To circumvent this dependency, we proposed the use of a second-order model in which the volume-independent elastance (E1) is used to set open-lung PEEP. Pressure-volume curves and a recruitment maneuver followed by decremental PEEP trials, with a Vt of 6 and 12 mL/kg, were performed in 24 Wistar rats with acute lung injury induced by intraperitoneally injected (n = 8) or intratracheally instilled (n = 8) Escherichia coli lipopolysaccharide. In 8 control animals, the anterior chest wall was surgically removed after PEEP trials, and the protocol was repeated. Airway pressure (Paw) and flow (F) were continuously acquired and fitted by the linear single-compartment model (Paw = Rrs·F + Ers·V + PEEP, where Rrs is the resistance of the respiratory system, and V is volume) and the volume-dependent elastance model (Paw = Rrs·F + E1 + E2·V·V + PEEP, where E2·V is the volume-dependent elastance). From each model, PEEPs of minimum Ers and E1 (PEEP(minE1)) were identified and compared with each respective MIP. The accuracy of PEEPminE1 and PEEPminErs in estimating MIP was assessed by bias and precision plots. Comparisons among groups were performed with the unpaired t test whereas a paired t test was used between the control group before and after chest wall removal and within groups at different Vts. All P values were then corrected for multiple comparisons by the Bonferroni procedure. In all experimental groups

  20. Pulmonary atelectasis during low stretch ventilation: "open lung" versus "lung rest" strategy.

    PubMed

    Fanelli, Vito; Mascia, Luciana; Puntorieri, Valeria; Assenzio, Barbara; Elia, Vincenzo; Fornaro, Giancarlo; Martin, Erica L; Bosco, Martino; Delsedime, Luisa; Fiore, Tommaso; Grasso, Salvatore; Ranieri, V Marco

    2009-03-01

    Limiting tidal volume (VT) may minimize ventilator-induced lung injury (VILI). However, atelectasis induced by low VT ventilation may cause ultrastructural evidence of cell disruption. Apoptosis seems to be involved as protective mechanisms from VILI through the involvement of mitogen-activated protein kinases (MAPKs). We examined the hypothesis that atelectasis may influence the response to protective ventilation through MAPKs. Prospective randomized study. University animal laboratory. Adult male 129/Sv mice. Isolated, nonperfused lungs were randomized to VILI: VT of 20 mL/kg and positive end-expiratory pressure (PEEP) zero; low stretch/lung rest: VT of 6 mL/kg and 8-10 cm H2O of PEEP; low stretch/open lung: VT of 6 mL/kg, two recruitment maneuvers and 14-16 cm H2O of PEEP. Ventilator settings were adjusted using the stress index. Both low stretch strategies equally blunted the VILI-induced derangement of respiratory mechanics (static volume-pressure curve), lung histology (hematoxylin and eosin), and inflammatory mediators (interleukin-6, macrophage inflammatory protein-2 [enzyme-linked immunosorbent assay], and inhibitor of nuclear factor-kB[Western blot]). VILI caused nuclear swelling and membrane disruption of pulmonary cells (electron microscopy). Few pulmonary cells with chromatin condensation and fragmentation were seen during both low stretch strategies. However, although cell thickness during low stretch/open lung was uniform, low stretch/lung rest demonstrated thickening of epithelial cells and plasma membrane bleb formation. Compared with the low stretch/open lung, low stretch/lung rest caused a significant decrease in apoptotic cells (terminal deoxynucleotidyl transferase mediated deoxyuridine-triphosphatase nick end-labeling) and tissue expression of caspase-3 (Western blot). Both low stretch strategies attenuated the activation of MAPKs. Such reduction was larger during low stretch/open lung than during low stretch/lung rest (p < 0.001). Low stretch

  1. Dielectric decrement of electrolyte solutions

    NASA Astrophysics Data System (ADS)

    Felderhof, B. U.

    We calculate the dielectric decrement of ionic solutions in a continuum model. We show that apart from a familiar static contribution there are three kinetic contributions to the effect, two of which are related by a symmetry relation. The third contribution is due to frequency dispersion of the friction coefficient and for small ions reduces the total effect considerably. We find that the total effect as calculated from the continuum model is too small to account for the experimental data.

  2. Antiinflammatory effect of sevoflurane in open lung surgery with one-lung ventilation

    PubMed Central

    Potočnik, Iztok; Novak-Janković, Vesna; Šostarič, Maja; Jerin, Ales; Štupnik, Tomaž; Skitek, Milan; Markovič-Božič, Jasmina; Klokočovnik, Tomislav

    2014-01-01

    Aim To prospectively assess the antiinflammatory effect of volatile anesthetic sevoflurane in patients undergoing open lung surgery with one lung ventilation (OLV). Methods This prospective, randomized study included 40 patients undergoing thoracic surgery with OLV (NCT02188407). The patients were randomly allocated into two equal groups that received either propofol or sevoflurane. Four patients were excluded from the study because after surgery they received blood transfusion or non-steroid antiinflammatory drugs. Inflammatory mediators (interleukins 6, 8, and 10, C-reactive protein [CRP], and procalcitonin) were measured perioperatively. The infiltration of the nonoperated lung was assessed on chest x-rays and the oxygenation index was calculated. The major postoperative complications were counted. Results Interleukin 6 levels were significantly higher in propofol than in sevoflurane group (P = 0.014). Preoperative CRP levels did not differ between the groups (P = 0.351) and in all patients they were lower than 20 mg/L, but postoperative CRP was significantly higher in propofol group (31 ± 6 vs 15 ± 7 ng/L; P = 0.035); Pre- and postoperative procalcitonin was within the reference range (<0.04 µg/L) in both groups. The oxygenation index was significantly lower in propofol group (339 ± 139 vs 465 ± 140; P = 0.021). There was no significant difference between the groups in lung infiltrates (P = 0.5849). The number of postoperative adverse events was higher in propofol group, but the difference was not-significant (5 vs 1; P = 0.115). Conclusion The study suggests an antiinflammatory effect of sevoflurane in patients undergoing thoracotomy with OLV. PMID:25559834

  3. Closed-loop mechanical ventilation for lung injury: a novel physiological-feedback mode following the principles of the open lung concept.

    PubMed

    Schwaiberger, David; Pickerodt, Philipp A; Pomprapa, Anake; Tjarks, Onno; Kork, Felix; Boemke, Willehad; Francis, Roland C E; Leonhardt, Steffen; Lachmann, Burkhard

    2017-06-26

    Adherence to low tidal volume (VT) ventilation and selected positive end-expiratory pressures are low during mechanical ventilation for treatment of the acute respiratory distress syndrome. Using a pig model of severe lung injury, we tested the feasibility and physiological responses to a novel fully closed-loop mechanical ventilation algorithm based on the "open lung" concept. Lung injury was induced by surfactant washout in pigs (n = 8). Animals were ventilated following the principles of the "open lung approach" (OLA) using a fully closed-loop physiological feedback algorithm for mechanical ventilation. Standard gas exchange, respiratory- and hemodynamic parameters were measured. Electrical impedance tomography was used to quantify regional ventilation distribution during mechanical ventilation. Automatized mechanical ventilation provided strict adherence to low VT-ventilation for 6 h in severely lung injured pigs. Using the "open lung" approach, tidal volume delivery required low lung distending pressures, increased recruitment and ventilation of dorsal lung regions and improved arterial blood oxygenation. Physiological feedback closed-loop mechanical ventilation according to the principles of the open lung concept is feasible and provides low tidal volume ventilation without human intervention. Of importance, the "open lung approach"-ventilation improved gas exchange and reduced lung driving pressures by opening atelectasis and shifting of ventilation to dorsal lung regions.

  4. Exploring a recognition-induced recognition decrement

    PubMed Central

    Dopkins, Stephen; Ngo, Catherine Trinh; Sargent, Jesse

    2007-01-01

    Four experiments explored a recognition decrement that is associated with the recognition of a word from a short list. The stimulus material for demonstrating the phenomenon was a list of words of different syntactic types. A word from the list was recognized less well following a decision that a word of the same type had occurred in the list than following a decision that such a word had not occurred in the list. A recognition decrement did not occur for a word of a given type following a positive recognition decision to a word of a different type. A recognition decrement did not occur when the list consisted exclusively of nouns. It was concluded that the phenomenon may reflect a criterion shift but probably does not reflect a list strength effect, suppression, or familiarity attribution consequent to a perceived discrepancy between actual and expected fluency. PMID:17063915

  5. Respiratory bronchiolitis-associated interstitial lung disease secondary to electronic nicotine delivery system use confirmed with open lung biopsy.

    PubMed

    Flower, Mark; Nandakumar, Lakshmy; Singh, Mahendra; Wyld, David; Windsor, Morgan; Fielding, David

    2017-05-01

    As a modern phenomenon, there is currently limited understanding of the possible toxic effects and broader implications of electronic nicotine delivery systems (ENDS). Large volumes of aerosolized particles are inhaled during "vaping" and there are now an increasing number of case reports demonstrating toxic effects of ENDS, as well as human studies demonstrating impaired lung function in users. This article presents a case of respiratory bronchiolitis interstitial lung disease (RB-ILD) precipitated by vaping in a 33-year-old male with 10 pack years of traditional cigarette and prior treatment for mixed germ cell tumour. The patient had started vaping 10-15 times per day while continuing to smoke 10 traditional cigarettes per day. After 3 months of exposure to e-cigarette vapour, chest computed tomography demonstrated multiple new poorly defined pulmonary nodules with fluffy parenchyma opacification centred along the terminal bronchovascular units. Video-assisted thoracoscopy with lung biopsy of the right upper and right middle lobes was undertaken. The microscopic findings were overall consistent with RB-ILD. This case demonstrates toxicity with use of ENDS on open lung biopsy with resolution of radiographic findings on cessation. We believe that this is the first case where open lung biopsy has demonstrated this and our findings are consistent with RB-ILD.

  6. Risk and relevance of open lung biopsy in pediatric ECMO patients: the Dutch experience.

    PubMed

    Houmes, Robert Jan; Ten Kate, Chantal A; Wildschut, Enno D; Verdijk, Rob M; Wijnen, René M H; de Blaauw, Ivo; Tibboel, Dick; van Heijst, Arno F

    2017-03-01

    Open lung biopsy can help differentiate between reversible and irreversible lung disease and may guide therapy. To assess the risk-benefit ratio of this procedure in pediatric extracorporeal membrane oxygenation (ECMO) patients, we reviewed data of all patients who underwent an open lung biopsy during ECMO in one of the two pediatric ECMO centers in a nationwide study in the Netherlands. In nineteen neonatal and six pediatric patients (0-15.5years), twenty-five open lung biopsies were performed during the study period. In 13 patients (52%), a classifying diagnosis of underlying lung disease could be made. In another nine patients (36%), specific pathological abnormalities were described. In three patients (12%), only nonspecific abnormalities were described. The histological results led to withdrawal of ECMO treatment in 6 neonates with alveolar capillary dysplasia/misalignment of pulmonary veins (24%) and in another 6 patients, corticosteroids were started (24%). All patients survived the biopsy procedure. Hemorrhagic complications were rare. An open lung biopsy during an ECMO run in neonates and children is a safe procedure with a minimum risk for blood loss and biopsy-related death. It can be very useful in diagnosing the underlying pathology and can guide cessation of ECMO treatment and thereby avoid continuation of futile treatment, especially in neonatal patients. III. Diagnostic study. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. The Influence of Dielectric Decrement on Electrokinetics

    PubMed Central

    Zhao, Hui; Zhai, Shengjie

    2013-01-01

    We treat the dielectric decrement induced by excess ion polarization as a source of ion specificity and explore its impact on electrokinetics. We employ a modified Poisson-Nernst-Planck (PNP) equations accounting for the dielectric decrement. The dielectric decrement is determined by the excess ion polarization parameter α and when α = 0 the standard PNP model is recovered. Our model shows that ions saturate at large zeta potentials (ζ). Because of ion saturation, a condensed counterion layer forms adjacent to the charged surface, introducing a new length scale, the thickness of the condensed layer (lc). For the electro-osmotic mobility, the dielectric decrement weakens the electro-osmotic flow owing to the decrease of the dielectric permittivity. At large ζ, when α ≠ 0, the electro-osmotic mobility is found to be proportional to ζ/2, in contrast to ζ predicted by the standard PNP model. This is attributed to ion saturation at large ζ. In terms of the electrophoretic mobility Me, we carry out both an asymptotic analysis in the thin-double-layer limit and solve the full modified PNP model to compute Me. Our analysis reveals that the impact of the dielectric decrement is intriguing. At small and moderate ζ, the dielectric decrement decreases Me with an increasing α. At large ζ, it is well known that the surface conduction becomes significant and plays an important role in determining Me. It is observed that the dielectric decrement effectively reduces the surface conduction. Hence in stark contrast, Me increases as α increases. Our predictions of the contrast dependence of the mobility on α at different zeta potentials qualitatively agree with experimental results on the dependence of the mobility among ions and provide a possible explanation for such ion specificity. Finally, the comparisons between the thin-double-layer asymptotic analysis and the full simulations of the modified PNP model suggest that at large ζ the validity of the thin

  8. Factors affecting opening and filling pressures in the lungs of the lizard Pogona vitticeps.

    PubMed

    Wood, P G; Daniels, C B

    1996-02-01

    We have previously reported that levels of pulmonary surfactant in the lungs of the lizard Pogona vitticeps increase with increasing body temperature. Static lung compliance decreases with increasing body temperature, and is only marginally affected by the presence of surfactant. Here, we examined the effects of surfactant, temperature, ventilatory pattern and autonomic neurotransmitters on opening and filling pressures. Isolated lungs were ventilated at either 18 or 37 degrees C at low, intermediate and high ventilatory regimes. The effects of acetylcholine and adrenaline were examined using an isolated perfused lung preparation at 27 degrees C. Changing ventilatory pattern or experimental temperature had no effect on either filling or opening pressures. Removal of surfactant increased both opening and filling pressures. Adrenaline administration reduced opening and filling pressures. Normal variations in surfactant levels, which occur with changes in body temperature, do not affect either opening or filling pressures. A critical amount of surfactant may be necessary to prevent adhesion of epithelial surfaces in the lungs of Pogona vitticeps. The anti-glue function of pulmonary surfactant may be more important at 18 than at 37 degrees C.

  9. Open Lung Biopsy Among Critically Ill, Mechanically Ventilated Patients. A Metaanalysis

    PubMed Central

    Walkey, Allan J.

    2015-01-01

    Rationale: Open lung biopsy may be performed to guide therapy in mechanically ventilated patients with diagnostic uncertainty regarding etiology of pulmonary infiltrates. Current evidence for open lung biopsy in mechanically ventilated patients comes from single-center case series. Objectives: We performed a metaanalysis of case series to determine diagnoses, complications, and changes in therapy after lung biopsy in critically ill patients requiring mechanical ventilation. Methods: We searched Medline for case series of lung biopsies in critically ill patients requiring mechanical ventilation. We pooled results of individual case series using random effects metaanalysis models to obtain summary proportions. Measurements and Main Results: We identified 14 case series including a total of 512 mechanically ventilated patients with 530 histopathological diagnoses. The most common diagnoses were “fibrosis/pneumonitis” (n = 155, 25%; 95% confidence interval [CI], 14–37%) and infection (n = 113, 20%; 95% CI, 15–27%). Viruses were the most commonly identified infectious etiology identified on open lung biopsy, representing 50% of potential pathogens. Diffuse alveolar damage was present in a minority of specimens (n = 100, 16%; 95% CI, 8–25%). Therapeutic changes after lung biopsy occurred in 399 patients (78%; 95% CI, 64–81%). Procedure-related complications occurred in 29% of patients (95% CI, 25–33%), most commonly persistent air leak. Mortality among mechanically ventilated patients after diagnostic open lung biopsy was 54%. Conclusions: Among mechanically ventilated patients with respiratory failure of unclear etiology, lung biopsy yielded a wide range of diagnoses and was associated with a change in therapy in most patients. PMID:26065712

  10. Posture-Dependent Human 3He Lung Imaging in an Open Access MRI System: Initial Results

    PubMed Central

    Tsai, L. L.; Mair, R. W.; Li, C.-H.; Rosen, M. S.; Patz, S.; Walsworth, R. L.

    2008-01-01

    Rationale and Objectives The human lung and its functions are extremely sensitive to orientation and posture, and debate continues as to the role of gravity and the surrounding anatomy in determining lung function and heterogeneity of perfusion and ventilation. However, study of these effects is difficult. The conventional high-field magnets used for most hyperpolarized 3He MRI of the human lung, and most other common radiological imaging modalities including PET and CT, restrict subjects to lying horizontally, minimizing most gravitational effects. Materials and Methods In this paper, we briefly review the motivation for posture-dependent studies of human lung function, and present initial imaging results of human lungs in the supine and vertical body orientations using inhaled hyperpolarized 3He gas and an open-access MRI instrument. The open geometry of this MRI system features a “walk-in” capability that permits subjects to be imaged in vertical and horizontal positions, and potentially allows for complete rotation of the orientation of the imaging subject in a two-dimensional plane. Results Initial results include two-dimensional lung images acquired with ~ 4 × 8 mm in-plane resolution and three-dimensional images with ~ 2 cm slice thickness. Conclusion Effects of posture variation are observed, including posture-related effects of the diaphragm and distension of the lungs while vertical. PMID:18486009

  11. The Effect of Arousal on Warm Up Decrement.

    ERIC Educational Resources Information Center

    Anshel, Mark H.

    1985-01-01

    This study examined whether particular strategies would enhance affective arousal and if these techniques would affect warm-up decrement during performance of a sport skill. One strategy eliminated warm-up decrement and two had no effect. Positive and negative arousal and the correlation of arousal level to warm-up decrement are explored.…

  12. Sorafenib for lung cancer: is the "Battle" still open?

    PubMed

    Bria, Emilio; Pilotto, Sara; Tortora, Giampaolo

    2012-10-01

    In the recent years, the improved understanding of the biological relevance of angiogenesis as a major cancer hallmark led to the development of a heterogeneous group of agents targeting this key process. Among the anti-angiogenic drugs (including monoclonal antibodies such as Bevacizumab, and other molecules with different mechanism of action, such as the vascular disrupting agents Vadimezan), the tyrosine kinase inhibitors (TKIs, Sorafenib, Sunitinib, Pazopanib, and Axitinib), are commonly thought to inhibit angiogenesis through a most rational and promising approach. In this regard, many tyrosine kinase inibitors, such as Sorafenib, are multi-targeted, which allows for the inhibition of those multiple functional pathways which are considered to be critical for both tumor development and progression. Besides, this multi-targeted activity may theoretically increase efficacy but also toxicity. As a member of this group, Sorafenib has already been approved for the treatment of advanced renal cell carcinoma (RCC) and hepatocellular carcinoma not suitable for locoregional treatment, and it is currently under investigation for advanced non small cell lung cancer (NSCLC), either alone or in combination with other biological/cytotoxic agents.

  13. The benefits of open lung biopsy in patients with previous non-diagnostic transbronchial lung biopsy. A guide to appropriate therapy.

    PubMed

    Toledo-Pereyra, L H; DeMeester, T R; Kinealey, A; MacMahon, H; Churg, A; Golomb, H

    1980-05-01

    In a 17-month period, 20 immunosuppressed patients underwent transbronchial biopsy of the lung for diagnostic evaluation of a pulmonary infiltrate of unknown etiology. In 19 patients, the transbronchial biopsy was nondiagnostic. Thirteen of the 19 patients were critically ill and were referred for an open lung biopsy. Eleven (85 percent) of these 13 patients left the hospital after open lung biopsy and appropriate medical treatment. Two patients who were receiving mechanical ventilation at the time of open biopsy succumbed to the combination of their underlying disease and respiratory failure. There were no deaths directly attributed to the open lung biopsy. Of the six patients whose condition appeared stable and who did not undergo open lung biopsy, two died from unrecognized progress of their underlying malignant disease. The remainder recovered. We conclude that open lung biopsy is safe in and beneficial to the diagnosis and subsequent treatment of unknown pulmonary infiltrates in immunosuppressed patients who previously had a nondiagnostic fiberoptic transbronchial biopsy of the lung.

  14. Open lung approach with low tidal volume mechanical ventilation attenuates lung injury in rats with massive brain damage

    PubMed Central

    2014-01-01

    Introduction The ideal ventilation strategy for patients with massive brain damage requires better elucidation. We hypothesized that in the presence of massive brain injury, a ventilation strategy using low (6 milliliters per kilogram ideal body weight) tidal volume (VT) ventilation with open lung positive end-expiratory pressure (LVT/OLPEEP) set according to the minimal static elastance of the respiratory system, attenuates the impact of massive brain damage on gas-exchange, respiratory mechanics, lung histology and whole genome alterations compared with high (12 milliliters per kilogram ideal body weight) VT and low positive end-expiratory pressure ventilation (HVT/LPEEP). Methods In total, 28 adult male Wistar rats were randomly assigned to one of four groups: 1) no brain damage (NBD) with LVT/OLPEEP; 2) NBD with HVT/LPEEP; 3) brain damage (BD) with LVT/OLPEEP; and 4) BD with HVT/LPEEP. All animals were mechanically ventilated for six hours. Brain damage was induced by an inflated balloon catheter into the epidural space. Hemodynamics was recorded and blood gas analysis was performed hourly. At the end of the experiment, respiratory system mechanics and lung histology were analyzed. Genome wide gene expression profiling and subsequent confirmatory quantitative polymerase chain reaction (qPCR) for selected genes were performed. Results In NBD, both LVT/OLPEEP and HVT/LPEEP did not affect arterial blood gases, as well as whole genome expression changes and real-time qPCR. In BD, LVT/OLPEEP, compared to HVT/LPEEP, improved oxygenation, reduced lung damage according to histology, genome analysis and real-time qPCR with decreased interleukin 6 (IL-6), cytokine-induced neutrophil chemoattractant 1 (CINC)-1 and angiopoietin-4 expressions. LVT/OLPEEP compared to HVT/LPEEP improved overall survival. Conclusions In BD, LVT/OLPEEP minimizes lung morpho-functional changes and inflammation compared to HVT/LPEEP. PMID:24693992

  15. K+ channel openers restore verapamil-inhibited lung fluid resolution and transepithelial ion transport

    PubMed Central

    2010-01-01

    Background Lung epithelial Na+ channels (ENaC) are regulated by cell Ca2+ signal, which may contribute to calcium antagonist-induced noncardiogenic lung edema. Although K+ channel modulators regulate ENaC activity in normal lungs, the therapeutical relevance and the underlying mechanisms have not been completely explored. We hypothesized that K+ channel openers may restore calcium channel blocker-inhibited alveolar fluid clearance (AFC) by up-regulating both apical and basolateral ion transport. Methods Verapamil-induced depression of heterologously expressed human αβγ ENaC in Xenopus oocytes, apical and basolateral ion transport in monolayers of human lung epithelial cells (H441), and in vivo alveolar fluid clearance were measured, respectively, using the two-electrode voltage clamp, Ussing chamber, and BSA protein assays. Ca2+ signal in H441 cells was analyzed using Fluo 4AM. Results The rate of in vivo AFC was reduced significantly (40.6 ± 6.3% of control, P < 0.05, n = 12) in mice intratracheally administrated verapamil. KCa3.1 (1-EBIO) and KATP (minoxidil) channel openers significantly recovered AFC. In addition to short-circuit current (Isc) in intact H441 monolayers, both apical and basolateral Isc levels were reduced by verapamil in permeabilized monolayers. Moreover, verapamil significantly altered Ca2+ signal evoked by ionomycin in H441 cells. Depletion of cytosolic Ca2+ in αβγ ENaC-expressing oocytes completely abolished verapamil-induced inhibition. Intriguingly, KV (pyrithione-Na), K Ca3.1 (1-EBIO), and KATP (minoxidil) channel openers almost completely restored the verapamil-induced decrease in Isc levels by diversely up-regulating apical and basolateral Na+ and K+ transport pathways. Conclusions Our observations demonstrate that K+ channel openers are capable of rescuing reduced vectorial Na+ transport across lung epithelial cells with impaired Ca2+ signal. PMID:20507598

  16. A System for Open-Access 3He Human Lung Imaging at Very Low Field

    PubMed Central

    RUSET, I.C.; TSAI, L.L.; MAIR, R.W.; PATZ, S.; HROVAT, M.I.; ROSEN, M.S.; MURADIAN, I.; NG, J.; TOPULOS, G.P.; BUTLER, J.P.; WALSWORTH, R.L.; HERSMAN, F.W.

    2010-01-01

    We describe a prototype system built to allow open-access very-low-field MRI of human lungs using laser-polarized 3He gas. The system employs an open four-coil electromagnet with an operational B0 field of 4 mT, and planar gradient coils that generate gradient fields up to 0.18 G/cm in the x and y direction and 0.41 G/cm in the z direction. This system was used to obtain 1H and 3He phantom images and supine and upright 3He images of human lungs. We include discussion on challenges unique to imaging at 50 –200 kHz, including noise filtering and compensation for narrow-bandwidth coils. PMID:20354575

  17. The role of open lung biopsy in early and late survival of ventilator-dependent patients with diffuse idiopathic lung disease.

    PubMed

    Canver, C C; Mentzer, R M

    1994-04-01

    Because of the high mortality associated with a diagnostic open lung biopsy in patients on mechanical ventilatory support, the clinical benefits of this procedure remain controversial. To assess the surgical results and the usefulness of open lung biopsies performed in this subset of patients, the clinical records of 27 patients who underwent open lung biopsy between January, 1987 and December, 1992 were reviewed. All patients were intubated for respiratory failure of unknown origin and were treated with antibiotics and/or steroids prior to the open lung biopsy. There were 13 men and 14 women with the mean age of 51 +/- 4.7 years (3 mos. to 82 years). The average duration for ventilatory support was 9 +/- 3.7 days (1 to 98 days). Nonoperative invasive diagnostic procedures were performed in 19 patients (70%). The operative approach for biopsy was an anterolateral thoracotomy using a linear stapler: right in 10 patients (37%), left in 17 (63%). A specific histologic diagnosis with open lung biopsy was established in all patients. Based on the biopsy findings, a change in treatment was unnecessary in 9 patients (33%), the dose of corticosteroids was increased in 7 (26%), the corticosteroids were initiated in 6 (22%), and a new antibiotic was added in 5 (19%). Perioperative complications occurred in 11 patients (40%). Prolonged air leak was the most common complication (6/11 patients). Fourteen patients (52%) died within 30 days of the biopsy procedure.(ABSTRACT TRUNCATED AT 250 WORDS)

  18. Diagnostic potential of open lung biopsy in mechanically ventilated patients with diffuse pulmonary infiltrates of unclear aetiology.

    PubMed

    Depuydt, O E; Daeze, C; Benoit, D; Praet, M; Vermassen, E; Decruyenaere, M

    2013-09-01

    Acute respiratory failure with bilateral pulmonary infiltrates is a clinical problem with a wide differential diagnosis. We evaluated whether open lung biopsy offered a diagnosis and therapeutic guidance in cases of unclear diagnosis after non-invasive tests. For this purpose, we reviewed 60 cases of open lung biopsy performed between 2002 and 2009 in patients with acute respiratory failure and bilateral infiltrates at the intensive care unit of Ghent University Hospital. Pathological diagnosis was classified as specific or non-specific and its contribution to therapy and decision-making was evaluated by a panel of three intensive care unit physicians. We found that a specific pathological diagnosis was present in 39 open lung biopsy patients (65%; 95% confidence interval 52 to 76%): idiopathic interstitial pneumonia in 24 patients, malignancy in four patients, pulmonary infectious disease in nine patients, and a combination of specific diagnoses in two patients. Open lung biopsy contributed to patient management in 53 cases (88%) as it led to the initiation, modification or discontinuation of therapeutic drugs in 36, and contributed to the decision to continue or withdraw ventilator support in 17. Complications of open lung biopsy were noted in 14 patients (23%). We conclude that open lung biopsy was a useful diagnostic intervention in of a selected group of patients with acute respiratory failure and bilateral infiltrates of unclear clinical diagnosis, as it offered a specific diagnosis in 65%.

  19. Chewing gum moderates the vigilance decrement.

    PubMed

    Morgan, Kate; Johnson, Andrew J; Miles, Christopher

    2014-05-01

    We examine the impact of chewing gum on a Bakan-type vigilance task that requires the continual updating of short-term order memory. Forty participants completed a 30-min auditory Bakan-task either with, or without, the requirement to chew gum. Self-rated measures of mood were taken both pre- and post-task. As expected, the vigilance task produced a time-dependent performance decrement indexed via decreases in target detections and lengthened correct reaction times (RTs), and a reduction in post-task self-rated alertness scores. The declines in both performance and subjective alertness were attenuated in the chewing-gum group. In particular, correct RTs were significantly shorter following the chewing of gum in the latter stages of the task. Additionally, the gradients of decline for target detection and incline for correct RTs were both attenuated for the chewing-gum group. These findings are consistent with the data of Tucha and Simpson (2011), Appetite, 56, 299-301, who showed beneficial effects of chewing gum in the latter stages of a 30 min visual attention task, and extend their data to a task that necessitates the continuous updating of order memory. It is noteworthy that our data contradict the claim (Kozlov, Hughes, & Jones, 2012, Q. J. Exp. Psychology, 65, 501-513) that chewing gum negatively impacts short-term memory task performance. © 2013 The British Psychological Society.

  20. Comparison of open gastrostomy tube to percutaneous endoscopic gastrostomy tube in lung transplant patients

    PubMed Central

    Taghavi, Sharven; Ambur, Vishnu; Jayarajan, Senthil; Gaughan, John; Toyoda, Yoshiya; Dauer, Elizabeth; Sjoholm, Lars Ola; Pathak, Abhijit; Santora, Thomas; Goldberg, Amy J.

    2015-01-01

    Introduction Lung transplant patients require a high degree of immunosuppression, which can impair wound healing when surgical procedures are required. We hypothesized that because of impaired healing, lung transplant patients requiring gastrostomy tubes would have better outcomes with open gastrostomy tube (OGT) as compared to percutaneous endoscopic gastrostomy tube (PEG). Methods The National Inpatient Sample (NIS) Database (2005–2010) was queried for all lung transplant recipients requiring OGT or PEG. Results There were 215 patients requiring gastrostomy tube, with 44 OGT and 171 PEG. The two groups were not different with respect to age (52.0 vs. 56.9 years, p = 0.40) and Charlson Comorbidity Index (3.3 vs. 3.5, p = 0.75). Incidence of acute renal failure was higher in the PEG group (35.2 vs. 11.8%, p = 0.003). Post-operative pneumonia, myocardial infarction, surgical site infection, DVT/PE, and urinary tract infection were not different. Post-operative mortality was higher in the PEG group (11.2 vs. 0.0%, p = 0.02). Using multiple variable analysis, PEG tube was independently associated with mortality (HR: 1.94, 95%C.I: 1.45–2.58). Variables associated with survival included age, female gender, white race, and larger hospital bed capacity. Discussion OGT may be the preferred method of gastric access for lung transplant recipients. Conclusions In lung transplant recipients, OGT results in decreased morbidity and mortality when compared to PEG. PMID:26900455

  1. The effects of open lung ventilation on respiratory mechanics and haemodynamics in atelectatic infants after cardiopulmonary bypass.

    PubMed

    Cui, Q; Zhou, H; Zhao, R; Liu, J; Yang, X; Zhu, H; Zheng, Q; Gu, C; Yi, D

    2009-01-01

    Acute lung injury (ALI) frequently occurs in infants after cardiopulmonary bypass (CPB) surgery and it sometimes develops into acute respiratory distress syndrome in critically ill infants, which can be life threatening. This study investigated the effects of open lung ventilation on the haemodynamics and respiratory mechanics of 64 infants (34 males; 30 females) with a mean +/- SD age of 8.3 +/- 0.3 months who developed ALI following CPB surgery. Open lung ventilation significantly improved the respiratory mechanics and oxygenation parameters of the infants, including the partial pressure of oxygen in arterial blood (PaO(2)), the ratio of PaO(2)/FiO(2) (fraction of inspired oxygen), peak inspiratory pressure, static compliance and airway resistance. It is concluded that open lung ventilation can greatly improve oxygenation and respiratory mechanics in infants with ALI following CPB surgery.

  2. Open Tracheostomy Gastric Acid Aspiration Murine Model of Acute Lung Injury Results in Maximal Acute Nonlethal Lung Injury.

    PubMed

    Alluri, Ravi; Kutscher, Hilliard L; Mullan, Barbara A; Davidson, Bruce A; Knight, Paul R

    2017-02-26

    Acid pneumonitis is a major cause of sterile acute lung injury (ALI) in humans. Acid pneumonitis spans the clinical spectrum from asymptomatic to acute respiratory distress syndrome (ARDS), characterized by neutrophilic alveolitis, and injury to both alveolar epithelium and vascular endothelium. Clinically, ARDS is defined by acute onset of hypoxemia, bilateral patchy pulmonary infiltrates and non-cardiogenic pulmonary edema. Human studies have provided us with valuable information about the physiological and inflammatory changes in the lung caused by ARDS, which has led to various hypotheses about the underling mechanisms. Unfortunately, difficulties determining the etiology of ARDS, as well as a wide range of pathophysiology have resulted in a lack of critical information that could be useful in developing therapeutic strategies. Translational animal models are valuable when their pathogenesis and pathophysiology accurately reproduce a concept proven in both in vitro and clinical settings. Although large animal models (e.g., sheep) share characteristics of the anatomy of human trachea-bronchial tree, murine models provide a host of other advantages including: low cost; short reproductive cycle lending itself to greater data acquisition; a well understood immunologic system; and a well characterized genome leading to the availability of a variety of gene deletion and transgenic strains. A robust model of low pH induced ARDS requires a murine ALI that targets mainly the alveolar epithelium, secondarily the vascular endothelium, as well as the small airways leading to the alveoli. Furthermore, a reproducible injury with wide differences between different injurious and non-injurious insults is important. The murine gastric acid aspiration model presented here using hydrochloric acid employs an open tracheostomy and recreates a pathogenic scenario that reproduces the low pH pneumonitis injury in humans. Additionally, this model can be used to examine interaction of a

  3. Acoustic evidence of airway opening during recruitment in excised dog lungs.

    PubMed

    Hantos, Z; Tolnai, J; Asztalos, T; Peták, F; Adamicza, A; Alencar, A M; Majumdar, A; Suki, B

    2004-08-01

    The aim of this study was to test the hypothesis that the mechanism of recruitment and the lower knee of the pressure-volume curve in the normal lung are primarily determined by airway reopenings via avalanches rather than simple alveolar recruitments. In isolated dog lung lobes, the pressure-volume loops were measured, and crackle sounds were recorded intrabronchially during both the first inflation from the collapsed state to total lobe capacity and a second inflation without prior degassing. The inflation flow contained transients that were accompanied by a series of crackles. Discrete volume increments were estimated from the flow transients, and the energy levels of the corresponding crackles were calculated from the sound recordings. Crackles were concentrated in the early phase of inflation, with the cumulative energy exceeding 90% of its final value by the lower knee of the pressure-volume curve. The values of volume increments were correlated with crackle energy during the flow transient for both the first and the second inflations (r(2) = 0.29-0.73 and 0.68-0.82, respectively). Because the distribution of volume increments followed a power law, the correlation between crackle energy and discrete volume increments suggests that an avalanche-like airway opening process governs the recruitment of collapsed normal lungs.

  4. Unusual presentation of pneumocystis pneumonia in an immunocompetent patient diagnosed by open lung biopsy.

    PubMed

    Harris, Kassem; Maroun, Rabih; Chalhoub, Michel; Elsayegh, Dany

    2012-04-01

    Pneumocystis pneumonia (PCP) is the most common opportunistic infection in acquired immune deficiency syndrome (AIDS) patients. It is a fungal infection with Pneumocystis jiroveci which can be isolated from bronchoalveolar lavage of healthy subjects. The infection occurs mainly in HIV patients; with CD4 lymphocyte count drop to less than 200 cells/μL. PCP has been reported in non-HIV patients with other risk factors such as immunosuppressive medications, malignancies, and other inflammatory conditions. PCP has been rarely reported in immunocompetent subjects. However, in most of these patients, PCP occurred after a period of acute illness with bacterial pneumonia and antibiotic therapy. In this report, we describe a case of PCP in an immunocompetent patient with nonreactive HIV and no immunosuppressive risk factors. The patient had large pulmonary nodules discovered incidentally on chest film as preoperative evaluation for hip surgery. Bronchoalveolar lavage, transbronchial biopsies (TBB), and computed tomography (CT) guided needle biopsy were all negative for P. jiroveci. PCP diagnosis was made after open lung biopsy and wedge resection. To our knowledge, this is the first case of PCP in immunocompetent patient with negative BAL, TBB and CT guided biopsy. The diagnosis of PCP required open lung biopsy and the patient recovered without complications.

  5. Open-Access, Low-Magnetic-Field MRI System for Lung Research

    NASA Technical Reports Server (NTRS)

    Mair, Ross W.; Rosen, Matthew S.; Tsai, Leo L.; Walsworth, Ronald L.; Hrovat, Mirko I.; Patz, Samuel; Ruset, Iullian C.; Hersman, F. William

    2009-01-01

    An open-access magnetic resonance imaging (MRI) system is being developed for use in research on orientational/gravitational effects on lung physiology and function. The open-access geometry enables study of human subjects in diverse orientations. This system operates at a magnetic flux density, considerably smaller than the flux densities of typical other MRI systems, that can be generated by resistive electromagnet coils (instead of the more-expensive superconducting coils of the other systems). The human subject inhales air containing He-3 or Xe-129 atoms, the nuclear spins of which have been polarized by use of a laser beam to obtain a magnetic resonance that enables high-resolution gas space imaging at the low applied magnetic field. The system includes a bi-planar, constant-current, four-coil electromagnet assembly and associated electronic circuitry to apply a static magnetic field of 6.5 mT throughout the lung volume; planar coils and associated circuitry to apply a pulsed magnetic-field-gradient for each spatial dimension; a single, detachable radio-frequency coil and associated circuitry for inducing and detecting MRI signals; a table for supporting a horizontal subject; and electromagnetic shielding surrounding the electromagnet coils.

  6. The Role of Open Lung Biopsy in Critically Ill Patients with Hypoxic Respiratory Failure: A Retrospective Cohort Study.

    PubMed

    Almotairi, Abdullah; Biswas, Sharmistha; Shahin, Jason

    2016-01-01

    Background. The aim of this study was to assess the utility of open lung biopsy in patients with hypoxic respiratory failure of unknown etiology admitted to an ICU and to examine the use of steroid therapy in this patient population. Methods. A retrospective cohort study was performed of all consecutive patients admitted to three tertiary care, university-affiliated, ICUs during the period from January 2000 to January 2012 with the principal diagnosis of hypoxic respiratory failure and who underwent an open lung biopsy. Results. Open lung biopsy resulted in a diagnostic yield of 68% and in a 67% change of management in patients. A multivariable analysis of clinical variables associated with acute hospital mortality demonstrated that postbiopsy systemic steroid therapy (OR 0.24, 95% C.I 0.06-0.96) was significantly associated with improved survival. Complications arising from the biopsy occurred in 30% of patients. Conclusion. Open lung biopsy had significant diagnostic yield and led to major changes in management and aided in end-of-life decision-making in the ICU. Systemic steroid therapy was associated with improved survival. The risk-benefit ratio of open lung biopsy is still unclear, especially given the availability of newer diagnostic tests and possible empirical therapy with steroids.

  7. Work related decrement in pulmonary function in silicon carbide production workers.

    PubMed Central

    Osterman, J W; Greaves, I A; Smith, T J; Hammond, S K; Robins, J M; Thériault, G

    1989-01-01

    The relation between pulmonary function, cigarette smoking, and exposure to mixed respirable dust containing silicon carbide (SiC), hydrocarbons, and small quantities of quartz, cristobalite, and graphite was evaluated in 156SiC production workers using linear regression models on the difference between measured and predicted FEV1 and FVC. Workers had an average of 16 (range 2-41) years of employment and 9.5 (range 0.6-39.7) mg-year/m3 cumulative respirable dust exposure; average dust exposure while employed was 0.63 (range 0.18-1.42) mg/m3. Occasional, low level (less than or equal to 1.5 ppm) sulphur dioxide (SO2) exposure also occurred. Significant decrements in FEV1 (8.2 ml; p less than 0.03) and FVC (9.4 ml; p less than 0.01) were related to each year of employment for the entire group. Never smokers lost 17.8 ml (p less than 0.02) of FEV1 and 17.0 (p less than 0.05) of FVC a year, whereas corresponding decrements of 9.1 ml (p = 0.12) in FEV1 and 14.4 ml (p less than 0.02) in FVC were found in current smokers. Similar losses in FEV1 and FVC were related to each mg-year/m3 of cumulative dust exposure for 138 workers with complete exposure information; these findings, however, were generally not significant owing to the smaller cohort and greater variability in this exposure measure. Never smokers had large decrements in FEV1 (40.7 ml; p less than 0.02) and FVC (32.9 ml; p = 0.08) per mg-year/m3 of cumulative dust exposure and non-significant decrements were found in current smokers (FEV1: -7.1 ml; FVC: -11.7 ml). A non-significant decrement in lung function was also related to average dust exposure while employed. No changes were associated with SO(2) exposure or and SO(2) dust interaction. These findings suggest that employment in SiC production is associated with an excessive decrement in pulmonary function and that current permissible exposure limits for dusts occurring in this industry may not adequately protect workers from developing chronic pulmonary

  8. Mueller-Lyer decrement: practice or prolonged inspection?

    NASA Technical Reports Server (NTRS)

    Schiano, D. J.; Jordan, K.

    1990-01-01

    Noting the similarity between the illusion decrement and selective adaptation paradigms, Long has challenged the view that illusion decrement effects reflect a strategic--as opposed to a structural--underlying mechanism, and has called for further research on this issue. To investigate the confound between prolonged free inspection and repeated trials in the standard decrement procedure, the effects of three inspection conditions (continuous, intermittent, and immediate) on the magnitude of the overestimation Mueller-Lyer illusion have been assessed under two levels of trials (a total of two or six judgments). Significant illusion decline was found only under conditions of repeated trials, with either continuous or intermittent inspection. These findings do not support the predictions of purely structural theories (including neural adaptation and efferent readiness theories), according to which degree of decrement should be determined solely by viewing time. Instead, the data demonstrate that illusion decrement is a product of practice, providing converging evidence for the view of decrement as involving a cognitive 'recalibration' or learning process.

  9. Open-Lung Ventilation Improves Clinical Outcomes in Off-Pump Coronary Artery Bypass Surgery: A Randomized Controlled Trial.

    PubMed

    Bolzan, Douglas W; Trimer, Renata; Begot, Isis; Nasrala, Mara L S; Forestieri, Patricia; Mendez, Vanessa M F; Arena, Ross; Gomes, Walter J; Guizilini, Solange

    2016-06-01

    To compare pulmonary function, functional capacity, and clinical outcomes among conventional mechanical ventilation (CMV), early open-lung (EOL), and late open-lung (LOL) strategies after off-pump coronary artery bypass surgery (OPCAB). Prospective, randomized, and double-blinded study. Two hospitals of the Federal University of Sao Paulo, Brazil. Ninety-three patients undergoing elective first-time OPCAB. Patients were randomized into 3 groups: CMV (n=31); LOL (n=32) initiated upon intensive care unit (ICU) arrival; EOL (n = 30) initiated after intubation. Spirometry was performed at bedside preoperatively and on postoperative days (PODs) 1, 3, and 5. Partial pressure of arterial oxygen (PaO2) and pulmonary shunt fraction were evaluated presurgically and on POD 1; 6-minute walk test (6MWT) was performed presurgically and on POD 5. Both open-lung groups demonstrated higher forced vital capacity and forced expiratory volume in 1 second on PODs 1, 3 and 5 compared to the CMV group (p<0.05). Similar results were found in relation to the 6MWT distance. Shunt fraction was lower and PaO2 was higher in both open-lung groups (p<0.05). Open-lung groups had shorter intubation time and hospital stay as well as fewer respiratory events (p<0.05). No statistical difference was found relative to the aforementioned results when the EOL and LOL groups were compared. Both open-lung strategies were able to promote higher pulmonary function preservation and greater recovery of functional capacity with better clinical outcomes after OPCAB. No difference in outcome was found when comparing initiation of OLS intraoperatively or after ICU arrival. Copyright © 2016 Elsevier Inc. All rights reserved.

  10. Feasibility of weaning and direct extubation from open lung high-frequency ventilation in preterm infants.

    PubMed

    van Velzen, Alice; De Jaegere, Anne; van der Lee, Johanna; van Kaam, Anton

    2009-01-01

    High-frequency ventilation (HFV) is increasingly used in preterm infants, but data on weaning and extubation are limited. We aimed to establish if weaning the continuous distending pressure (CDP) below 8 cm H2O and the Fio2 below 0.30 is feasible in preterm infants on open lung HFV and if these settings result in successful extubation. Retrospective cohort study. Neonatal intensive care unit in a university hospital. Preterm infants ventilated and directly extubated from HFV between January 2003 and August 2005. Data on patient characteristics, ventilator settings, gas exchange, respiratory support after extubation and the number of patients failing extubation (i.e., reintubation within 48 hr) were retrospectively collected. Two hundred fourteen infants, accounting for 242 ventilation periods, were included in the study. The CDP, but not the Fio2, decreased significantly in the 24-hr period before extubation, resulting in a mean CDP of 6.8 +/- 1.6 cm H2O and a mean Fio2 of 0.25 at the time of extubation. At these settings, 193 (90%) infants were successfully extubated. Multivariate logistic regression analysis showed that birth weight was the only independent variable positively associated with successful extubation. This study shows that weaning the CDP below 8 cm H2O with an Fio2 below 0.30 is feasible during open lung HFV and extubation at these settings can be successful in preterm infants. In our series, a 90% success rate was observed. The value of this approach should be prospectively compared with conventional weaning and extubation strategies.

  11. Nonlinear electrophoresis in the presence of dielectric decrement

    NASA Astrophysics Data System (ADS)

    Figliuzzi, B.; Chan, W. H. R.; Buie, C. R.; Moran, J. L.

    2016-08-01

    The nonlinear phenomena that occur in the electric double layer (EDL) that forms at charged surfaces strongly influence electrokinetic effects, including electro-osmosis and electrophoresis. In particular, saturation effects due to either dielectric decrement or ion crowding effects are of paramount importance. Dielectric decrement significantly influences the ionic concentration in the EDL at high ζ potential, leading to the formation of a condensed layer near the particle's surface. In this article, we present a model incorporating both steric effects due to the finite size of ions and dielectric decrement to describe the physics in the electric double layer. The model remains valid in both weakly and strongly nonlinear regimes, as long as the electric double layer remains in quasiequilibrium. We apply this model to the study of two archetypal problems in electrokinetics, namely the electrophoresis of particles with fixed surface charges and the electrophoresis of ideally polarizable particles.

  12. Clinical significance of respiratory bronchiolitis on open lung biopsy and its relationship to smoking related interstitial lung disease.

    PubMed

    Moon, J; du Bois, R M; Colby, T V; Hansell, D M; Nicholson, A G

    1999-11-01

    Respiratory bronchiolitis-associated interstitial lung disease (RBILD) is a rare form of interstitial lung disease which may present in similar fashion to other types of chronic interstitial pneumonia. The purpose of this study was to undertake a clinicopathological review of 10 patients with RBILD and to examine the clinical and imaging data related to its histopathological pattern, in particular the relationship of RBILD to smoking. Thirteen out of 168 retrospectively reviewed patients, from whom biopsy specimens were taken for suspected diffuse lung disease, were identified with a histopathological pattern of RBILD. Three cases were rejected as follow up data were unavailable. The 10 remaining cases constituted the study group and both clinical and imaging data were collected from patients' notes and referring physicians. Histopathologically, four cases of RBILD overlapped with the pattern of desquamative interstitial pneumonitis (DIP) and nine also had microscopic evidence of centrilobular emphysema. Nine patients were smokers, ranging from 3 to 80 pack years. The one non-smoker had an occupational exposure to the fumes of solder flux. The sex distribution was equal with an age range of 32-65 years. Two patients were clubbed. Lung function tests showed both restrictive and obstructive patterns together with severe reductions in carbon monoxide transfer factor in seven patients. Chest radiographs showed reticular or reticulonodular infiltrates in five patients and a ground glass pattern in two. CT scans were consistent with either DIP or RBILD in six of eight patients. Although seven patients remained stable or improved, either with or without treatment, three patients deteriorated. This study adds weight to the hypothesis that smoking can cause clinically significant interstitial lung disease, with deterioration in pulmonary function despite treatment. Given the overlapping histopathological patterns of RBILD and DIP and their strong association with smoking

  13. Clinical significance of respiratory bronchiolitis on open lung biopsy and its relationship to smoking related interstitial lung disease

    PubMed Central

    Moon, J.; du Bois, R. M; Colby, T.; Hansell, D.; Nicholson, A.

    1999-01-01

    BACKGROUND—Respiratory bronchiolitis-associated interstitial lung disease (RBILD) is a rare form of interstitial lung disease which may present in similar fashion to other types of chronic interstitial pneumonia. The purpose of this study was to undertake a clinicopathological review of 10 patients with RBILD and to examine the clinical and imaging data related to its histopathological pattern, in particular the relationship of RBILD to smoking.
METHODS—Thirteen out of 168 retrospectively reviewed patients, from whom biopsy specimens were taken for suspected diffuse lung disease, were identified with a histopathological pattern of RBILD. Three cases were rejected as follow up data were unavailable. The 10remaining cases constituted the study group and both clinical and imaging data were collected from patients' notes and referring physicians.
RESULTS—Histopathologically, four cases of RBILD overlapped with the pattern of desquamative interstitial pneumonitis (DIP) and nine also had microscopic evidence of centrilobular emphysema. Nine patients were smokers, ranging from 3 to 80 pack years. The one non-smoker had an occupational exposure to the fumes of solder flux. The sex distribution was equal with an age range of 32-65 years. Two patients were clubbed. Lung function tests showed both restrictive and obstructive patterns together with severe reductions in carbon monoxide transfer factor in seven patients. Chest radiographs showed reticular or reticulonodular infiltrates in five patients and a ground glass pattern in two. CT scans were consistent with either DIP or RBILD in six of eight patients. Although seven patients remained stable or improved, either with or without treatment, three patients deteriorated.
CONCLUSIONS—This study adds weight to the hypothesis that smoking can cause clinically significant interstitial lung disease, with deterioration in pulmonary function despite treatment. Given the overlapping histopathological patterns of RBILD

  14. Manual ventilation and open suction procedures contribute to negative pressures in a mechanical lung model

    PubMed Central

    Nakstad, Espen Rostrup; Opdahl, Helge; Heyerdahl, Fridtjof; Borchsenius, Fredrik; Skjønsberg, Ole Henning

    2017-01-01

    Introduction Removal of pulmonary secretions in mechanically ventilated patients usually requires suction with closed catheter systems or flexible bronchoscopes. Manual ventilation is occasionally performed during such procedures if clinicians suspect inadequate ventilation. Suctioning can also be performed with the ventilator entirely disconnected from the endotracheal tube (ETT). The aim of this study was to investigate if these two procedures generate negative airway pressures, which may contribute to atelectasis. Methods The effects of device insertion and suctioning in ETTs were examined in a mechanical lung model with a pressure transducer inserted distal to ETTs of 9 mm, 8 mm and 7 mm internal diameter (ID). A 16 Fr bronchoscope and 12, 14 and 16 Fr suction catheters were used at two different vacuum levels during manual ventilation and with the ETTs disconnected. Results During manual ventilation with ETTs of 9 mm, 8 mm and 7 mm ID, and bronchoscopic suctioning at moderate suction level, peak pressure (PPEAK) dropped from 23, 22 and 24.5 cm H2O to 16, 16 and 15 cm H2O, respectively. Maximum suction reduced PPEAK to 20, 17 and 11 cm H2O, respectively, and the end-expiratory pressure fell from 5, 5.5 and 4.5 cm H2O to –2, –6 and –17 cm H2O. Suctioning through disconnected ETTs (open suction procedure) gave negative model airway pressures throughout the duration of the procedures. Conclusions Manual ventilation and open suction procedures induce negative end-expiratory pressure during endotracheal suctioning, which may have clinical implications in patients who need high PEEP (positive end-expiratory pressure). PMID:28725445

  15. Manual ventilation and open suction procedures contribute to negative pressures in a mechanical lung model.

    PubMed

    Nakstad, Espen Rostrup; Opdahl, Helge; Heyerdahl, Fridtjof; Borchsenius, Fredrik; Skjønsberg, Ole Henning

    2017-01-01

    Removal of pulmonary secretions in mechanically ventilated patients usually requires suction with closed catheter systems or flexible bronchoscopes. Manual ventilation is occasionally performed during such procedures if clinicians suspect inadequate ventilation. Suctioning can also be performed with the ventilator entirely disconnected from the endotracheal tube (ETT). The aim of this study was to investigate if these two procedures generate negative airway pressures, which may contribute to atelectasis. The effects of device insertion and suctioning in ETTs were examined in a mechanical lung model with a pressure transducer inserted distal to ETTs of 9 mm, 8 mm and 7 mm internal diameter (ID). A 16 Fr bronchoscope and 12, 14 and 16 Fr suction catheters were used at two different vacuum levels during manual ventilation and with the ETTs disconnected. During manual ventilation with ETTs of 9 mm, 8 mm and 7 mm ID, and bronchoscopic suctioning at moderate suction level, peak pressure (PPEAK) dropped from 23, 22 and 24.5 cm H2O to 16, 16 and 15 cm H2O, respectively. Maximum suction reduced PPEAK to 20, 17 and 11 cm H2O, respectively, and the end-expiratory pressure fell from 5, 5.5 and 4.5 cm H2O to -2, -6 and -17 cm H2O. Suctioning through disconnected ETTs (open suction procedure) gave negative model airway pressures throughout the duration of the procedures. Manual ventilation and open suction procedures induce negative end-expiratory pressure during endotracheal suctioning, which may have clinical implications in patients who need high PEEP (positive end-expiratory pressure).

  16. Physical and Psychological Decrements Affecting Reading in the Aged.

    ERIC Educational Resources Information Center

    Wilson, Molly M.

    While reading has been recognized as a potentially useful and enjoyable pastime for the elderly, physical and psychological decrements affect the ability of the elderly to read. As the eyes age, near-point tasks become more difficult. In addition to reduced sensory intake, perceptual changes occur. The central nervous system slows, and data travel…

  17. Physical and Psychological Decrements Affecting Reading in the Aged.

    ERIC Educational Resources Information Center

    Wilson, Molly M.

    While reading has been recognized as a potentially useful and enjoyable pastime for the elderly, physical and psychological decrements affect the ability of the elderly to read. As the eyes age, near-point tasks become more difficult. In addition to reduced sensory intake, perceptual changes occur. The central nervous system slows, and data travel…

  18. The diagnostic yield and complications of open lung biopsies in kidney transplant patients with pulmonary disease

    PubMed Central

    Tomotani, Daniere Yurie Vieira; Pacheco, Eduardo Souza; de Sandes-Freitas, Tainá Veras; Viana, Laila Almeida; de Oliveira Pontes, Edgar Porto; Tamura, Nikkei; Tedesco-Silva, Hélio; Machado, Flavia Ribeiro; Freitas, Flávio Geraldo Rezende

    2017-01-01

    Background The purpose of this study was to assess the efficacy of open lung biopsy (OLB) in determining the specific diagnosis and the related complications in patients with undiagnosed diffuse pulmonary infiltrates. Methods This single center, retrospective study included adult kidney transplant patients who underwent OLB. The patients had diffuse pulmonary infiltrates without definitive diagnoses and failed to respond to empiric antibiotic treatment. We analyzed the number of specific diagnoses, changes in treatment and the occurrence of complications in these patients. A logistic regression was used to determine which variables were predictors of hospital mortality. Results From April 2010 to April 2014, 87 patients consecutively underwent OLB. A specific diagnosis was reached in 74 (85.1%) patients. In 46 patients (53%), their therapeutic management was changed after the OLB results. Twenty-five (28.7%) patients had complications related to the OLB. The hospital mortality rate was 25.2%. Age, SAPS3 score and complications related to the procedure were independent predictors of all-cause mortality. Conclusions OLB is a high-risk procedure with a high diagnostic yield in kidney transplant patients with diffuse pulmonary infiltrates who did not have a definitive diagnosis and who failed to respond to empiric antibiotic treatment. Complications related to OLB were common and were independently associated with intra-hospital mortality. PMID:28203420

  19. Open lung biopsy in early-stage acute respiratory distress syndrome

    PubMed Central

    Kao, Kuo-Chin; Tsai, Ying-Huang; Wu, Yao-Kuang; Chen, Ning-Hung; Hsieh, Meng-Jer; Huang, Shiu-Feng; Huang, Chung-Chi

    2006-01-01

    Introduction Acute respiratory distress syndrome (ARDS) has heterogeneous etiologies, rapid progressive change and a high mortality rate. To improve the outcome of ARDS, accurate diagnosis is essential to the application of effective early treatment. The present study investigated the clinical effects and safety of open lung biopsy (OLB) in patients with early-stage ARDS of suspected non-infectious origin. Methods We undertook a retrospective study of 41 patients with early-stage ARDS (defined as one week or less after intubation) who underwent OLB in two medical intensive care units of a tertiary care hospital from 1999 to 2005. Data analyzed included baseline characteristics, complication rate, pathological diagnoses, treatment alterations, and hospital survival. Results The age of patients was 55 ± 17 years (mean ± SD). The average ratio of arterial partial pressure of oxygen (PaO2) to fraction of inspired oxygen (FiO2) was 116 ± 43 mmHg (mean ± SD) at biopsy. Seventeen patients (41%) were immunocompromised. Postoperative complications occurred in 20% of patients (8/41). All biopsies provided a pathological diagnosis with a diagnostic yield of 100%. Specific pathological diagnoses were made for 44% of patients (18/41). Biopsy findings led to an alteration of treatment modality in 73% of patients (30/41). The treatment alteration rate was higher in patients with nonspecific diagnoses than in patients with specific diagnoses (p = 0.0024). Overall mortality was 50% (21/41) and was not influenced by age, gender, pre-OLB oxygenation, complication rate, pathological results, and alteration of treatment. There was no surgery-related mortality. The survival rate for immunocompromised patients was better than that for immunocompetent patients (71% versus 33%; p = 0.0187) in this study. Conclusion Our retrospective study suggests that OLB was a useful and acceptably safe diagnostic procedure in some selected patients with early-stage ARDS. PMID:16859510

  20. 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.

  1. Deviation of tracheal pressure from airway opening pressure during high-frequency oscillatory ventilation in a porcine lung model.

    PubMed

    Johannes, Amélie; Zollhoefer, Bernd; Eujen, Ulrike; Kredel, Markus; Rauch, Stefan; Roewer, Norbert; Muellenbach, Ralf M

    2013-04-01

    Oxygenation during high-frequency oscillatory ventilation is secured by a high level of mean airway pressure. Our objective was to identify a pressure difference between the airway opening of the respiratory circuit and the trachea during application of different oscillatory frequencies. Six female Pietrain pigs (57.1 ± 3.6 kg) were first ventilated in a conventional mechanical ventilation mode. Subsequently, the animals were switched to high-frequency oscillatory ventilation by setting mean airway opening pressure 5 cmH(2)O above the one measured during controlled mechanical ventilation. Measurements at the airway opening and at tracheal levels were performed in healthy lungs and after induction of acute lung injury by surfactant depletion. During high-frequency oscillatory ventilation, the airway opening pressure was set at a constant level. The pressure amplitude was fixed at 90 cmH(2)O. Starting from an oscillatory frequency of 3 Hz, the frequency was increased in steps of 3 Hz to 15 Hz and then decreased accordingly. At each frequency, measurements were performed in the trachea through a side-lumen of the endotracheal tube and the airway opening pressure was recorded. The pressure difference was calculated. At every oscillatory frequency, a pressure loss towards the trachea could be shown. This pressure difference increased with higher oscillatory frequencies (3 Hz 2.2 ± 2.1 cmH(2)O vs. 15 Hz 7.5 ± 1.8 cmH(2)O). The results for healthy and injured lungs were similar. Tracheal pressures decreased with higher oscillatory frequencies. This may lead to pulmonary derecruitment. This has to be taken into consideration when increasing oscillatory frequencies and differentiated pressure settings are mandatory.

  2. Fatigue and associated performance decrements in air transport operations

    NASA Technical Reports Server (NTRS)

    Lyman, E. G.; Orlady, H. W.

    1981-01-01

    A study of safety reports was conducted to examine the hypothesis that fatigue and associated performance decrements occur in air transport operations, and that these are associated with some combination of factors: circadian desynchronosis, duty time; pre-duty activity; sleep; work scheduling; workload; and environmental deprivation. The findings are based on a selected sample of reported incidents in which the reporter associated fatigue with the occurrence. In comparing the fatigue reports with a control set, significant performance decrements were found to exist related to time-of-day, awareness and attention to duty, less significantly, final phases of flights. The majority of the fatigue incidents involved such unsafe events as altitude deviations, takeoffs and landing without clearance, and the like. Considerations of duty and sleep are the major factors in the reported fatigue conditions.

  3. Cognitive Performance Decrement in U.S. Army Aircrews.

    DTIC Science & Technology

    1985-08-31

    PERFORMANCE DECREMENT IN U.S. ARMY AIRCREWS Joseph I. Peters Mark A. Archer Michael J. Moyer Science Applications International Corporation P.O. Box 1303...Science Applications (if applicable) Director International Corporation Defense Nuclear Agency 6c ADDRESS (City, State. and ZIP Code) 7b ADDRESS (City...Technology Division of Science Applications International Corporation (SAIC) for the Biomedical Effects Directorate of the Defense Nuclear Agency under

  4. Nanomagnetosols: magnetism opens up new perspectives for targeted aerosol delivery to the lung.

    PubMed

    Plank, Christian

    2008-02-01

    A recent article in Nature Nanotechnology reports the guiding of aerosols to specific regions of the lung using an external magnetic field. This novel approach of nanomagnetic drug targeting is made feasible with aerosols that comprise magnetically responsive nanoparticles along with a drug of choice. This promising method could be used in the future to specifically accumulate effective drug doses in diseased lung regions and thus reduce undesired side effects.

  5. Application of the open-lung concept during positive-pressure ventilation reduces pulmonary inflammation in newborn piglets.

    PubMed

    van Kaam, Anton H; Dik, Willem A; Haitsma, Jack J; De Jaegere, Anne; Naber, Birgitta A; van Aalderen, Wim M; Kok, Joke H; Lachmann, Burkhard

    2003-01-01

    It has been shown that application of the open-lung concept (OLC) during high-frequency oscillatory ventilation (HFOV) attenuates pulmonary inflammation. We hypothesized that this attenuation could also be achieved by applying the OLC during positive-pressure ventilation (PPV). After repeated whole-lung lavage, newborn piglets were assigned to one of three ventilation groups: (1) PPV(OLC); (2) HFOV(OLC), or (3) conventional PPV (PPV(CON)). After a ventilation period of 5 h, analysis of bronchoalveolar lavage fluid showed a reduced influx of polymorphonuclear neutrophils, interleukin 8, and thrombin activity in both OLC groups as compared with the PPV(CON) group. There were no differences in tumor necrosis factor alpha levels. We conclude that application of the OLC during PPV reduces pulmonary inflammation as compared with conventional PPV and that the magnitude of this reduction is comparable to that of HFOV.

  6. Effects of ATP-sensitive potassium channel opener on potassium transport and alveolar fluid clearance in the resected human lung.

    PubMed

    Sakuma, T; Takahashi, K; Ohya, N; Nakada, T; Matthay, M A

    1998-07-01

    Since the effect of an ATP-sensitive potassium channel (KATP channel) opener on the function of alveolar epithelial cells is unknown, the effect of YM934, a newly synthesized KATP channel opener, on potassium influx into the alveolar spaces and alveolar fluid clearance was determined in the resected human lung. An isosmolar albumin solution with a low potassium concentration was instilled into the distal airspaces of resected human lungs. Alveolar fluid clearance was measured by the progressive increase in alveolar protein concentration. Net potassium transport was measured by the change in potassium concentration and alveolar fluid volume. YM934 (10(-4) M) increased net influx of potassium by 140% into the alveolar spaces and also increased alveolar fluid clearance by 60% in the experiments with a potassium concentration of 0.3 mEq/1. Glibenclamide (10(-4) M), a KATP channel blocker, inhibited the YM934-increased influx of potassium transport and the increase in alveolar fluid clearance. Also amiloride (10(-5) M), an inhibitors of apical sodium uptake, blocked the YM934 stimulated increase in net alveolar fluid clearance. These results indicate that a KATP channel opener can effect potassium transport and net vectorial fluid movement across the human alveolar epithelium.

  7. Hypokinesia without decrement distinguishes progressive supranuclear palsy from Parkinson's disease.

    PubMed

    Ling, Helen; Massey, Luke A; Lees, Andrew J; Brown, Peter; Day, Brian L

    2012-04-01

    Repetitive finger tapping is commonly used to assess bradykinesia in Parkinson's disease. The Queen Square Brain Bank diagnostic criterion of Parkinson's disease defines bradykinesia as 'slowness of initiation with progressive reduction in speed and amplitude of repetitive action'. Although progressive supranuclear palsy is considered an atypical parkinsonian syndrome, it is not known whether patients with progressive supranuclear palsy have criteria-defined bradykinesia. This study objectively assessed repetitive finger tap performance and handwriting in patients with Parkinson's disease (n = 15), progressive supranuclear palsy (n = 9) and healthy age- and gender-matched controls (n = 16). The motion of the hand and digits was recorded in 3D during 15-s repetitive index finger-to-thumb tapping trials. The main finding was hypokinesia without decrement in patients with progressive supranuclear palsy, which differed from the finger tap pattern in Parkinson's disease. Average finger separation amplitude in progressive supranuclear palsy was less than half of that in controls and Parkinson's disease (P < 0.001 in both cases). Change in tap amplitude over consecutive taps was computed by linear regression. The average amplitude slope in progressive supranuclear palsy was nearly zero (0.01°/cycle) indicating a lack of decrement, which differed from the negative slope in patients with Parkinson's disease OFF levodopa (-0.20°/cycle, P = 0.002). 'Hypokinesia', defined as <50% of control group's mean amplitude, combined with 'absence of decrement', defined as mean positive amplitude slope, were identified in 87% of finger tap trials in the progressive supranuclear palsy group and only 12% in the Parkinson's disease OFF levodopa group. In progressive supranuclear palsy, the mean amplitude was not correlated with disease duration or other clinimetric scores. In Parkinson's disease, finger tap pattern was compatible with criteria-defined bradykinesia

  8. An open-access, very-low-field MRI system for posture-dependent 3He human lung imaging

    NASA Astrophysics Data System (ADS)

    Tsai, L. L.; Mair, R. W.; Rosen, M. S.; Patz, S.; Walsworth, R. L.

    2008-08-01

    We describe the design and operation of an open-access, very-low-field, magnetic resonance imaging (MRI) system for in vivo hyperpolarized 3He imaging of the human lungs. This system permits the study of lung function in both horizontal and upright postures, a capability with important implications in pulmonary physiology and clinical medicine, including asthma and obesity. The imager uses a bi-planar B0 coil design that produces an optimized 65 G (6.5 mT) magnetic field for 3He MRI at 210 kHz. Three sets of bi-planar coils produce the x, y, and z magnetic field gradients while providing a 79-cm inter-coil gap for the imaging subject. We use solenoidal Q-spoiled RF coils for operation at low frequencies, and are able to exploit insignificant sample loading to allow for pre-tuning/matching schemes and for accurate pre-calibration of flip angles. We obtain sufficient SNR to acquire 2D 3He images with up to 2.8 mm resolution, and present initial 2D and 3D 3He images of human lungs in both supine and upright orientations. 1H MRI can also be performed for diagnostic and calibration reasons.

  9. An Open-Access, Very-Low-Field MRI System for Posture-Dependent 3He Human Lung Imaging

    PubMed Central

    Tsai, L. L.; Mair, R. W.; Rosen, M. S.; Patz, S.; Walsworth, R. L.

    2008-01-01

    We describe the design and operation of an open-access, very-low-field, magnetic resonance imaging (MRI) system for in-vivo hyperpolarized 3He imaging of the human lungs. This system permits the study of lung function in both horizontal and upright postures, a capability with important implications in pulmonary physiology and clinical medicine, including asthma and obesity. The imager uses a bi-planar B0 coil design that produces an optimized 65 G (6.5 mT) magnetic field for 3He MRI at 210 kHz. Three sets of bi-planar coils produce the x, y, and z magnetic field gradients while providing a 79-cm inter-coil gap for the imaging subject. We use solenoidal Q-spoiled RF coils for operation at low frequencies, and are able to exploit insignificant sample loading to allow for pre-tuning/matching schemes and for accurate pre-calibration of flip angles. We obtain sufficient SNR to acquire 2D 3He images with up to 2.8 mm resolution, and present initial 2D and 3D 3He images of human lungs in both supine and upright orientations. 1H MRI can also be performed for diagnostic and calibration reasons. PMID:18550402

  10. Epigenetic changes in Alzheimer's disease: decrements in DNA methylation

    PubMed Central

    Mastroeni, Diego; Grover, Andrew; Delvaux, Elaine; Whiteside, Charisse; Coleman, Paul D.; Rogers, Joseph

    2010-01-01

    DNA methylation is a vital component of the epigenetic machinery that orchestrates changes in multiple genes and helps regulate gene expression in all known vertebrates. We evaluated immunoreactivity for two markers of DNA methylation and eight methylation maintenance factors in entorhinal cortex layer II, a region exhibiting substantial Alzheimer's disease (AD) pathology in which expression changes have been reported for a wide variety of genes. We show, for the first time, neuronal immunoreactivity for all 10 of the epigenetic markers and factors, with highly significant decrements in AD cases. These decrements were particularly marked in PHF1/PS396 immunoreactive, neurofibrillary tangle-bearing neurons. In addition, two of the DNA methylation maintenance factors, DNMT1 and MBD2, have been reported also to interact with ribosomal RNAs and ribosome synthesis. Consistent with these findings, DNMT1 and MBD2, as well as p66α, exhibited punctate cytoplasmic immunoreactivity that co-localized with the ribosome markers RPL26 and 5.8s rRNA in ND neurons. By contrast, AD neurons generally lacked such staining, and there was a qualitative decrease in RPL26 and 5.8s rRNA immunoreactivity. Collectively, these findings suggest epigenetic dysfunction in AD-vulnerable neurons. PMID:19117641

  11. Resistance to extinction, generalization decrement, and conditioned reinforcement.

    PubMed

    Dulaney, Alana E; Bell, Matthew C

    2008-06-01

    This study investigated generalization decrement during an extinction resistance-to-change test for pigeon key pecking using a two-component multiple schedule with equal variable-interval 3-min schedules and different reinforcer amounts (one component presented 2-s access to reinforcement and the other 8s). After establishing baseline responding, subjects were assigned to one of the two extinction conditions: hopper stimuli (hopper and hopper light were activated but no food was available) or Control (inactive hopper and hopper light). Responding in the 8-s component was more resistant to extinction than responding in the 2-s component, the hopper stimuli group was more resistant to extinction compared to the Control group, and an interaction between amount of reinforcement, extinction condition, and session block was present. This finding supports generalization decrement as a factor that influences resistance to extinction. Hopper-time data (the amount of time subjects spent with their heads in the hopper) were compared to resistance-to-change data in an investigation of the role of conditioned reinforcement on resistance to change.

  12. Tracking Decrement as a Result of Grip Holding Endurance.

    PubMed

    Bloswick, D S; Ellis, N C

    1974-01-01

    This study explores the feasibility of using the static strength and endurance relationships suggested by Rohmert in 1960 to predict pursuit tracking performance, Ten male subjects are tested on a pursuit rotor before and after being subjected to specific levels of loading on a grip holding device. The loading corresponded to specific levels of each subject's maximum endurance as determined from Rohmert's strength and endurance equation. The hypotheses are: (a) predetermined schedules of strength expenditure cause a systematic decrement in tracking efficiency; and (b) the process of recovering efficiency is dependent upon the expenditure schedules. Resulting data support these hypotheses, suggesting that tracking efficiency can be reliably predicted using some of the strength and endurance relationships postulated by Rohmert.

  13. Mechanical ventilation in acute respiratory distress syndrome: The open lung revisited.

    PubMed

    Amado-Rodríguez, L; Del Busto, C; García-Prieto, E; Albaiceta, G M

    2017-02-23

    Acute respiratory distress syndrome (ARDS) is still related to high mortality and morbidity rates. Most patients with ARDS will require ventilatory support. This treatment has a direct impact upon patient outcome and is associated to major side effects. In this regard, ventilator-associated lung injury (VALI) is the main concern when this technique is used. The ultimate mechanisms of VALI and its management are under constant evolution. The present review describes the classical mechanisms of VALI and how they have evolved with recent findings from physiopathological and clinical studies, with the aim of analyzing the clinical implications derived from them. Lastly, a series of knowledge-based recommendations are proposed that can be helpful for the ventilator assisted management of ARDS at the patient bedside. Copyright © 2017 Elsevier España, S.L.U. y SEMICYUC. All rights reserved.

  14. Open-lung biopsy in patients with undiagnosed lung lesions referred at a tertiary cancer center is safe and reveals noncancerous, noninfectious entities as the most common diagnoses.

    PubMed

    Georgiadou, S P; Sampsonas, F L; Rice, D; Granger, J M; Swisher, S; Kontoyiannis, D P

    2013-01-01

    We evaluated the diagnostic yield of open-lung biopsies (OLBs) in a large tertiary cancer center to determine the role of infectious diseases as causes of undiagnosed pulmonary lesions. All consecutive adult patients with either single or multiple pulmonary nodules or masses who underwent a diagnostic OLB over a period of 10 years (1998-2007) were retrospectively identified. Their risk factors for malignancy and clinical and radiological characteristics were reviewed, and their postoperative complications were assessed. We evaluated 155 patients with a median age of 57 years (range, 19-83 years). We identified infectious etiologies in 29 patients (19 %). The most common diagnosis in this group was histoplasmosis (12 [41 %]), followed by nontuberculous mycobacterial infection (7 [24 %]) and aspergillosis (4 [14 %]). The majority of the 126 remaining patients had nonmalignant diagnoses, the most prevalent being nonspecific granuloma (26 %), whereas only 17 % had malignant diagnoses. We observed no significant differences among the patients with infectious, malignant, or both noninfectious and nonmalignant final diagnoses regarding their demographic, laboratory, and clinical characteristics. Six percent of the patients had at least one post-OLB complication, and the post-OLB mortality rate was 1 %. OLB is a safe diagnostic procedure which frequently identifies a wide variety of infectious and inflammatory diseases.

  15. Openings

    PubMed Central

    Selwyn, Peter A.

    2015-01-01

    Reviewing his clinic patient schedule for the day, a physician reflects on the history of a young woman he has been caring for over the past 9 years. What starts out as a routine visit then turns into a unique opening for communication and connection. A chance glimpse out the window of the exam room leads to a deeper meditation on parenthood, survival, and healing, not only for the patient but also for the physician. How many missed opportunities have we all had, without even realizing it, to allow this kind of fleeting but profound opening? PMID:26195687

  16. Alemtuzumab in lung transplantation: an open-label, randomized, prospective single center study.

    PubMed

    Jaksch, P; Ankersmit, J; Scheed, A; Kocher, A; Muraközy, G; Klepetko, W; Lang, G

    2014-08-01

    Induction therapy with alemtuzumab followed by lower maintenance immunosuppression (IS) has been associated with reduced morbidity and mortality in abdominal and heart transplantation (TX). In the current study, alemtuzumab, in combination with reduced levels of maintenance IS, was compared to thymoglobulin in combination with standard IS. Sixty consecutive patients who underwent lung transplantation (LUTX) at a single center were prospectively randomized in two groups: group A received alemtuzumab in conjunction with reduced doses of tacrolimus, steroids and mycophenolate mofetil. Group B received thymoglobulin in association with standard dose IS. Patient and graft survival, freedom from acute cellular rejection (ACR), lymphocytic bronchiolitis, bronchiolitis obliterans syndrome, kidney function, infectious complications and posttransplant lymphoproliferative disorder were analyzed. Alemtuzumab induction therapy resulted in complete the absence of ACR episodes ≥ A2 within the first year post-TX. The difference to thymoglobulin was significant (alemtuzumab 0 vs. ATG 0.33; p = 0.019). All other factors studied did not show any differences between the two groups. Alemtuzumab induction therapy after LUTX in combination with reduced maintenance IS significantly reduces higher-grade rejection rates. This novel therapeutic agent had no impact on survival, infections rates, kidney function and incidence of malignancies. © Copyright 2014 The American Society of Transplantation and the American Society of Transplant Surgeons.

  17. Results of an open-access lung cancer screening program with low-dose computed tomography: the Gdańsk experience.

    PubMed

    Rzyman, Witold; Dziedzic, Robert; Jelitto-Górska, Małgorzata; Biadacz, Iwona; Książek, Janina; Siebert, Janusz; Zdrojewski, Tomasz; Studniarek, Michał

    2015-01-01

    Lung cancer screening with low-dose computed tomography (LDCT) is one of the most promising tools for reducing mortality from lung cancer. The aim of the study was to evaluate the results of an open-access lung cancer screening program with LDCT. In total, 8649 asymptomatic volunteers between 50 and 75 years of age with a smoking history of at least 20 pack-years underwent LDCT screening. The presence of lung nodules with a diameter of less than 5 mm required a follow-up control visit after 12 months, and with a diameter of 5 to 10 mm--after 3, 6, and 12 months. Patients with a nodule of more than 10 mm in diameter required further diagnostic workup. Lung nodules were detected in 4694 individuals (54%). Lung cancer was diagnosed in 107 patients (1.24%). Of 8649 participants, 300 (3.5%) were referred for further diagnostic workup, and 125 (1.5%) underwent surgical resection (81 because of malignant lesions; 44, benign lesions). Eighty-one participants (75%) underwent surgery with a curative intent, and 26 participants underwent oncological treatment. There were no perioperative deaths. The majority of surgical patients underwent lobectomy (video-assisted, in 30 patients; and open, in 38 patients). Stage I non-small cell lung cancer was detected in 64 of the surgical patients (79%). The detection rate of lung cancer in the screening program with low-dose computed tomography is relatively low but patients were diagnosed at a very early stage of the disease compared with standard clinical practice.

  18. Early Open-Lung Ventilation Improves Clinical Outcomes in Patients with Left Cardiac Dysfunction Undergoing Off-Pump Coronary Artery Bypass: a Randomized Controlled Trial

    PubMed Central

    Bolzan, Douglas W.; Gomes, Walter José; Rocco, Isadora S.; Viceconte, Marcela; Nasrala, Mara L. S.; Pauletti, Hayanne O.; Moreira, Rita Simone L.; Hossne Jr, Nelson A.; Arena, Ross; Guizilini, Solange

    2016-01-01

    Objective To compare pulmonary function, functional capacity and clinical outcomes amongst three groups of patients with left ventricular dysfunction following off-pump coronary artery bypass, namely: 1) conventional mechanical ventilation (CMV); 2) late open lung strategy (L-OLS); and 3) early open lung strategy (E-OLS). Methods Sixty-one patients were randomized into 3 groups: 1) CMV (n=21); 2) L-OLS (n=20) initiated after intensive care unit arrival; and 3) E-OLS (n=20) initiated after intubation. Spirometry was performed at bedside on preoperative and postoperative days (PODs) 1, 3, and 5. Partial pressure of arterial oxygen (PaO2) and pulmonary shunt fraction were evaluated preoperatively and on POD1. The 6-minute walk test was applied on the day before the operation and on POD5. Results Both the open lung groups demonstrated higher forced vital capacity and forced expiratory volume in 1 second on PODs 1, 3 and 5 when compared to the CMV group (P<0.05). The 6-minute walk test distance was more preserved, shunt fraction was lower, and PaO2 was higher in both open-lung groups (P<0.05). Open-lung groups had shorter intubation time and hospital stay and also fewer respiratory events (P<0.05). Key measures were significantly more favorable in the E-OLS group compared to the L-OLS group. Conclusion Both OLSs (L-OLS and E-OLS) were able to promote higher preservation of pulmonary function, greater recovery of functional capacity and better clinical outcomes following off-pump coronary artery bypass when compared to conventional mechanical ventilation. However, in this group of patients with reduced left ventricular function, initiation of the OLS intra-operatively was found to be more beneficial and optimal when compared to OLS initiation after intensive care unit arrival. PMID:27982344

  19. Evaluation of short-term outcome after lung lobectomy for resection of primary lung tumors via video-assisted thoracoscopic surgery or open thoracotomy in medium- to large-breed dogs.

    PubMed

    Mayhew, Philipp D; Hunt, Geraldine B; Steffey, Michele A; Culp, William T N; Mayhew, Kelli N; Fuller, Mark; Johnson, Lynelle R; Pascoe, Peter J

    2013-09-01

    To describe clinicopathologic features of dogs that underwent lung lobectomy for resection of primary lung tumors via video-assisted thoracoscopic surgery (VATS) or open thoracotomy (OT) and to compare short-term outcomes for dogs following these procedures. Retrospective cohort study. 46 medium- to large-breed dogs with primary lung tumors. Medical records of dogs that underwent a lung lobectomy via VATS (n = 22) or OT (24) for resection of primary lung tumors between 2004 and 2012 were reviewed. Dogs were included if they weighed > 10 kg (22 lb) and resection of a primary lung tumor was confirmed histologically. Tumor volumes were calculated from preoperative CT scans where available. Surgical time, completeness of excision, time in the ICU, indwelling thoracic drain time, postoperative and total hospitalization time, incidence of major complications, and short-term survival rate were evaluated. VATS was performed with a 3-port (n = 12) or 4-port (10) technique and 1-lung ventilation (22). In 2 of 22 (9%) dogs, VATS was converted to OT. All dogs survived to discharge from the hospital. There were no significant differences between the VATS and OT groups with regard to most variables. Surgery time was significantly longer for VATS than for OT (median, 120 vs 95 minutes, respectively). In medium- to large-breed dogs, short-term outcomes for dogs that underwent VATS for lung lobectomy were comparable to those of dogs that underwent OT. Further studies are required to evaluate the effects of surgical approach on indices of postoperative pain and long-term outcomes.

  20. X-shooter spectroscopy of young stellar objects. VI. H i line decrements

    NASA Astrophysics Data System (ADS)

    Antoniucci, S.; Nisini, B.; Giannini, T.; Rigliaco, E.; Alcalá, J. M.; Natta, A.; Stelzer, B.

    2017-03-01

    Context. Hydrogen recombination emission lines commonly observed in accreting young stellar objects represent a powerful tracer for the gas conditions in the circumstellar structures (accretion columns, and winds or jets). Aims: Here we perform a study of the H i decrements and line profiles, from the Balmer and Paschen H i lines detected in the X-shooter spectra of a homogeneous sample of 36 T Tauri objects in Lupus, the accretion and stellar properties of which were already derived in a previous work. We aim to obtain information on the H i gas physical conditions to delineate a consistent picture of the H i emission mechanisms in pre-main sequence low-mass stars (M∗< 2 M⊙). Methods: We have empirically classified the sources based on their H i line profiles and decrements. We identified four Balmer decrement types (which we classified as 1, 2, 3, and 4) and three Paschen decrement types (A, B, and C), characterised by different shapes. We first discussed the connection between the decrement types and the source properties and then compared the observed decrements with predictions from recently published local line excitation models. Results: We identify a few groups of sources that display similar H i properties. One third of the objects show lines with narrow symmetric profiles, and present similar Balmer and Paschen decrements (straight decrements, types 2 and A). Lines in these sources are consistent with optically thin emission from gas with hydrogen densities of order 109 cm-3 and 5000 < T < 15 000 K. These objects are associated with low mass accretion rates. Type 4 (L-shaped) Balmer and type B Paschen decrements are found in conjunction with very wide line profiles and are characteristic of strong accretors, with optically thick emission from high-density gas (log nH > 11 cm-3). Type 1 (curved) Balmer decrements are observed only in three sub-luminous sources viewed edge-on, so we speculate that these are actually type 2 decrements that are reddened

  1. Influence of modified open lung concept ventilation on the cardiovascular and pulmonary function of horses during total intravenous anaesthesia.

    PubMed

    Bringewatt, T; Hopster, K; Kästner, S B R; Rohn, K; Ohnesorge, B

    2010-12-25

    The influence of a modified open lung concept (mOLC) on pulmonary and cardiovascular function during total intravenous anaesthesia (TIVA) in horses was evaluated. Forty-two warmblood horses (American Society of Anesthesiologists class 1 to 2), scheduled for elective surgery (mean [sd] weight 526 [65] kg, age 6.4 [5.4] years) were randomly divided into three groups: ventilation with mOLC, intermittent positive-pressure ventilation (IPPV), and spontaneous breathing. Premedication (0.8 mg/kg xylazine), induction (2.2 mg/kg ketamine and 0.05 mg/kg diazepam) and maintenance of anaesthesia with TIVA (1.4 mg/kg/hour xylazine, 5.6 mg/kg/hour ketamine and 131.1 mg/kg/hour guaifenesin), with inhalation of 35 per cent oxygen in air, were identical in all horses. Heart rate, respiratory rate, mean arterial blood pressure (MAP), pH, and arterial partial pressure of oxygen (p(a)O(2)) and carbon dioxide (p(a)CO(2)) were evaluated. Data were collected every 10 minutes from 20 to 90 minutes anaesthesia time. Factorial analysis of variance and Tukey's post hoc test were used for statistical analysis (a=5 per cent). Horses in the mOLC-ventilated group had an overall significantly higher p(a)O(2) (16.9 [1.0] v 11.7 [1.34] v 10.5 [0.57] kPa) and lower MAP (93.1 [5.47] v 107.1 [6.99] v 101.2 [5.45] mmHg) than the IPPV and spontaneously breathing groups, respectively.

  2. Usefulness of open lung biopsy in mechanically ventilated patients with undiagnosed diffuse pulmonary infiltrates: influence of comorbidities and organ dysfunction

    PubMed Central

    Lim, Seong Yong; Suh, Gee Young; Choi, Jae Chol; Koh, Won Jung; Lim, Si Young; Han, Joungho; Lee, Kyung Soo; Shim, Young Mog; Chung, Man Pyo; Kim, Hojoong; Kwon, O Jung

    2007-01-01

    Background The purpose of this study was to evaluate the clinical usefulness of open lung biopsy (OLB) in patients undergoing mechanical ventilation for diffuse pulmonary infiltrates of unknown etiology. Methods This was a 10-year retrospective study in a 10-bed medical intensive care unit. The medical records of 36 ventilator-dependent patients who underwent OLB for the diagnosis of unknown pulmonary infiltrates from 1994 to 2004 were reviewed retrospectively. Data analyzed included demographic data, Charlson age–comorbidity score, number of organ dysfunctions, Acute Physiology and Chronic Health Evaluation (APACHE) II, Simplified Acute Physiology Score (SAPS) II, Sequential Organ Failure Assessment (SOFA) score, ventilation variables, and radiological patterns. Diagnostic yield, effect on subsequent treatment changes, and complications of OLB were also assessed. Results A specific clinico-pathologic diagnosis was obtained for 31 patients (86%). The most common diagnoses were interstitial pneumonia (n = 17, including 8 acute interstitial pneumonia) and viral pneumonia (n = 4). Therapeutic modifications were made in 64% of patients. Patients who received OLB less than 1 week after initiation of mechanical ventilation were more likely to survive (63% versus 11%; P = 0.018). There were no major complications associated with the procedure. Factors independently associated with survival were the Charlson age-comorbidity score, number of organ dysfunction and the PaO2/FiO2 ratio on the day of the OLB. Conclusion OLB can provide a specific diagnosis in many ventilator-dependent patients with undiagnosed pulmonary infiltrate. Early OLB seems to be useful in critically ill patients with isolated respiratory failure. PMID:17725820

  3. The effects of deep and light propofol anesthesia on stress response in patients undergoing open lung surgery: a randomized controlled trial

    PubMed Central

    Jung, Sung Mee

    2015-01-01

    Background This prospective, randomized controlled study was undertaken to compare stress hormone response to open thoracotomy for lung resection at different anesthetic depths, as determined by bispectral index (BIS) monitoring, in patients under propofol-remifentanil anesthesia. Methods Forty-eight adult patients scheduled for lung resection surgery using one-lung ventilation were randomly assigned to either a deep anesthesia group (BIS score of 40 ± 5, n = 24) or a light anesthesia group (BIS score of 60 ± 5, n = 24) by adjusting propofol infusion rates. Blood norepinephrine, epinephrine, adrenocorticotropic hormone, and cortisol levels were measured before the induction of anesthesia, at the end of surgery, and at 2 hours postoperatively. Blood glucose, hemodynamic, and oxygenation-ventilation variables, and postoperative outcomes were also measured. Results Norepinephrine and epinephrine levels remained unchanged over time in the deep group, but norepinephrine levels significantly increased in the light group at 2 h after surgery than at baseline (P = 0.007 and 0.004, respectively). Temporal changes in norepinephrine, but not in epinephrine, were significantly different between the two groups (P = 0.036). Plasma glucose levels in the light group increased with time and were significantly higher than in the deep group at the end of surgery (P = 0.002). Conclusions A deep level of anesthesia achieved using high propofol infusion rates during lung surgery provided lower perioperative norepinephrine and glucose responses than light level of anesthesia during the early postoperative period but failed to affect immediate postoperative outcomes. PMID:26045924

  4. A randomized trial of open lung biopsy versus empiric antimicrobial therapy in cancer patients with diffuse pulmonary infiltrates.

    PubMed

    Browne, M J; Potter, D; Gress, J; Cotton, D; Hiemenz, J; Thaler, M; Hathorn, J; Brower, S; Gill, V; Glatstein, E

    1990-02-01

    Twenty-four cancer patients with diffuse interstitial pneumonitis (DIP) were randomized to undergo an open lung biopsy (OLB) within 8 hours of presentation (12 patients) or to receive empiric antimicrobial therapy (ET) with trimethoprim-sulfamethoxazole (TMP-SMX) erythromycin for a minimum of 4 days (12 patients). Patients whose condition deteriorated underwent an OLB on day 4. Eight of 12 patients (67%) having OLB survived versus 10 of 12 (83%) receiving ET (P = .64). Morbidity occurred in nine of 12 (75%) having OLB versus eight of 12 (67%) receiving ET (P = 1.0). Concurrently, there were 14 additional cancer patients with DIP who were not randomized (nine refused, three had a coagulopathy contraindicating surgery, two were excluded by primary care physicians) and who were comparable demographically to the randomized group. Two received OLB and 12 ET. Combining the randomized and nonrandomized groups, eight of 14 (57%) having an initial OLB survived versus 18 of 24 (75%) of ET-treated patients (P2 = .19). Results of the OLB were seven Pneumocystis carinii pneumonia (PCP), five nonspecific pneumonitis (NSP), one cytomegalovirus, and one lymphoma. Results of OLB led to discontinuation of antibiotics in three patients. Of the 24 ET patients, eight failed to improve by day 4 and had an OLB. Results were two NSP, two PCP, two cancer, one blastomycosis, and one Candida pneumonia. Complications were seen in 10 of 14 (72%) initial OLB patients versus 14 of 24 (58%) patients on the ET arm (P = .65). When the complication rate between patients receiving only empiric antibiotics was compared with all patients having an OLB (initially or on day 4), the difference was greater in patients undergoing OLB (37% v 72%, respectively) (P2 = .14). ET with TMP-SMX plus erythromycin and broad spectrum antibiotics in granulocytopenic patients appeared to be as successful and potentially less toxic than an OLB in this study. Although the number of patients in this study was small, these

  5. Intestinal Glycolysis Visualized by FDG PET/CT Correlates With Glucose Decrement After Gastrectomy.

    PubMed

    Ku, Cheol Ryong; Lee, Narae; Hong, Jae Won; Kwon, In Gyu; Hyung, Woo Jin; Noh, Sung Hoon; Lee, Eun Jig; Yun, Mijin; Cho, Arthur

    2017-02-01

    Gastrectomy method is known to influence glucose homeostasis. (18)F-fluoro-2-fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) images acquired after gastrectomy often reveals newly developed physiological small bowel uptake. We correlated newly developed small bowel FDG uptake and glucose homeostasis in postgastrectomy gastric cancer patients. We retrospectively analyzed 239 patients without diabetes who underwent staging and follow-up FDG PET/CT scanning before and after gastrectomy for gastric cancer. Postoperative small bowel glycolysis was quantified by recording intestinal total lesion glycolysis (TLG). TLG was assessed with regard to surgical method (Billroth I, Billroth II [BII], Roux-en-Y [RY]), fasting glucose decrement (≥10 mg/dL), and other clinical factors. Patients' weight, fasting glucose, cholesterol, TLG, and body fat levels significantly decreased after surgery. The glucose decrement was significantly associated with fasting glucose, surgical methods, total cholesterol, TLG, and total body fat on univariate analysis. Multivariate analysis showed that BII surgery (odds ratio 6.51) and TLG (odds ratio 3.17) were significantly correlated with glucose decrement. High small bowel glycolysis (TLG >42.0 g) correlated with glucose decrement in RY patients. Newly developed small bowel glycolysis on postgastrectomy FDG PET/CT scanning is correlated with a glucose decrement. These findings suggest a potential role of FDG PET/CT scanning in the evaluation of small bowel glycolysis and glucose control. © 2017 by the American Diabetes Association.

  6. Chromatic discrimination in the presence of incremental and decremental rod pedestals.

    PubMed

    Cao, Dingcai; Zele, Andrew J; Pokorny, Joel

    2008-01-01

    Signals from rods can alter chromatic discrimination. Here, chromatic discrimination ellipses were determined in the presence of rod incremental and decremental pedestals at mesopic light levels. The data were represented in a relative cone Troland space, normalized by discrimination thresholds measured along the cardinal axes without a rod pedestal. In the quadrant of cone space where L-cone relative to M-cone excitation increased, and S-cone excitation decreased, rod incremental pedestals degraded chromatic discrimination, and rod decremental pedestals improved chromatic discrimination. Discrimination in the other three quadrants of cone space was unaffected by the incremental or decremental rod pedestals. A second experiment measured chromatic discrimination under conditions where cone pedestals were matched to the appearances of the incremental and decremental rod pedestals. Based on the matching pedestal data, discrimination then could be measured independently along the cardinal axes using either chromatic [L/(L + M); S/(L + M)] or luminance (L + M) pedestal components. The discrimination data altered by the rod pedestals were similar to chromatic cone pedestals for L/M increment discrimination, but similar to luminance cone pedestals for S decrement discrimination. The results indicated that the rod and cone signals combined differently in determining chromatic discrimination for different post-receptoral pathways.

  7. Genetics Home Reference: lung cancer

    MedlinePlus

    ... Me Understand Genetics Home Health Conditions lung cancer lung cancer Enable Javascript to view the expand/collapse boxes. Download PDF Open All Close All Description Lung cancer is a disease in which certain cells ...

  8. Time-on-task decrements in "steer clear" performance of patients with sleep apnea and narcolepsy

    NASA Technical Reports Server (NTRS)

    Findley, L. J.; Suratt, P. M.; Dinges, D. F.

    1999-01-01

    Loss of attention with time-on-task reflects the increasing instability of the waking state during performance in experimentally induced sleepiness. To determine whether patients with disorders of excessive sleepiness also displayed time-on-task decrements indicative of wake state instability, visual sustained attention performance on "Steer Clear," a computerized simple RT driving simulation task, was compared among 31 patients with untreated sleep apnea, 16 patients with narcolepsy, and 14 healthy control subjects. Vigilance decrement functions were generated by analyzing the number of collisions in each of six four-minute periods of Steer Clear task performance in a mixed-model analysis of variance and linear regression equations. As expected, patients had more Steer Clear collisions than control subjects (p=0.006). However, the inter-subject variability in errors among the narcoleptic patients was four-fold that of the apnea patients, and 100-fold that of the controls volunteers; the variance in errors among untreated apnea patients was 27-times that of controls. The results of transformed collision data revealed main effects for group (p=0.006), time-on-task (p=0.001), and a significant interaction (p=0.022). Control subjects showed no clear evidence of increasing collision errors with time-on-task (adjusted R2=0.22), while apnea patients showed a trend toward vigilance decrement (adjusted R2=0.42, p=0.097), and narcolepsy patients evidenced a robust linear vigilance decrement (adjusted R2=0.87, p=0.004). The association of disorders of excessive somnolence with escalating time-on-task decrements makes it imperative that when assessment of neurobehavioral performance is conducted in patients, it involves task durations and analyses that will evaluate the underlying vulnerability of potentially sleepy patients to decrements over time in tasks that require sustained attention and timely responses, both of which are key components in safe driving performance.

  9. Rationale and study design for an individualized perioperative open lung ventilatory strategy (iPROVE): study protocol for a randomized controlled trial.

    PubMed

    Ferrando, Carlos; Soro, Marina; Canet, Jaume; Unzueta, Ma Carmen; Suárez, Fernando; Librero, Julián; Peiró, Salvador; Llombart, Alicia; Delgado, Carlos; León, Irene; Rovira, Lucas; Ramasco, Fernando; Granell, Manuel; Aldecoa, César; Diaz, Oscar; Balust, Jaume; Garutti, Ignacio; de la Matta, Manuel; Pensado, Alberto; Gonzalez, Rafael; Durán, M Eugenia; Gallego, Lucia; Del Valle, Santiago García; Redondo, Francisco J; Diaz, Pedro; Pestaña, David; Rodríguez, Aurelio; Aguirre, Javier; García, Jose M; García, Javier; Espinosa, Elena; Charco, Pedro; Navarro, Jose; Rodríguez, Clara; Tusman, Gerardo; Belda, Francisco Javier

    2015-04-27

    Postoperative pulmonary and non-pulmonary complications are common problems that increase morbidity and mortality in surgical patients, even though the incidence has decreased with the increased use of protective lung ventilation strategies. Previous trials have focused on standard strategies in the intraoperative or postoperative period, but without personalizing these strategies to suit the needs of each individual patient and without considering both these periods as a global perioperative lung-protective approach. The trial presented here aims at comparing postoperative complications when using an individualized ventilatory management strategy in the intraoperative and immediate postoperative periods with those when using a standard protective ventilation strategy in patients scheduled for major abdominal surgery. This is a comparative, prospective, multicenter, randomized, and controlled, four-arm trial that will include 1012 patients with an intermediate or high risk for postoperative pulmonary complications. The patients will be divided into four groups: (1) individualized perioperative group: intra- and postoperative individualized strategy; (2) intraoperative individualized strategy + postoperative continuous positive airway pressure (CPAP); (3) intraoperative standard ventilation + postoperative CPAP; (4) intra- and postoperative standard strategy (conventional strategy). The primary outcome is a composite analysis of postoperative complications. The Individualized Perioperative Open-lung Ventilatory Strategy (iPROVE) is the first multicenter, randomized, and controlled trial to investigate whether an individualized perioperative approach prevents postoperative pulmonary complications. Registered on 5 June 2014 with identification no. NCT02158923 .

  10. Challenges in the Detection of Working Memory and Attention Decrements Among Overweight Adolescent Girls

    PubMed Central

    Bauer, Lance O.; Manning, Kevin J.

    2016-01-01

    Background The present study is unique in employing unusually difficult attention and working memory tasks to reveal subtle cognitive decrements among overweight/obese adolescents. It evaluated novel measures of background electroencephalographic (EEG) activity during one of the tasks and tested correlations of these and other measures with psychological and psychiatric predictors of obesity maintenance or progression. Methods Working memory and sustained attention tasks were presented to 158 female adolescents who were rated on dichotomous (body mass index percentile < vs. >=85) and continuous (triceps skinfold thickness) measures of adiposity. Results The results revealed a significant association between excess adiposity and performance errors during the working memory task. During the sustained attention task, overweight/obese adolescents exhibited more EEG frontal beta power as well as greater intraindividual variability in reaction time and beta power across task periods than their normal-weight peers. Secondary analyses showed that frontal beta power during the sustained attention task was positively correlated with anxiety, panic, borderline personality features, drug abuse, and loss of control over food intake. Conclusions The findings suggest that working memory and sustained attention decrements do exist among overweight/obese adolescent girls. The reliable detection of the decrements may depend on the difficulty of the tasks as well as the manner in which performance and brain activity are measured. Future studies should examine the relevance of these decrements to diet education efforts and treatment response. PMID:26812684

  11. Impact of Decremental State Budgeting on Elementary/Secondary Education--A Case Study.

    ERIC Educational Resources Information Center

    Sederberg, Charles H.

    This study examines the results of decremental state budgeting on Minnesota elementary and secondary education during the 1981-83 biennium, a period of sudden fiscal crisis. Using the fiscal reports of various departments of Minnesota State government and interviews with state officials, the author narrates the sequence of revenue shortfalls and…

  12. The Effect of Arousal and Focused Attention on Warm-Up Decrement.

    ERIC Educational Resources Information Center

    Anshel, Mark H.; Wrisberg, Craig A.

    The resumption of skilled performance following a period of no practice is often characterized by motor activity of a lower quality than that demonstrated prior to the rest period. This phenomenon, termed warm-up decrement, is usually brief, lasting for only a few trials or minutes of postrest practice. This study attempted to determine the effect…

  13. Decrements in Human Performance During 72-84 Hours of Sustained Operations

    DTIC Science & Technology

    2006-11-01

    SUSOPS model could be used to model appropriate work/rest ratios, determine optimal feeding schedules, identify ergogenic aids , improve physical...training programs, identify appropriate manpower selection and allocation, and aid in planning for personnel replacement. Approved for public release...Severe Decrements In Cognition Function And Mood Induced By Sleep Loss, Heat, Dehydration, And Undernutrition During Simulated Combat. Biol

  14. Oxygen uptake kinetics during incremental- and decremental-ramp cycle ergometry.

    PubMed

    Ozyener, Fadil; Rossiter, Harry B; Ward, Susan A; Whipp, Brian J

    2011-01-01

    The pulmonary oxygen uptake (VO2) response to incremental-ramp cycle ergometry typically demonstrates lagged-linear first-order kinetics with a slope of ~10-11 ml·min(-1)·W(-1), both above and below the lactate threshold (θL), i.e. there is no discernible VO2 slow component (or "excess" VO2) above θL. We were interested in determining whether a reverse ramp profile would yield the same response dynamics. Ten healthy males performed a maximum incremental -ramp (15-30 W·min(-1), depending on fitness). On another day, the work rate (WR) was increased abruptly to the incremental maximum and then decremented at the same rate of 15-30 W.min(-1) (step-decremental ramp). Five subjects also performed a sub-maximal ramp-decremental test from 90% of θL. VO2 was determined breath-by-breath from continuous monitoring of respired volumes (turbine) and gas concentrations (mass spectrometer). The incremental-ramp VO2-WR slope was 10.3 ± 0.7 ml·min(-1)·W(-1), whereas that of the descending limb of the decremental ramp was 14.2 ± 1.1 ml·min(-1)·W(-1) (p < 0.005). The sub-maximal decremental-ramp slope, however, was only 9. 8 ± 0.9 ml·min(-1)·W(-1): not significantly different from that of the incremental-ramp. This suggests that the VO2 response in the supra-θL domain of incremental-ramp exercise manifest not actual, but pseudo, first-order kinetics. Key pointsThe slope of the decremental-ramp response is appreciably greater than that of the incremental.The response dynamics in supra-θL domain of the incremental-ramp appear not to manifest actual first-order kinetics.The mechanisms underlying the different dynamic response behaviour for incremental and decremental ramps are presently unclear.

  15. Further studies of bulk and orosensory decrement in producing satiation of feeding in Aplysia.

    PubMed

    Horn, C C; Geizhals, C R; Kupfermann, I

    2001-11-09

    Prior evidence has suggested that meal satiation in the marine mollusk Aplysia is associated with stretch of the crop. The current data, however, suggest that under some conditions, bulk in the crop can be dissociated from the propensity to feed. The crop was hyper-distended 6 h after a satiating meal of rehydrated seaweed; that is, the crop took in water and therefore contained a greater volume than it had contained immediately after satiation. Animals presented with food 6 h after an initial satiating meal consumed a new meal despite the fact that their crop was distended beyond the level at which they had previously terminated feeding. This unexpected result led to additional experiments designed to study possible orosensory decrement during presentation of food. Orosensory input was assessed by recording from the metacerebral cell (MCC) in free-moving animals. The MCC receives excitatory input in response to chemosensory stimulation of the lips, and exhibited a slow decrement during the course of a meal or during repeated lip stimulation without ingestion. Lesions of the cerebro-buccal connectives abolished the long-term MCC response decrement to lip stimulation. This result suggests that the MCC long-term response decrement to lip stimulation is a product of buccal-ganglion feedback and may not reflect sensory decrement of chemosensory pathways. Therefore, satiation may not produce a change in lip sensitivity to chemosensory input. Our data suggest that one important factor that determines satiation is a stretch stimulus of the posterior esophagus/anterior crop. This stretch stimulus may subside over several hours as the crop contents are redistributed or as receptors slowly adapt.

  16. Mathematical Modeling of Physical and Cognitive Performance Decrement from Mechanical and Inhalation Insults

    DTIC Science & Technology

    2006-12-01

    on specific short term problems. 1.1.1 Dynamic Physiological Modeling The oxygenation of the blood by the lung through respiration is a critical...with severe lung injuries such as pneumothorax, hemothorax , severe lung contusion. However, in order to be able to integrate the biomechanical models... on the functions of regions of lung and whole lung have to be 4 understood, which requires accurate anatomical and functional models of lung at

  17. Cognitive Decrement.

    DTIC Science & Technology

    1985-08-31

    Mark A. Archer Science Applications International Corporation P. 0. Box 1303 McLean, VA 22102-1303 31 August 1985 Technical Report CONTRACT No. DNA 001...International Corporation Defense Nuclear Agency 6c ADDRESS (City, State, and ZIP Code) 7b ADDRESS (City, State, and ZIP Code) P.O. Box 1303 Washington...UNCLASSIF IED ’ 0 , PREFACE This report was prepared by the Human Performance Technology Division of Science Applications International Corporation (SAIC

  18. Decremental propagation of reflex spikes along giant axons of the earthworm Amynthas hawayanus.

    PubMed

    Assmé, Z; Chang, Y C

    1990-01-01

    The constant-velocity conduction of an action potential evoked by stimulating the isolated nerve cord of the earthworm Amynthas hawayanus differs from the propagation of a reflex spike evoked by stimulating the epithelium of an epithelio-muscular-nerve-cord (EMNC) preparation and recorded between pairs of microelectrodes spaced every 10 segments along either giant axon. The reflex spike is decremental and lasts for no more than 20 segments before it eventually disappears. Secondary and tertiary spikes sometimes arise even before the disappearance of the primary spike, and disappear after propagating for a short distance. This decremental propagation is tentatively attributed to the summation of excitatory postsynaptic potentials from the synaptic impingings of afferent interneurons in a polysynaptic reflex arc.

  19. Impact of window decrement rate on TCP performance in an adhoc network

    NASA Astrophysics Data System (ADS)

    Suherman; Hutasuhut, Arief T. W.; Badra, Khaldun; Al-Akaidi, Marwan

    2017-09-01

    Transmission control protocol (TCP) is a reliable transport protocol handling end to end connection in TCP/IP stack. It works well in copper or optical fibre link, but experiences increasing delay in wireless network. Further, TCP experiences multiple retransmissions due to higher collision probability within wireless network. The situation may get worsen in an ad hoc network. This paper examines the impact half window or window reduction rate to the overall TCP performances. The evaluation using NS-2 simulator shows that the smaller the window decrement rate results the smaller end to end delay. Delay is reduced to 17.05% in average when window decrement rate decreases. Average jitter also decreases 4.15%, while packet loss is not affected.

  20. Improvement of decentralized random decrement technique for data processing in wireless sensor network

    NASA Astrophysics Data System (ADS)

    Liu, Chengyin; Xu, Chunchuan; Teng, Jun

    2016-09-01

    The Random Decrement Technique (RDT), based on decentralized computing approaches implemented in wireless sensor networks (WSNs), has shown advantages for modal parameter and data aggregation identification. However, previous studies of RDT-based approaches from ambient vibration data are based on the assumption of a broad-band stochastic process input excitation. The process normally is modeled by filtered white or white noise. In addition, the choice of the triggering condition in RDT is closely related to data communication. In this project, research has been conducted to study the nonstationary white noise excitations as the input to verify the random decrement technique. A local extremum triggering condition is chosen and implemented for the purpose of minimum data communication in a RDT-based distributed computing strategy. Numerical simulation results show that the proposed technique is capable of minimizing the amount of data transmitted over the network with accuracy in modal parameters identification.

  1. Illusion decrement as a function of duration of inspection and figure type.

    PubMed

    Brosvic, G M; Walker, M A; Perry, N; Degnan, S; Dihoff, R E

    1997-06-01

    Illusion decrement for the Müller-Lyer and Horizontal-Vertical illusions was examined. The experiment consisted of an initial adjustment of an illusion followed by 20 test trials, each with an intervening 60-sec. intertrial interval during which a comparator line and a standard line set to equality were visually inspected for 0, 20, 40, or 60 sec. After each intertrial interval the length of the comparator line was reset by the experimenter to either 0 or 90 cm, and subjects then adjusted its length to perceived equality with the standard line (42 cm). Illusion decrement was inversely related to the duration of inspection for each illusion, with significant reductions in magnitude of illusion observed for all groups. These results support prior demonstrations that perceptual learning mechanisms are operative during brief periods of visual inspection, especially when these periods are followed by the opportunity to make repeated adjustments.

  2. Antegrade and retrograde decremental conduction properties of an accessory pathway associated with the coronary sinus musculature.

    PubMed

    Nakamura, Kohki; Naito, Shigeto; Kaseno, Kenichi; Oshima, Shigeru

    2015-01-01

    A 32-year-old man underwent catheter ablation of an orthodromic atrioventricular reentrant tachycardia. The sinus rhythm electrocardiogram exhibited a normal PQ interval and no delta waves, but atrial pacing produced a prolonged PQ interval and wide QRS morphology with right bundle-branch block due to antegrade accessory pathway (AP) conduction. During the tachycardia, atrial double potentials consisting of the coronary sinus musculature (CSM) and left atrial (LA) potentials were observed. Ventricular extrastimulation exhibited retrograde decremental conduction with an identical atrial activation sequence as during the tachycardia. A radiofrequency application within the posterolateral CS during ventricular pacing eliminated the CSM-LA conduction and concomitantly the ventriculoatrial conduction via the AP was abolished. In this case, the CSM was associated with the bidirectional decremental conduction properties of the AP, and the antegrade slow conduction resulted in the absence of a shortening of the PQ interval and delta waves during sinus rhythm despite the continuous presence of antegrade AP conduction.

  3. Detection of ‘best’ positive end-expiratory pressure derived from electrical impedance tomography parameters during a decremental positive end-expiratory pressure trial

    PubMed Central

    2014-01-01

    Introduction This study compares different parameters derived from electrical impedance tomography (EIT) data to define ‘best’ positive end-expiratory pressure (PEEP) during a decremental PEEP trial in mechanically-ventilated patients. ‘Best’ PEEP is regarded as minimal lung collapse and overdistention in order to prevent ventilator-induced lung injury. Methods A decremental PEEP trial (from 15 to 0 cm H2O PEEP in 4 steps) was performed in 12 post-cardiac surgery patients on the ICU. At each PEEP step, EIT measurements were performed and from this data the following were calculated: tidal impedance variation (TIV), regional compliance, ventilation surface area (VSA), center of ventilation (COV), regional ventilation delay (RVD index), global inhomogeneity (GI index), and intratidal gas distribution. From the latter parameter we developed the ITV index as a new homogeneity parameter. The EIT parameters were compared with dynamic compliance and the PaO2/FiO2 ratio. Results Dynamic compliance and the PaO2/FiO2 ratio had the highest value at 10 and 15 cm H2O PEEP, respectively. TIV, regional compliance and VSA had a maximum value at 5 cm H2O PEEP for the non-dependent lung region and a maximal value at 15 cm H2O PEEP for the dependent lung region. GI index showed the lowest value at 10 cm H2O PEEP, whereas for COV and the RVD index this was at 15 cm H2O PEEP. The intratidal gas distribution showed an equal contribution of both lung regions at a specific PEEP level in each patient. Conclusion In post-cardiac surgery patients, the ITV index was comparable with dynamic compliance to indicate ‘best’ PEEP. The ITV index can visualize the PEEP level at which ventilation of the non-dependent region is diminished, indicating overdistention. Additional studies should test whether application of this specific PEEP level leads to better outcome and also confirm these results in patients with acute respiratory distress syndrome. PMID:24887391

  4. Chlorpheniramine as a Prophylaxis to Radiation-Induced Performance Decrement in the Monkey

    DTIC Science & Technology

    The effectiveness of the antihistamine chlorpheniramine maleate in preventing the early performance decrement in monkeys following a supralethal dose... chlorpheniramine and were performance tested 24 hours prior to irradiation. These five animals and 10 additional animals were then injected with 10 mg of... chlorpheniramine at 60 minutes and at 30 minutes before irradiation. The monkeys were tested and their performance was recorded for 2 hours following a 4000

  5. Critical Review of Selected Components of RIPD (Radiation-Induced Performance Decrement)

    DTIC Science & Technology

    2012-12-01

    consideration both the prompt gamma and the neutron exposures that would be expected after a nuclear detonation. Since RIPD was designed for...performance decrement; • incidence of lethality; • time to lethality. The RIPD model applies to whole–body exposures to gamma rays and/or neutrons ...exposures to gamma rays and/or neutrons ; dose–rate histories can be complex and the exposure period can be as long as one week. RIPD estimates severity

  6. On-line failure detection and damping measurement of aerospace structures by random decrement signatures

    NASA Technical Reports Server (NTRS)

    Cole, H. A., Jr.

    1973-01-01

    Random decrement signatures of structures vibrating in a random environment are studied through use of computer-generated and experimental data. Statistical properties obtained indicate that these signatures are stable in form and scale and hence, should have wide application in one-line failure detection and damping measurement. On-line procedures are described and equations for estimating record-length requirements to obtain signatures of a prescribed precision are given.

  7. Temperature after Arc Discharge Affected by Current Decrement Ratio in Wall Stabilized Arc

    NASA Astrophysics Data System (ADS)

    Sato, Ken; Suzuki, Daichi; Iwao, Toru

    2015-11-01

    Recently, the stable supply of electric power is indispensable in a power generation, and a transmission and distribution system of electric power. The GCB (Gas Circuit Breaker) has been researched for performance improvement of the arc interruption of abnormal fault current without the fail. The GCB has been researched for the high capacity and downsizing for development of practical use. Because the power network is expanded, the capacity of interruption current increased for reliability. The GCB should interrupt the arc of high current and voltage, shorten the time to interrupt, and become the high capability in order to improve the reliability and practicability. It is important to prevent the insulation of re-ignition and thermal re-ignition of arc after the arc interruption. It is mainly considered that the factor of thermal re-ignition is the arc temperature distribution after current zero. The temperature distribution has been elucidated by the current decrement ratio (di/dt). However, the variation of temperature distribution and decrement process of the temperature by the wall radius is also important in order to design the circuit breaker. In this paper, temperature after Arc Discharge Affected by Current Decrement Ratio in Wall Stabilized Arc was elucidated in order to know the effect on the temperature in the wall radius. As a result, when the wall radius decreases, the temperature at 0 A after 200 μs is lower.

  8. Life span decrements in fluid intelligence and processing speed predict mortality risk.

    PubMed

    Aichele, Stephen; Rabbitt, Patrick; Ghisletta, Paolo

    2015-09-01

    We examined life span changes in 5 domains of cognitive performance as predictive of mortality risk. Data came from the Manchester Longitudinal Study of Cognition, a 20-plus-year investigation of 6,203 individuals ages 42-97 years. Cognitive domains were general crystallized intelligence, general fluid intelligence, verbal memory, visuospatial memory, and processing speed. Life span decrements were evident across these domains, controlling for baseline performance at age 70 and adjusting for retest effects. Survival analyses stratified by sex and conducted independently by cognitive domain showed that lower baseline performance levels in all domains-and larger life span decrements in general fluid intelligence and processing speed-were predictive of increased mortality risk for both women and men. Critically, analyses of the combined predictive power of cognitive performance variables showed that baseline levels of processing speed (in women) and general fluid intelligence (in men), and decrements in processing speed (in women and in men) and general fluid intelligence (in women), accounted for most of the explained variation in mortality risk. In light of recent evidence from brain-imaging studies, we speculate that cognitive abilities closely linked to cerebral white matter integrity (such as processing speed and general fluid intelligence) may represent particularly sensitive markers of mortality risk. In addition, we presume that greater complexity in cognition-survival associations observed in women (in analyses incorporating all cognitive predictors) may be a consequence of longer and more variable cognitive declines in women relative to men.

  9. Lung cancer diagnosis and staging with endobronchial ultrasound-guided transbronchial needle aspiration compared with conventional approaches: an open-label, pragmatic, randomised controlled trial

    PubMed Central

    Navani, Neal; Nankivell, Matthew; Lawrence, David R; Lock, Sara; Makker, Himender; Baldwin, David R; Stephens, Richard J; Parmar, Mahesh K; Spiro, Stephen G; Morris, Stephen; Janes, Sam M

    2015-01-01

    Summary Background The diagnosis and staging of lung cancer is an important process that identifies treatment options and guides disease prognosis. We aimed to assess endobronchial ultrasound-guided transbronchial needle aspiration as an initial investigation technique for patients with suspected lung cancer. Methods In this open-label, multicentre, pragmatic, randomised controlled trial, we recruited patients who had undergone a CT scan and had suspected stage I to IIIA lung cancer, from six UK centres and randomly assigned them to either endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) or conventional diagnosis and staging (CDS), for further investigation and staging. If a target node could not be accessed by EBUS-TBNA, then endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) was allowed as an alternative procedure. Randomisation was stratified according to the presence of mediastinal lymph nodes measuring 1 cm or more in the short axis and by recruiting centre. We used a telephone randomisation method with permuted blocks of four generated by a computer. Because of the nature of the intervention, masking of participants and consenting investigators was not possible. The primary endpoint was the time-to-treatment decision after completion of the diagnostic and staging investigations and analysis was by intention-to-diagnose. This trial is registered with ClinicalTrials.gov, number NCT00652769. Findings Between June 10, 2008, and July 4, 2011, we randomly allocated 133 patients to treatment: 66 to EBUS-TBNA and 67 to CDS (one later withdrew consent). Two patients from the EBUS-TBNA group underwent EUS-FNA. The median time to treatment decision was shorter with EBUS-TBNA (14 days; 95% CI 14–15) than with CDS (29 days; 23–35) resulting in a hazard ratio of 1·98, (1·39–2·82, p<0·0001). One patient in each group had a pneumothorax from a CT-guided biopsy sample; the patient from the CDS group needed intercostal drainage

  10. Hot and Hypoxic Environments Inhibit Simulated Soccer Performance and Exacerbate Performance Decrements When Combined

    PubMed Central

    Aldous, Jeffrey W. F.; Chrismas, Bryna C. R.; Akubat, Ibrahim; Dascombe, Ben; Abt, Grant; Taylor, Lee

    2016-01-01

    The effects of heat and/or hypoxia have been well-documented in match-play data. However, large match-to-match variation for key physical performance measures makes environmental inferences difficult to ascertain from soccer match-play. Therefore, the present study aims to investigate the hot (HOT), hypoxic (HYP), and hot-hypoxic (HH) mediated-decrements during a non-motorized treadmill based soccer-specific simulation. Twelve male University soccer players completed three familiarization sessions and four randomized crossover experimental trials of the intermittent Soccer Performance Test (iSPT) in normoxic-temperate (CON: 18°C 50% rH), HOT (30°C; 50% rH), HYP (1000 m; 18°C 50% rH), and HH (1000 m; 30°C; 50% rH). Physical performance and its performance decrements, body temperatures (rectal, skin, and estimated muscle temperature), heart rate (HR), arterial blood oxygen saturation (SaO2), perceived exertion, thermal sensation (TS), body mass changes, blood lactate, and plasma volume were all measured. Performance decrements were similar in HOT and HYP [Total Distance (−4%), High-speed distance (~−8%), and variable run distance (~−12%) covered] and exacerbated in HH [total distance (−9%), high-speed distance (−15%), and variable run distance (−15%)] compared to CON. Peak sprint speed, was 4% greater in HOT compared with CON and HYP and 7% greater in HH. Sprint distance covered was unchanged (p > 0.05) in HOT and HYP and only decreased in HH (−8%) compared with CON. Body mass (−2%), temperatures (+2–5%), and TS (+18%) were altered in HOT. Furthermore, SaO2 (−8%) and HR (+3%) were changed in HYP. Similar changes in body mass and temperatures, HR, TS, and SaO2 were evident in HH to HOT and HYP, however, blood lactate (p < 0.001) and plasma volume (p < 0.001) were only significantly altered in HH. Perceived exertion was elevated (p < 0.05) by 7% in all conditions compared with CON. Regression analysis identified that absolute TS and absolute

  11. Hot and Hypoxic Environments Inhibit Simulated Soccer Performance and Exacerbate Performance Decrements When Combined.

    PubMed

    Aldous, Jeffrey W F; Chrismas, Bryna C R; Akubat, Ibrahim; Dascombe, Ben; Abt, Grant; Taylor, Lee

    2015-01-01

    The effects of heat and/or hypoxia have been well-documented in match-play data. However, large match-to-match variation for key physical performance measures makes environmental inferences difficult to ascertain from soccer match-play. Therefore, the present study aims to investigate the hot (HOT), hypoxic (HYP), and hot-hypoxic (HH) mediated-decrements during a non-motorized treadmill based soccer-specific simulation. Twelve male University soccer players completed three familiarization sessions and four randomized crossover experimental trials of the intermittent Soccer Performance Test (iSPT) in normoxic-temperate (CON: 18°C 50% rH), HOT (30°C; 50% rH), HYP (1000 m; 18°C 50% rH), and HH (1000 m; 30°C; 50% rH). Physical performance and its performance decrements, body temperatures (rectal, skin, and estimated muscle temperature), heart rate (HR), arterial blood oxygen saturation (SaO2), perceived exertion, thermal sensation (TS), body mass changes, blood lactate, and plasma volume were all measured. Performance decrements were similar in HOT and HYP [Total Distance (-4%), High-speed distance (~-8%), and variable run distance (~-12%) covered] and exacerbated in HH [total distance (-9%), high-speed distance (-15%), and variable run distance (-15%)] compared to CON. Peak sprint speed, was 4% greater in HOT compared with CON and HYP and 7% greater in HH. Sprint distance covered was unchanged (p > 0.05) in HOT and HYP and only decreased in HH (-8%) compared with CON. Body mass (-2%), temperatures (+2-5%), and TS (+18%) were altered in HOT. Furthermore, SaO2 (-8%) and HR (+3%) were changed in HYP. Similar changes in body mass and temperatures, HR, TS, and SaO2 were evident in HH to HOT and HYP, however, blood lactate (p < 0.001) and plasma volume (p < 0.001) were only significantly altered in HH. Perceived exertion was elevated (p < 0.05) by 7% in all conditions compared with CON. Regression analysis identified that absolute TS and absolute rise in skin and

  12. Afatinib versus erlotinib as second-line treatment of patients with advanced squamous cell carcinoma of the lung (LUX-Lung 8): an open-label randomised controlled phase 3 trial.

    PubMed

    Soria, Jean-Charles; Felip, Enriqueta; Cobo, Manuel; Lu, Shun; Syrigos, Konstantinos; Lee, Ki Hyeong; Göker, Erdem; Georgoulias, Vassilis; Li, Wei; Isla, Dolores; Guclu, Salih Z; Morabito, Alessandro; Min, Young J; Ardizzoni, Andrea; Gadgeel, Shirish M; Wang, Bushi; Chand, Vikram K; Goss, Glenwood D

    2015-08-01

    There is a major unmet need for effective treatments in patients with squamous cell carcinoma of the lung. LUX-Lung 8 compared afatinib (an irreversible ErbB family blocker) with erlotinib (a reversible EGFR tyrosine kinase inhibitor), as second-line treatment for patients with advanced squamous cell carcinoma of the lung. We did this open-label, phase 3 randomised controlled trial at 183 cancer centres in 23 countries worldwide. We enrolled adults with stage IIIB or IV squamous cell carcinoma of the lung who had progressed after at least four cycles of platinum-based-chemotherapy. Participants were randomly assigned (1:1) to receive afatinib (40 mg per day) or erlotinib (150 mg per day) until disease progression. The randomisation was done centrally with an interactive voice or web-based response system and stratified by ethnic origin (eastern Asian vs non-eastern Asian). Clinicians and patients were not masked to treatment allocation. The primary endpoint was progression-free survival assessed by independent central review (intention-to-treat population). The key secondary endpoint was overall survival. This trial is registered with ClinicalTrials.gov, NCT01523587. 795 eligible patients were randomly assigned (398 to afatinib, 397 to erlotinib). Median follow-up at the time of the primary analysis of progression-free survival was 6·7 months (IQR 3·1-10·2), at which point enrolment was not complete. Progression free-survival at the primary analysis was significantly longer with afatinib than with erlotinib (median 2·4 months [95% CI 1·9-2·9] vs 1·9 months [1·9-2·2]; hazard ratio [HR] 0·82 [95% CI 0·68-1·00], p=0·0427). At the time of the primary analysis of overall survival (median follow-up 18·4 months [IQR 13·8-22·4]), overall survival was significantly greater in the afatinib group than in the erloinib group (median 7·9 months [95% CI 7·2-8·7] vs 6·8 months [5·9-7·8]; HR 0·81 [95% CI 0·69-0·95], p=0·0077), as were progression

  13. TLR4 Signaling Is Coupled to SRC Family Kinase Activation, Tyrosine Phosphorylation of Zonula Adherens Proteins, and Opening of the Paracellular Pathway in Human Lung Microvascular Endothelia*

    PubMed Central

    Gong, Ping; Angelini, Daniel J.; Yang, Shiqi; Xia, Guanjun; Cross, Alan S.; Mann, Dean; Bannerman, Douglas D.; Vogel, Stefanie N.; Goldblum, Simeon E.

    2008-01-01

    Bacterial lipopolysaccharide (LPS) is a key mediator in the vascular leak syndromes associated with Gram-negative bacterial infections. LPS opens the paracellular pathway in pulmonary vascular endothelia through protein tyrosine phosphorylation. We now have identified the protein-tyrosine kinases (PTKs) and their substrates required for LPS-induced protein tyrosine phosphorylation and opening of the paracellular pathway in human lung microvascular endothelial cells (HMVEC-Ls). LPS disrupted barrier integrity in a dose- and time-dependent manner, and prior broad spectrum PTK inhibition was protective. LPS increased tyrosine phosphorylation of zonula adherens proteins, VE-cadherin, γ-catenin, and p120ctn. Two SRC family PTK (SFK)-selective inhibitors, PP2 and SU6656, blocked LPS-induced increments in tyrosine phosphorylation of VE-cadherin and p120ctn and paracellular permeability. In HMVEC-Ls, c-SRC, YES, FYN, and LYN were expressed at both mRNA and protein levels. Selective small interfering RNA-induced knockdown of c-SRC, FYN, or YES diminished LPS-induced SRC Tyr416 phosphorylation, tyrosine phosphorylation of VE-cadherin and p120ctn, and barrier disruption, whereas knockdown of LYN did not. For VE-cadherin phosphorylation, knockdown of either c-SRC or FYN provided total protection, whereas YES knockdown was only partially protective. For p120ctn phosphorylation, knockdown of FYN, c-SRC, or YES each provided comparable but partial protection. Toll-like receptor 4 (TLR4) was expressed both on the surface and intracellular compartment of HMVEC-Ls. Prior knockdown of TLR4 blocked both LPS-induced SFK activation and barrier disruption. These data indicate that LPS recognition by TLR4 activates the SFKs, c-SRC, FYN, and YES, which, in turn, contribute to tyrosine phosphorylation of zonula adherens proteins to open the endothelial paracellular pathway. PMID:18326860

  14. A Phase Ib Open-Label Multicenter Study of AZD4547 in Patients with Advanced Squamous Cell Lung Cancers.

    PubMed

    Paik, Paul K; Shen, Ronglai; Berger, Michael F; Ferry, David; Soria, Jean-Charles; Mathewson, Alastair; Rooney, Claire; Smith, Neil R; Cullberg, Marie; Kilgour, Elaine; Landers, Donal; Frewer, Paul; Brooks, Nigel; André, Fabrice

    2017-09-15

    Purpose: Squamous cell lung cancers (SQCLC) account for 25% of all NSCLCs, yet the prognosis of these patients is poor and treatment options are limited. Amplified FGFR1 is one of the most common oncogenic events in SQCLCs, occurring in approximately 20% of cases. AZD4547 is a potent and selective FGFR1-3 inhibitor with antitumor activity in FGFR1-amplified SQCLC cell lines and patient-derived xenografts.Experimental Design: On the basis of these data, we performed a phase I study of AZD4547 in patients with previously treated stage IV FGFR1-amplified SQCLCs (NCT00979134). FGFR1 amplification (FGFR1:CEP8 ≥ 2) was determined by FISH. The primary endpoint was safety/tolerability. Secondary endpoints included antitumor activity, pharmacokinetics, pharmacodynamics, and molecular analyses.Results: Fifteen FGFR1-amplified patients were treated. The most common related adverse events (AE) were gastrointestinal and dermatologic. Grade ≥3-related AEs occurred in 3 patients (23%). Thirteen patients were evaluable for radiographic response assessment. The overall response rate was 8% (1 PR). Two of 15 patients (13.3%) were progression-free at 12 weeks, and the median overall survival was 4.9 months. Molecular tests, including next-generation sequencing, gene expression analysis, and FGFR1 immunohistochemistry, showed poor correlation between gene amplification and expression, potential genomic modifiers of efficacy, and heterogeneity in 8p11 amplicon.Conclusions: AZD4547 was tolerable at a dosage of 80 mg oral twice a day, with modest antitumor activity. Detailed molecular studies show that these tumors are heterogeneous, with a range of mutational covariates and stark differences in gene expression of the 8p11 amplicon that likely explain the modest efficacy of FGFR inhibition in this disease. Clin Cancer Res; 23(18); 5366-73. ©2017 AACR. ©2017 American Association for Cancer Research.

  15. Nimotuzumab plus chemotherapy versus chemotherapy alone in advanced non-small-cell lung cancer: a multicenter, randomized, open-label Phase II study.

    PubMed

    Babu, K Govind; Prabhash, Kumar; Vaid, Ashok K; Sirohi, Bhawna; Diwakar, Ravi B; Rao, Raghunadha; Kar, Madhuchanda; Malhotra, Hemant; Nag, Shona; Goswami, Chanchal; Raina, Vinod; Mohan, Ravi

    2014-01-01

    The purpose of this study was to evaluate the safety and efficacy of nimotuzumab in combination with chemotherapy (docetaxel and carboplatin) versus chemotherapy alone in patients with stage IIIB/IV non-small-cell lung cancer. This multicenter, open-label, Phase II study randomized 110 patients to receive nimotuzumab plus chemotherapy (nimotuzumab group) or chemotherapy alone (control group), and comprised concomitant, maintenance, and follow-up phases. Nimotuzumab 200 mg was administered once weekly for 13 weeks during the first two phases with four cycles of chemotherapy and docetaxel 75 mg/m(2) and carboplatin (area under the curve 5 mg/mL*min) every 3 weeks for a maximum of four cycles during the concomitant phase. The primary endpoint was objective response rate (sum of complete response and partial response). Secondary endpoints, ie, overall survival and progression-free survival, were estimated using the Kaplan-Meier method. Efficacy was evaluated on the intent-to-treat and efficacy-evaluable sets. Safety was assessed from adverse event and serious adverse event data. The objective response rate was significantly higher in the nimotuzumab group than in the control group in the intent-to-treat population (54% versus 34.5%; P=0.04). A complete response and partial response were achieved in 3.6% and 50% of patients, respectively, in the nimotuzumab group, and in 4% and 30.9% of patients, respectively, in the control group. No significant differences in median progression-free survival and overall survival were observed. Safety profiles were comparable between the two groups. Nimotuzumab plus chemotherapy significantly improved the objective response rate as compared with chemotherapy alone. The combination was safe and well tolerated in patients with stage IIIB/IV non-small-cell lung cancer.

  16. Nimotuzumab plus chemotherapy versus chemotherapy alone in advanced non-small-cell lung cancer: a multicenter, randomized, open-label Phase II study

    PubMed Central

    Babu, K Govind; Prabhash, Kumar; Vaid, Ashok K; Sirohi, Bhawna; Diwakar, Ravi B; Rao, Raghunadha; Kar, Madhuchanda; Malhotra, Hemant; Nag, Shona; Goswami, Chanchal; Raina, Vinod; Mohan, Ravi

    2014-01-01

    Background The purpose of this study was to evaluate the safety and efficacy of nimotuzumab in combination with chemotherapy (docetaxel and carboplatin) versus chemotherapy alone in patients with stage IIIB/IV non-small-cell lung cancer. Methods This multicenter, open-label, Phase II study randomized 110 patients to receive nimotuzumab plus chemotherapy (nimotuzumab group) or chemotherapy alone (control group), and comprised concomitant, maintenance, and follow-up phases. Nimotuzumab 200 mg was administered once weekly for 13 weeks during the first two phases with four cycles of chemotherapy and docetaxel 75 mg/m2 and carboplatin (area under the curve 5 mg/mL*min) every 3 weeks for a maximum of four cycles during the concomitant phase. The primary endpoint was objective response rate (sum of complete response and partial response). Secondary endpoints, ie, overall survival and progression-free survival, were estimated using the Kaplan–Meier method. Efficacy was evaluated on the intent-to-treat and efficacy-evaluable sets. Safety was assessed from adverse event and serious adverse event data. Results The objective response rate was significantly higher in the nimotuzumab group than in the control group in the intent-to-treat population (54% versus 34.5%; P=0.04). A complete response and partial response were achieved in 3.6% and 50% of patients, respectively, in the nimotuzumab group, and in 4% and 30.9% of patients, respectively, in the control group. No significant differences in median progression-free survival and overall survival were observed. Safety profiles were comparable between the two groups. Conclusion Nimotuzumab plus chemotherapy significantly improved the objective response rate as compared with chemotherapy alone. The combination was safe and well tolerated in patients with stage IIIB/IV non-small-cell lung cancer. PMID:24966687

  17. A system identification technique based on the random decrement signatures. Part 1: Theory and simulation

    NASA Technical Reports Server (NTRS)

    Bedewi, Nabih E.; Yang, Jackson C. S.

    1987-01-01

    Identification of the system parameters of a randomly excited structure may be treated using a variety of statistical techniques. Of all these techniques, the Random Decrement is unique in that it provides the homogeneous component of the system response. Using this quality, a system identification technique was developed based on a least-squares fit of the signatures to estimate the mass, damping, and stiffness matrices of a linear randomly excited system. The mathematics of the technique is presented in addition to the results of computer simulations conducted to demonstrate the prediction of the response of the system and the random forcing function initially introduced to excite the system.

  18. A decrement in probabilistic category learning in cocaine users after controlling for marijuana and alcohol use.

    PubMed

    Vadhan, Nehal P; Myers, Catherine E; Benedict, Elysia; Rubin, Eric; Foltin, Richard W; Gluck, Mark A

    2014-02-01

    Aspects of stimulus-response (S-R) learning, mediated by striatal dopamine signaling, have been found to be altered in cocaine users relative to healthy controls. However, the influence of cocaine users' marijuana and alcohol use has not been accounted for. This study evaluated S-R learning and other neurocognitive functions in cocaine users while controlling for the relative influences of marijuana and alcohol use. Twenty-five long-term cocaine users and 2 control groups (25 moderate marijuana and alcohol users and 23 healthy controls) completed a computerized assessment of probabilistic category learning (the Weather Prediction task), as well as measures of equivalence learning, declarative learning, and executive, attentional, and motor function. Cocaine users exhibited decreased performance on the Weather Prediction task, as well as measures of declarative learning, attention, and motor function (p < 0.05), relative to both control groups. Cocaine users exhibited decrements in probabilistic category learning, declarative recall, and attentional and motor function, compared with both marijuana and alcohol users and nondrug users. Therefore, these decrements appear to be specifically related to the cocaine use, but not the moderate marijuana and alcohol use, of long-term cocaine users.

  19. Indomethacin pretreatment reduces ozone-induced pulmonary function decrements in human subjects

    SciTech Connect

    Schelegle, E.S.; Adams, W.C.; Siefkin, A.D.

    1987-12-01

    We studied whether O/sub 3/-induced pulmonary function decrements could be inhibited by the prostaglandin synthetase inhibitor, indomethacin, in healthy human subjects. Fourteen college-age males completed six 1-h exposure protocols consisting of no drug, placebo, and indomethacin (Indocin SR 75 mg every 12 h for 5 days) pretreatments, with filtered air and O/sub 3/ (0.35 ppm) exposures within each pretreatment. Pretreatments were delivered weekly in random order in a double-blind fashion. Ozone and filtered air exposures, separated by 72 h, were delivered in random order in a single-blind fashion. Exposures consisted of 1-h exercise on a bicycle ergometer with work loads set to elicit a mean minute ventilation of 60 L/min. Statistical analysis revealed significant (p less than 0.05) across pretreatment effects for FVC and FEV1, with no drug versus indomethacin and placebo versus indomethacin comparisons being significant. These findings suggest that cyclooxygenase products of arachidonic acid, which are sensitive to indomethacin inhibition, play a prominent role in the development of pulmonary function decrements consequent to acute O/sub 3/ exposure.

  20. Relationship between Mean Airways Pressure, Lung Mechanics, and Right Ventricular Output during High-Frequency Oscillatory Ventilation in Infants.

    PubMed

    Zannin, Emanuela; Doni, Daniela; Ventura, Maria Luisa; Fedeli, Tiziana; Rigotti, Camilla; Dellacá, Raffaele L; Tagliabue, Paolo E

    2017-01-01

    To characterize changes in lung mechanics and right ventricular output (RVO) during incremental/decremental continuous distending pressure (CDP) maneuvers in newborn infants receiving high-frequency oscillatory ventilation, with the aim of evaluating when open lung maneuvers are needed and whether they are beneficial. Thirteen infants on high-frequency oscillatory ventilation were studied with a median (IQR) gestational age of 26(1) (25(3)-29(1)) weeks and median (IQR) body weight of 810 (600-1020) g. CDP was increased stepwise from 8 cmH2O to a maximum pressure and subsequently decreased until oxygenation deteriorated or a CDP of 8 cmH2O was reached. The lowest CDP that maintained good oxygenation was considered the clinically optimal CDP. At each CDP, the following variables were evaluated: oxygenation, respiratory system reactance (Xrs), and RVO by Doppler echocardiography. At maximal CDP reached during the trial, 19 [1] cmH2O (mean [SEM]), oxygenation markedly improved, and Xrs and RVO decreased. During deflation, oxygenation remained stable over a wide range of CDP settings, Xrs returned to the baseline values, and RVO increased but the baseline values were not readily restored in all patients. These results suggest that Xrs and RVO are more sensitive than oxygenation to overdistension and they may be useful in clinical practice to guide open lung maneuvers. Copyright © 2016 Elsevier Inc. All rights reserved.

  1. Parameter-specific modulation of the mismatch negativity to duration decrement and increment: evidence for asymmetric processes.

    PubMed

    Takegata, Rika; Tervaniemi, Mari; Alku, Paavo; Ylinen, Sari; Näätänen, Risto

    2008-07-01

    The mismatch negativity (MMN) component of event-related potentials (ERPs) reflects a change-detection process in the brain. The present study investigated whether stimulus parameters (sound type and duration) exert a differential influence on the MMN for a duration decrement and increment of an equal magnitude. Some asymmetries were reported in the previous studies; yet no systematical study has been conducted. ERPs were recorded from 16 healthy adults presented with repetitive standard sounds interspersed with duration changes (deviant sounds). In separate sequences, stimuli were vowels, music chord, sinusoid, or band-pass filtered white noise. The stimulus durations (standard/deviant) were either 200/120 ms or 400/240 ms for decrements, and vice versa for increments. The MMN for the increments was abolished in the 400/240 ms condition, whereas the MMN for decrements was significant irrespective of the sound duration. The amplitude of the increment MMN paralleled with the spectral complexity of the stimulus sound, whereas that of the decrement MMN was larger for natural sounds than artificial sounds. The observed interactions demonstrated asymmetries in the MMN for duration increment and decrement. The present findings suggest that the effects of stimulus parameters should be taken into account when comparing different studies, especially where clinical populations are involved, with one another.

  2. Vigilance decrement during the on-the-road driving tests: the importance of time-on-task in psychopharmacological research.

    PubMed

    Verster, Joris C; Roth, Thomas

    2013-09-01

    Time dependent decrements in performance are characteristic of activities that are monotonous and require focused attention for an extended period of time. A vigilance task is a task that participants can perform without difficulty for a short period of time, but with time their performance becomes impaired. A real world example of such a vigilance task is prolonged highway driving. The on-the-road driving test in normal traffic was specifically designed to measure the effects of vigilance decrement associated with driving. The primary parameter of this test is the Standard Deviation of Lateral Position (SDLP), i.e. the weaving of the car. This methodological paper explains the typical vigilance decrement seen in the on-the-road driving test and discusses the importance of sufficient time-on-task to elucidate potential adverse drug effects on driving. Performance decrements (SDLP increment) as a function of time are seen after both drug and placebo treatment, following a similar pattern over distance/time traveled. However, whereas for some drugs SDLP differences between drug and placebo are constant, other drugs produce additional performance decrement that increases over distance traveled. It is concluded that driving tests of short duration (e.g. less than half an hour) may fail to detect drug-related impairment, because participants are capable of, at least in part, counteracting the impairment by increased effort and motivation to perform the test. Copyright © 2012 Elsevier Ltd. All rights reserved.

  3. Estimating the ride quality characteristics of vehicles with random decrement analysis of on-the-road vibration response data

    NASA Astrophysics Data System (ADS)

    Ainalis, Daniel; Rouillard, Vincent; Sek, Michael

    2016-06-01

    This paper describes the application of a practical analytical technique based on the random decrement method to estimate the rigid sprung mass dynamic characteristics (frequency response function) of road vehicles using only vibration response data during constant-speed operation. A brief history and development of the random decrement technique is presented, along with a summary of work undertaken on optimal parameter selection to establish the random decrement signature. Two approaches to estimate the dynamic characteristics from the random decrement signature are described and evaluated. A custom, single-wheeled vehicle (physical quarter car) was commissioned to undertake a series of on-the-road experiments at various nominally constant operating speeds. The vehicle, also instrumented as an inertial profilometer, simultaneously measured the longitudinal pavement profile to establish the vehicle's actual dynamic characteristics during operation. The main outcome of the paper is that the random decrement technique can be used to provide accurate estimates of the sprung mass mode of the vehicle's dynamic characteristics for both linear and nonlinear suspension systems of an idealised vehicle.

  4. Dabrafenib in BRAF V600E–Mutant Advanced Non-Small Cell Lung Cancer: an Open-label, Single arm, Multicenter, Phase 2 Trial

    PubMed Central

    Planchard, David; Kim, Tae Min; Mazieres, Julien; Quoix, Elisabeth; Riely, Gregory; Barlesi, Fabrice; Souquet, Pierre-John; Smit, Egbert F.; Groen, Harry J. M.; Kelly, Ronan J.; Cho, B. C.; Socinski, Mark A.; Pandite, Lini; Nase, Christine; Ma, Bo; D’Amelio, Anthony; Mookerjee, Bijoyesh; Curtis, C. Martin; Johnson, Bruce E.

    2016-01-01

    Background Activating BRAF V600E mutations are found in approximately 1–2% of adenocarcinomas of the lung offering an opportunity to test targeted therapy for this disease. Dabrafenib is an oral selective inhibitor of the BRAF kinase. The aim of this study was to assess the clinical activity of dabrafenib in patients with advanced BRAF V600E-mutant non-small cell lung cancer (NSCLC). Methods In this phase 2, multicenter, nonrandomized, open-label study of previously treated and untreated patients with stage IV, metastatic NSCLC and BRAF V600E mutation, we evaluated the antitumor activity and safety of oral dabrafenib (150 mg twice daily). The primary endpoint was investigator-assessed overall response rate (ORR) in patients receiving ≥ 1 dose of study drug. Safety analysis was performed on the all-treated population (all previously treated and untreated patients receiving ≥ 1 dose of study drug). The study is ongoing but not enrolling participants in this cohort. This trial is registered with ClinicalTrials.gov, number NCT01336634. Findings Between August 2011 and February 2014 a total of 84 previously treated and untreated patients were enrolled. Investigator-assessed ORR for 78 pretreated patients was 33% (95% confidence interval [CI], 23·1 to 44·9). Independent review committee assessment of ORR was consistent with investigator-based assessment. Four of the six previously untreated patients had an objective response. One patient died on study due to intracranial hemorrhage that was considered by the investigator to be due to study drug. Serious adverse events were reported in 35 (42%) of 84 patients. The most frequent grade 3 or higher adverse events were cutaneous squamous cell carcinoma (10 [12%] of 84 patients), asthenia (4 [5%] of 84 patients), and basal cell carcinoma (4 [5%] of 84 patients). Interpretation This is, to our knowledge, the first prospective trial focusing on BRAF V600E-mutant NSCLC to show clinical activity of a BRAF inhibitor. The

  5. Early decrements in bone density after completion of neoadjuvant chemotherapy in pediatric bone sarcoma patients

    PubMed Central

    2010-01-01

    Background Bone mineral density (BMD) accrual during childhood and adolescence is important for attaining peak bone mass. BMD decrements have been reported in survivors of childhood bone sarcomas. However, little is known about the onset and development of bone loss during cancer treatment. The objective of this cross-sectional study was to evaluate BMD in newly diagnosed Ewing's and osteosarcoma patients by means of dual-energy x-ray absorptiometry (DXA) after completion of neoadjuvant chemotherapy. Methods DXA measurements of the lumbar spine (L2-4), both femora and calcanei were performed perioperatively in 46 children and adolescents (mean age: 14.3 years, range: 8.6-21.5 years). Mean Z-scores, areal BMD (g/cm2), calculated volumetric BMD (g/cm3) and bone mineral content (BMC, g) were determined. Results Lumbar spine mean Z-score was -0.14 (95% CI: -0.46 to 0.18), areal BMD was 1.016 g/cm2 (95% CI: 0.950 to 1.082) and volumetric BMD was 0.330 g/cm3 (95% CI: 0.314 to 0.347) which is comparable to healthy peers. For patients with a lower extremity tumor (n = 36), the difference between the affected and non-affected femoral neck was 12.1% (95% CI: -16.3 to -7.9) in areal BMD. The reduction of BMD was more pronounced in the calcaneus with a difference between the affected and contralateral side of 21.7% (95% CI: -29.3 to -14.0) for areal BMD. Furthermore, significant correlations for femoral and calcaneal DXA measurements were found with Spearman-rho coefficients ranging from ρ = 0.55 to ρ = 0.80. Conclusions The tumor disease located in the lower extremity in combination with offloading recommendations induced diminished BMD values, indicating local osteopenia conditions. However, the results revealed no significant decrements of lumbar spine BMD in pediatric sarcoma patients after completion of neoadjuvant chemotherapy. Nevertheless, it has to be taken into account that bone tumor patients may experience BMD decrements or secondary osteoporosis in later life

  6. The Atacama Cosmology Telescope: Detection or Sunyaev-Zel'Dovich Decrement in Groups and Clusters Associated with Luminous Red Galaxies

    NASA Technical Reports Server (NTRS)

    Hand, Nick; Appel, John William; Battaglia, Nick; Bond, J. Richard; Das, Sudeep; Devlin, Mark J.; Dunkley, Joanna; Dunner, Rolando; Essinger-Hileman, Thomas; Fowler, Joseph W.; Hajian, Amir; Halpern, Mark; Hasselfield, Matthew; Hilton, Matt; Hincks, Adam D.; Hlozek, Renee; Hughes, John P.; Irwin, Kent D.; Klein, Jeff; Kosowsky, Arthur; Lin, Yen-Ting; Marriage, Tobias A.; Marsden, Danica; McLaren, Mike; Wollack, Ed

    2010-01-01

    We present a detection of the Sunyaev-Zel'dovich (SZ) decrement associated with the Luminous Red Galaxy (LRG) sample of the Sloan Digital Sky Survey. The SZ data come from 148 GHz maps of the equatorial region made by the Atacama Cosmology Telescope (ACT). The LRG sample is divided by luminosity into four bins, and estimates for the central Sunyaev-Zel'dovich temperature decrement are calculated through a stacking process. We detect and account for a bias of the SZ signal due to weak radio sources. We use numerical simulations to relate the observed decrement to Y(sub 200) and clustering properties to relate the galaxy luminosity bins to mass. We also use a relation between BCG luminosity and cluster mass based on stacked gravitational lensing measurements to estimate the characteristic halo masses. The masses are found to be in the range approx.10(exp 13) - 10(exp 14)/h Stellar Mass, a lower range than has been previously probed.

  7. THE ATACAMA COSMOLOGY TELESCOPE: DETECTION OF SUNYAEV-ZEL'DOVICH DECREMENT IN GROUPS AND CLUSTERS ASSOCIATED WITH LUMINOUS RED GALAXIES

    SciTech Connect

    Hand, Nick; Das, Sudeep; Dunkley, Joanna; Hajian, Amir; Appel, John W.; Essinger-Hileman, Thomas; Fowler, Joseph W.; Hincks, Adam D.; Battaglia, Nick; Richard Bond, J.; Devlin, Mark J.; Klein, Jeff; Duenner, Rolando; Halpern, Mark; Hasselfield, Matthew; Hilton, Matt; Hlozek, Renee; Hughes, John P.; Irwin, Kent D.; Kosowsky, Arthur

    2011-07-20

    We present a detection of the Sunyaev-Zel'dovich (SZ) decrement associated with the luminous red galaxy (LRG) sample of the Sloan Digital Sky Survey. The SZ data come from 148 GHz maps of the equatorial region made by the Atacama Cosmology Telescope. The LRG sample is divided by luminosity into four bins, and estimates for the central SZ temperature decrement are calculated through a stacking process. We detect and account for a bias of the SZ signal due to weak radio sources. We use numerical simulations to relate the observed decrement to Y{sub 200} and clustering properties to relate the galaxy luminosity to halo mass. We also use a relation between brightest cluster galaxy luminosity and cluster mass based on stacked gravitational lensing measurements to estimate the characteristic halo masses. The masses are found to be around 10{sup 14} M{sub sun}.

  8. Alectinib versus crizotinib in patients with ALK-positive non-small-cell lung cancer (J-ALEX): an open-label, randomised phase 3 trial.

    PubMed

    Hida, Toyoaki; Nokihara, Hiroshi; Kondo, Masashi; Kim, Young Hak; Azuma, Koichi; Seto, Takashi; Takiguchi, Yuichi; Nishio, Makoto; Yoshioka, Hiroshige; Imamura, Fumio; Hotta, Katsuyuki; Watanabe, Satoshi; Goto, Koichi; Satouchi, Miyako; Kozuki, Toshiyuki; Shukuya, Takehito; Nakagawa, Kazuhiko; Mitsudomi, Tetsuya; Yamamoto, Nobuyuki; Asakawa, Takashi; Asabe, Ryoichi; Tanaka, Tomohiro; Tamura, Tomohide

    2017-07-01

    Alectinib, a potent, highly selective, CNS-active inhibitor of anaplastic lymphoma kinase (ALK), showed promising efficacy and tolerability in the single-arm phase 1/2 AF-001JP trial in Japanese patients with ALK-positive non-small-cell lung cancer. Given those promising results, we did a phase 3 trial to directly compare the efficacy and safety of alectinib and crizotinib. J-ALEX was a randomised, open-label, phase 3 trial that recruited ALK inhibitor-naive Japanese patients with ALK-positive non-small-cell lung cancer, who were chemotherapy-naive or had received one previous chemotherapy regimen, from 41 study sites in Japan. Patients were randomly assigned (1:1) via an interactive web response system using a permuted-block method stratified by Eastern Cooperative Oncology Group performance status, treatment line, and disease stage to receive oral alectinib 300 mg twice daily or crizotinib 250 mg twice daily until progressive disease, unacceptable toxicity, death, or withdrawal. The primary endpoint was progression-free survival assessed by an independent review facility. The efficacy analysis was done in the intention-to-treat population, and safety analyses were done in all patients who received at least one dose of the study drug. The study is ongoing and patient recruitment is closed. This study is registered with the Japan Pharmaceutical Information Center (number JapicCTI-132316). Between Nov 18, 2013, and Aug 4, 2015, 207 patients were recruited and assigned to the alectinib (n=103) or crizotinib (n=104) groups. At data cutoff for the second interim analysis, 24 patients in the alectinib group had discontinued treatment compared with 61 in the crizotinib group, mostly due to lack of efficacy or adverse events. At the second interim analysis (data cutoff date Dec 3, 2015), an independent data monitoring committee determined that the primary endpoint of the study had been met (hazard ratio 0·34 [99·7% CI 0·17-0·71], stratified log-rank p<0·0001) and

  9. Comparisons of PRD (power-reactivity-decrements) components for various EBR-II configurations

    SciTech Connect

    Meneghetti, D.; Kucera, D.A.

    1986-09-19

    Comparison of detailed calculations of contributions by region and component of the power-reactivity-decrements (PRD) for four differing loading configurations of the Experimental Breeder Reactor-II (EBR-II) are given. The linear components and Doppler components are calculated. The non-linear (primarily subassembly bowing) components are deduced by differences relative to measured total PRD values. Variations in linear components range from about 10% to as much as about 100% depending upon the component. The deduced non-linear components differ both in magnitude and sign as functions of reactor power. Effects of differing assumptions of the nature of the fuel-to-clad interactions upon the PRD components are also calculated.

  10. Modal identification of structures from the responses and random decrement signatures

    NASA Technical Reports Server (NTRS)

    Brahim, S. R.; Goglia, G. L.

    1977-01-01

    The theory and application of a method which utilizes the free response of a structure to determine its vibration parameters is described. The time-domain free response is digitized and used in a digital computer program to determine the number of modes excited, the natural frequencies, the damping factors, and the modal vectors. The technique is applied to a complex generalized payload model previously tested using sine sweep method and analyzed by NASTRAN. Ten modes of the payload model are identified. In case free decay response is not readily available, an algorithm is developed to obtain the free responses of a structure from its random responses, due to some unknown or known random input or inputs, using the random decrement technique without changing time correlation between signals. The algorithm is tested using random responses from a generalized payload model and from the space shuttle model.

  11. Auditory Memory Decrements, Without Dissimulation, among Patients with Major Depressive Disorder

    PubMed Central

    Considine, Ciaran M.; Weisenbach, Sara L.; Walker, Sara J.; McFadden, E. Michelle; Franti, Lindsay M.; Bieliauskas, Linas A.; Maixner, Daniel F.; Giordani, Bruno; Berent, Stanley; Langenecker, Scott A.

    2011-01-01

    Questions have been raised about whether poor performance on memory tasks by individuals with major depressive disorder (MDD) might be the result of poor or variable effort or disease-related disruption of neural circuits supporting memory functions. The present study examined performance on a measure of task engagement and on an auditory memory task among 45 patients with MDD (M age = 47.82, SD = 19.55) relative to 32 healthy controls (HC; M age = 51.03, SD = 22.09). One-hundred percent of HC and MDD volunteers performed above the threshold for adequate effort on a formal measure of task engagement. The MDD subjects performed significantly more poorly than the HC subjects on an auditory learning and memory test. The present results suggest that auditory memory difficulties do occur among those with MDD and that decrements in performance in this group may be related to factors other than lack of effort. PMID:21593060

  12. Stimulated emission and the flat Balmer decrements of cataclysmic variable stars

    NASA Technical Reports Server (NTRS)

    Elitzur, M.; Ferland, G. J.; Mathews, S. G.; Shields, G. A.

    1983-01-01

    Balmer emission lines from cataclysmic variables often have nearly equal intensities rather than the rapid decrement predicted by simple nebular theory. Traditionally, this has been interpreted in terms of local thermodynamic equilibrium emission from a dense gas with small volume located just above the accretion disk. It is shown that the intense radiation field within a close binary system can affect excited state populations and optical emission in ways which allow a relatively low density gas to closely mimic the high density situation. In at least one case, the old nova V603 Aql, the emitting gas has a low density and nearly fills the orbital plane of the system. If this is characteristic of other systems, then the determination of orbital parameters and masses of cataclysmic variables from emission line radial velocities, as well as the prediction of soft X-ray emission from accreting binaries, will be affected.

  13. Submitting to defeat: social anxiety, dominance threat, and decrements in testosterone.

    PubMed

    Maner, Jon K; Miller, Saul L; Schmidt, Norman B; Eckel, Lisa A

    2008-08-01

    Although theory suggests a link between social anxiety and social dominance, direct empirical evidence for this link is limited. The present experiment tested the hypothesis that socially anxious individuals, particularly men, would respond to a social-dominance threat by exhibiting decrements in their testosterone levels, an endocrinological change that typically reflects pronounced social submission in humans and other animals. Participants were randomly assigned to either win or lose a rigged face-to-face competition with a confederate. Although no zero-order relationship between social anxiety and level of testosterone was observed, testosterone levels showed a pronounced drop among socially anxious men who lost the competition. No significant changes were observed in nonanxious men or in women. This research provides novel insight into the nature and consequences of social anxiety, and also illustrates the utility of integrating social psychological theory with endocrinological approaches to psychological science.

  14. Associated decrements in rate of force development and neural drive after maximal eccentric exercise.

    PubMed

    Farup, J; Rahbek, S K; Bjerre, J; de Paoli, F; Vissing, K

    2016-05-01

    The present study investigated the changes in contractile rate of force development (RFD) and the neural drive following a single bout of eccentric exercise. Twenty-four subjects performed 15 × 10 maximal isokinetic eccentric knee extensor contractions. Prior to and at 24, 48, 72, 96, and 168 h during post-exercise recovery, isometric RFD (30, 50 100, and 200 ms), normalized RFD [1/6,1/2, and 2/3 of maximal voluntary contraction (MVC)] and rate of electromyography rise (RER; 30, 50, and 75 ms) were measured. RFD decreased by 28-42% peaking at 48 h (P < 0.01-P < 0.001) and remained depressed at 168 h (P < 0.05). Normalized RFD at 2/3 of MVC decreased by 22-39% (P < 0.01), peaked at 72 h and returned to baseline at 168 h. These changes in RFD were associated with a decrease in RER at 48 h-96 h (P < 0.05-P < 0.001). Accumulated changes (area under curve) revealed a greater relative decrease in accumulated RFD at 100 ms by -2727 ± 309 (%h; P < 0.05) and 200 ms by -3035 ± 271 (%h; P < 0.001) compared with MVC, which decreased, by -1956 ± 234 (%h). In conclusion, RFD and RER are both markedly reduced following a bout of maximal eccentric exercise. This association suggests that exercise-induced decrements in RFD can, in part, be explained decrements in neural drive.

  15. Sleep Deprivation and Time-on-Task Performance Decrement in the Rat Psychomotor Vigilance Task

    PubMed Central

    Oonk, Marcella; Davis, Christopher J.; Krueger, James M.; Wisor, Jonathan P.; Van Dongen, Hans P.A.

    2015-01-01

    Study Objectives: The rat psychomotor vigilance task (rPVT) was developed as a rodent analog of the human psychomotor vigilance task (hPVT). We examined whether rPVT performance displays time-on-task effects similar to those observed on the hPVT. Design: The rPVT requires rats to respond to a randomly presented light stimulus to obtain a water reward. Rats were water deprived for 22 h prior to each 30-min rPVT session to motivate performance. We analyzed rPVT performance over time on task and as a function of the response-stimulus interval, at baseline and after sleep deprivation. Setting: The study was conducted in an academic research vivarium. Participants: Male Long-Evans rats were trained to respond to a 0.5 sec stimulus light within 3 sec of stimulus onset. Complete data were available for n = 20 rats. Interventions: Rats performed the rPVT for 30 min at baseline and after 24 h total sleep deprivation by gentle handling. Measurements and Results: Compared to baseline, sleep deprived rats displayed increased performance lapses and premature responses, similar to hPVT lapses of attention and false starts. However, in contrast to hPVT performance, the time-on-task performance decrement was not significantly enhanced by sleep deprivation. Moreover, following sleep deprivation, rPVT response times were not consistently increased after short response-stimulus intervals. Conclusions: The rat psychomotor vigilance task manifests similarities to the human psychomotor vigilance task in global performance outcomes, but not in post-sleep deprivation effects of time on task and response-stimulus interval. Citation: Oonk M, Davis CJ, Krueger JM, Wisor JP, Van Dongen HPA. Sleep deprivation and time-on-task performance decrement in the rat psychomotor vigilance task. SLEEP 2015;38(3):445–451. PMID:25515099

  16. Nonuniform, age-related decrements in regional sweating and skin blood flow

    PubMed Central

    Alexander, Lacy M.; Kenney, W. Larry

    2013-01-01

    Aging is associated with attenuated thermoregulatory function that varies regionally over the body. Decrements in vasodilation and sweating are well documented with age, yet limited data are available concerning the regional relation between these responses. We aimed to examine age-related alterations in the relation between regional sweating (RSR) and skin blood flow (SkBF) to thermal and pharmacological stimuli. Four microdialysis fibers were inserted in the ventral forearm, abdomen, thigh, and lower back of eight healthy aged subjects (64 ± 7 yr) and nine young (23 ± 3 yr) during 1) ACh dose response (1 × 10−7 to 0.1 M, mean skin temperature 34°C) and 2) passive whole body heating to Δ1°C rise in oral temperature (Tor). RSR and SkBF were measured over each microdialysis membrane using ventilated capsules and laser-Doppler flowmetry. Maximal SkBF was measured at the end of both protocols (50 mM SNP). Regional sweating thresholds and RSR were attenuated in aged vs. young at all sites (P < 0.0001) during whole body heating. Vasodilation thresholds were similar between groups (P > 0.05). Attenuated SkBF were observed at the arm and back in the aged, representing 56 and 82% of those in the young at these sites, respectively (0.5 ΔTor). During ACh perfusion, SkBF (P = 0.137) and RSR were similar between groups (P = 0.326). Together these findings suggest regional age-related decrements in heat-activated sweat gland function but not cholinergic sensitivity. Functional consequences of such thermoregulatory impairment include the compromised ability of older individuals to defend core temperature during heat exposure and a subsequently greater susceptibility to heat-related illness and injury. PMID:23926135

  17. Age-related decrements in bone mineral density in women over 65

    NASA Technical Reports Server (NTRS)

    Steiger, P.; Cummings, S. R.; Black, D. M.; Spencer, N. E.; Genant, H. K.

    1992-01-01

    Age-related changes in bone density contribute to the risk of fractures. To describe the relationship between age and bone mass in elderly women, we studied a large cohort of women over age 65 years who were recruited from population-based lists in four cities in the United States. Bone density in g/cm2 was measured by single-photon absorptiometry (SPA) and dual x-ray absorptiometry (DXA) at the distal and proximal radius, the calcaneus, the lumbar spine, and the proximal femur. Centralized data collection was used to control data quality and consistency. We found a strong inverse relationship between bone density and age for most sites. Decrements in bone density between women aged 65-69 years and women 85 years and older exceeded 16% in all regions except the spine, where the difference between the two age groups was 6%. Ward's triangle and the calcaneus exhibited the largest decrements, with 26 and 21%, respectively. The estimates of annual changes in bone mineral density by linear regression at sites other than the spine ranged from -0.82% at the femoral neck and trochanter to -1.30% at Ward's triangle. Correlations between the different regions ranged from r = 0.51 between the proximal radius and Ward's triangle to r = 0.66 between the distal radius and calcaneus. We conclude that the inverse relationship between age and bone mass measured by absorptiometry techniques in white women continues into the ninth decade of life. The relationship is strongest for bone density of Ward's triangle and the calcaneus and weakest for the spine.

  18. Age-related decrements in bone mineral density in women over 65

    NASA Technical Reports Server (NTRS)

    Steiger, P.; Cummings, S. R.; Black, D. M.; Spencer, N. E.; Genant, H. K.

    1992-01-01

    Age-related changes in bone density contribute to the risk of fractures. To describe the relationship between age and bone mass in elderly women, we studied a large cohort of women over age 65 years who were recruited from population-based lists in four cities in the United States. Bone density in g/cm2 was measured by single-photon absorptiometry (SPA) and dual x-ray absorptiometry (DXA) at the distal and proximal radius, the calcaneus, the lumbar spine, and the proximal femur. Centralized data collection was used to control data quality and consistency. We found a strong inverse relationship between bone density and age for most sites. Decrements in bone density between women aged 65-69 years and women 85 years and older exceeded 16% in all regions except the spine, where the difference between the two age groups was 6%. Ward's triangle and the calcaneus exhibited the largest decrements, with 26 and 21%, respectively. The estimates of annual changes in bone mineral density by linear regression at sites other than the spine ranged from -0.82% at the femoral neck and trochanter to -1.30% at Ward's triangle. Correlations between the different regions ranged from r = 0.51 between the proximal radius and Ward's triangle to r = 0.66 between the distal radius and calcaneus. We conclude that the inverse relationship between age and bone mass measured by absorptiometry techniques in white women continues into the ninth decade of life. The relationship is strongest for bone density of Ward's triangle and the calcaneus and weakest for the spine.

  19. Relating lab to life: Decrements in attention over time predict math productivity among children with ADHD.

    PubMed

    Fosco, Whitney D; Hawk, Larry W

    2017-02-01

    A child's ability to sustain attention over time (AOT) is critical in attention-deficit/hyperactivity disorder (ADHD), yet no prior work has examined the extent to which a child's decrement in AOT on laboratory tasks relates to clinically-relevant behavior. The goal of this study is to provide initial evidence for the criterion validity of laboratory assessments of AOT. A total of 20 children with ADHD (7-12 years of age) who were enrolled in a summer treatment program completed two lab attention tasks (a continuous performance task and a self-paced choice discrimination task) and math seatwork. Analyses focused on relations between attention task parameters and math productivity. Individual differences in overall attention (OA) measures (averaged across time) accounted for 23% of the variance in math productivity, supporting the criterion validity of lab measures of attention. The criterion validity was enhanced by consideration of changes in AOT. Performance on all laboratory attention measures deteriorated as time-on-task increased, and individual differences in the decrement in AOT accounted for 40% of the variance in math productivity. The only variable to uniquely predict math productivity was from the self-paced choice discrimination task. This study suggests that attention tasks in the lab do predict a clinically-relevant target behavior in children with ADHD, supporting their use as a means to study attention processes in a controlled environment. Furthermore, this prediction is improved when attention is examined as a function of time-on-task and when the attentional demands are consistent between lab and life contexts.

  20. Randomized, open-label trial evaluating the preventive effect of tetracycline on afatinib induced-skin toxicities in non-small cell lung cancer patients.

    PubMed

    Arrieta, Oscar; Vega-González, María Teresa; López-Macías, Diego; Martínez-Hernández, Jorge Negueb; Bacon-Fonseca, Ludwing; Macedo-Pérez, Eleazar Omar; Ramírez-Tirado, Laura Alejandra; Flores-Estrada, Diana; de la Garza-Salazar, Jaime

    2015-06-01

    Afatinib has shown long progression free survival and improvement in quality of life in advanced Non-Small Cell Lung Cancer (NSCLC) patients. Although afatinib causes acneiform rash, it can be manageable. Tetracyclines are usually used to treat it; nonetheless, there is no trial that evaluates their prophylactic efficacy on afatinib induced-skin toxicities (AIST). This open-label, randomized, controlled trial assessed the preventive effect of tetracycline for reducing afatinib-skin toxicities in NSCLC patients receiving afatinib 40 mg/day. Patients were randomly assigned to receive pre-emptive treatment with tetracycline 250 mg every 12h for 4 weeks or not. Reactive treatment in both groups included general dermatological recommendations such as use of skin moisturizers, sunscreen and topical steroids, according to toxicity severity. All patients were blindly monitored for skin toxicities by an expert dermatologist at the start of treatment with afatinib (day 0), weeks 2 and 4 of treatment. The protocol is registered on clinicaltrials.gov (NCT01880515). We included 90 patients, no differences were found in clinical and dermatological baseline characteristics. Rash incidence of any grade, and grade ≥2 was less frequent in the pre-emptive arm vs. the control arm (44.5 vs. 75.6%, RR 0.4 [95% CI 0.17-0.99], p=0.046 and 15.6 vs. 35.6%, RR 0.35 [95% CI, 0.12-0.91], p=0.030, respectively). No difference was found in paronychia, xerosis, mucositis, folliculitis, and skin fissure. No adverse event was associated with tetracycline. Neither rash nor pre-emptive tetracycline impacted on response rate, progression-free or overall survivals. Pre-emptive tetracycline was well tolerated and reduced the rash incidence and severity associated with afatinib in more than 60%. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  1. Analysis of lung function and survival in RECAP: An open-label extension study of pirfenidone in patients with idiopathic pulmonary fibrosis.

    PubMed

    Costabel, Ulrich; Albera, Carlo; Bradford, Williamson Z; Hormel, Phil; King, Talmadge E; Noble, Paul W; Sahn, Steven A; Valeyre, Dominique; du Bois, Roland M

    2014-10-20

    RECAP is an open-label extension study evaluating pirfenidone in patients with idiopathic pulmonary fibrosis (IPF) who completed the Phase 3 CAPACITY program. We examined the effect of pirfenidone on lung function and survival in patients who were previously randomised to the placebo group in one of the two CAPACITY studies and received pirfenidone for the first time in RECAP. Eligible patients received oral pirfenidone 2403 mg/day. Forced vital capacity (FVC) was measured at baseline and at weeks 12, 36, and 60. To facilitate comparison with CAPACITY outcomes, analyses were based on patients newly treated with pirfenidone in RECAP who had baseline FVC and carbon monoxide diffusing capacity (DLCO) values that met CAPACITY entry criteria. A total of 178 patients were included in the analysis. Among these, 16.3% experienced an FVC decline ≥10% at week 60, compared with 16.8% and 24.8%, respectively, in the CAPACITY pirfenidone (n=345) and placebo (n=347) groups. The mean change from baseline to week 60 in %FVC was -5.9%, compared with -7.0% and -9.4% in the CAPACITY pirfenidone and placebo groups. Overall survival was similar to that of pirfenidone treated patients in CAPACITY. Treatment was safe and generally well tolerated; the type and frequency of adverse events were consistent with previous clinical experience. FVC and survival outcomes in IPF patients newly treated with pirfenidone in RECAP were similar to those in the CAPACITY pirfenidone group. These data provide further evidence to support the use of pirfenidone in patients with IPF.

  2. Lung surgery - discharge

    MedlinePlus

    ... Lung biopsy - discharge; Thoracoscopy - discharge; Video-assisted thoracoscopic surgery - discharge; VATS - discharge ... milk) for 2 weeks after video-assisted thoracoscopic surgery and 6 to 8 weeks after open surgery. ...

  3. Advances in artificial lungs.

    PubMed

    Ota, Kei

    2010-04-01

    Artificial lungs have already been developed as complete artificial organs, and results of many investigations based on innovative concepts have been reported continuously. In open-heart surgery, artificial lungs are used for extracorporeal circulation to maintain gas exchange, and the commercial products currently available perform adequately, including providing for antithrombogenicity. However, patients after cardiopulmonary arrest or severe respiratory/circulatory failure have required long-term assist with extracorporeal membrane oxygenation (ECMO). The number of artificial lungs used for ECMO in those cases has shown significant growth in recent years. Therefore, it is expected that durability and antithrombogenicity will ensure the prolonged use of an artificial lung for several weeks or months. Furthermore, interests in research are shifting to use of oxygenators as a bridge to lung transplantation and an implantable artificial lung. This paper discusses recent advances in artificial lungs, focusing on the current state and on trends in research and development.

  4. Afatinib versus cisplatin plus gemcitabine for first-line treatment of Asian patients with advanced non-small-cell lung cancer harbouring EGFR mutations (LUX-Lung 6): an open-label, randomised phase 3 trial.

    PubMed

    Wu, Yi-Long; Zhou, Caicun; Hu, Cheng-Ping; Feng, Jifeng; Lu, Shun; Huang, Yunchao; Li, Wei; Hou, Mei; Shi, Jian Hua; Lee, Kye Young; Xu, Chong-Rui; Massey, Dan; Kim, Miyoung; Shi, Yang; Geater, Sarayut L

    2014-02-01

    Afatinib-an oral irreversible ErbB family blocker-improves progression-free survival compared with pemetrexed and cisplatin for first-line treatment of patients with EGFR mutation-positive advanced non-small-cell lung cancer (NSCLC). We compared afatinib with gemcitabine and cisplatin-a chemotherapy regimen widely used in Asia-for first-line treatment of Asian patients with EGFR mutation-positive advanced NSCLC. This open-label, randomised phase 3 trial was done at 36 centres in China, Thailand, and South Korea. After central testing for EGFR mutations, treatment-naive patients (stage IIIB or IV cancer [American Joint Committee on Cancer version 6], performance status 0-1) were randomly assigned (2:1) to receive either oral afatinib (40 mg per day) or intravenous gemcitabine 1000 mg/m(2) on day 1 and day 8 plus cisplatin 75 mg/m(2) on day 1 of a 3-week schedule for up to six cycles. Randomisation was done centrally with a random number-generating system and an interactive internet and voice-response system. Randomisation was stratified by EGFR mutation (Leu858Arg, exon 19 deletions, or other; block size three). Clinicians and patients were not masked to treatment assignment, but the independent central imaging review group were. Treatment continued until disease progression, intolerable toxic effects, or withdrawal of consent. The primary endpoint was progression-free survival assessed by independent central review (intention-to-treat population). This study is registered with ClinicalTrials.gov, NCT01121393. 910 patients were screened and 364 were randomly assigned (242 to afatinib, 122 to gemcitabine and cisplatin). Median progression-free survival was significantly longer in the afatinib group (11·0 months, 95% CI 9·7-13·7) than in the gemcitabine and cisplatin group (5·6 months, 5·1-6·7; hazard ratio 0·28, 95% CI 0·20-0·39; p<0·0001). The most common treatment-related grade 3 or 4 adverse events in the afatinib group were rash or acne (35 [14·6%] of

  5. Afatinib versus gefitinib as first-line treatment of patients with EGFR mutation-positive non-small-cell lung cancer (LUX-Lung 7): a phase 2B, open-label, randomised controlled trial.

    PubMed

    Park, Keunchil; Tan, Eng-Huat; O'Byrne, Ken; Zhang, Li; Boyer, Michael; Mok, Tony; Hirsh, Vera; Yang, James Chih-Hsin; Lee, Ki Hyeong; Lu, Shun; Shi, Yuankai; Kim, Sang-We; Laskin, Janessa; Kim, Dong-Wan; Arvis, Catherine Dubos; Kölbeck, Karl; Laurie, Scott A; Tsai, Chun-Ming; Shahidi, Mehdi; Kim, Miyoung; Massey, Dan; Zazulina, Victoria; Paz-Ares, Luis

    2016-05-01

    The irreversible ErbB family blocker afatinib and the reversible EGFR tyrosine kinase inhibitor gefitinib are approved for first-line treatment of EGFR mutation-positive non-small-cell lung cancer (NSCLC). We aimed to compare the efficacy and safety of afatinib and gefitinib in this setting. This multicentre, international, open-label, exploratory, randomised controlled phase 2B trial (LUX-Lung 7) was done at 64 centres in 13 countries. Treatment-naive patients with stage IIIB or IV NSCLC and a common EGFR mutation (exon 19 deletion or Leu858Arg) were randomly assigned (1:1) to receive afatinib (40 mg per day) or gefitinib (250 mg per day) until disease progression, or beyond if deemed beneficial by the investigator. Randomisation, stratified by EGFR mutation type and status of brain metastases, was done centrally using a validated number generating system implemented via an interactive voice or web-based response system with a block size of four. Clinicians and patients were not masked to treatment allocation; independent review of tumour response was done in a blinded manner. Coprimary endpoints were progression-free survival by independent central review, time-to-treatment failure, and overall survival. Efficacy analyses were done in the intention-to-treat population and safety analyses were done in patients who received at least one dose of study drug. This ongoing study is registered with ClinicalTrials.gov, number NCT01466660. Between Dec 13, 2011, and Aug 8, 2013, 319 patients were randomly assigned (160 to afatinib and 159 to gefitinib). Median follow-up was 27·3 months (IQR 15·3-33·9). Progression-free survival (median 11·0 months [95% CI 10·6-12·9] with afatinib vs 10·9 months [9·1-11·5] with gefitinib; hazard ratio [HR] 0·73 [95% CI 0·57-0·95], p=0·017) and time-to-treatment failure (median 13·7 months [95% CI 11·9-15·0] with afatinib vs 11·5 months [10·1-13·1] with gefitinib; HR 0·73 [95% CI 0·58-0·92], p=0·0073) were

  6. Rationale and study design for an individualised perioperative open-lung ventilatory strategy with a high versus conventional inspiratory oxygen fraction (iPROVE-O2) and its effects on surgical site infection: study protocol for a randomised controlled trial.

    PubMed

    Ferrando, Carlos; Soro, Marina; Unzueta, Carmen; Canet, Jaume; Tusman, Gerardo; Suarez-Sipmann, Fernando; Librero, Julian; Peiró, Salvador; Pozo, Natividad; Delgado, Carlos; Ibáñez, Maite; Aldecoa, César; Garutti, Ignacio; Pestaña, David; Rodríguez, Aurelio; García Del Valle, Santiago; Diaz-Cambronero, Oscar; Balust, Jaume; Redondo, Francisco Javier; De La Matta, Manuel; Gallego, Lucía; Granell, Manuel; Martínez, Pascual; Pérez, Ana; Leal, Sonsoles; Alday, Kike; García, Pablo; Monedero, Pablo; Gonzalez, Rafael; Mazzinari, Guido; Aguilar, Gerardo; Villar, Jesús; Belda, Francisco Javier

    2017-07-31

    Surgical site infection (SSI) is a serious postoperative complication that increases morbidity and healthcare costs. SSIs tend to increase as the partial pressure of tissue oxygen decreases: previous trials have focused on trying to reduce them by comparing high versus conventional inspiratory oxygen fractions (FIO2) in the perioperative period but did not use a protocolised ventilatory strategy. The open-lung ventilatory approach restores functional lung volume and improves gas exchange, and therefore it may increase the partial pressure of tissue oxygen for a given FIO2. The trial presented here aims to compare the efficacy of high versus conventional FIO2 in reducing the overall incidence of SSIs in patients by implementing a protocolised and individualised global approach to perioperative open-lung ventilation. This is a comparative, prospective, multicentre, randomised and controlled two-arm trial that will include 756 patients scheduled for abdominal surgery. The patients will be randomised into two groups: (1) a high FIO2 group (80% oxygen; FIO2 of 0.80) and (2) a conventional FIO2 group (30% oxygen; FIO2 of 0.30). Each group will be assessed intra- and postoperatively. The primary outcome is the appearance of postoperative SSI complications. Secondary outcomes are the appearance of systemic and pulmonary complications. The iPROVE-O2 trial has been approved by the Ethics Review Board at the reference centre (the Hospital Clínico Universitario in Valencia). Informed consent will be obtained from all patients before their participation. If the approach using high FIO2 during individualised open-lung ventilation decreases SSIs, use of this method will become standard practice for patients scheduled for future abdominal surgery. Publication of the results is anticipated in early 2019. NCT02776046; Pre-results. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted

  7. [Humidifier lung].

    PubMed

    Gerber, P; de Haller, R; Pyrozynski, W J; Sturzenegger, E R; Brändli, O

    1981-02-07

    Breathing air from a humidifier or an air conditioning unit contaminated by various microorganisms can cause an acute lung disease involving fever, cough and dyspnea, termed "humidifier fever". This type of hypersensitivity pneumonitis was first described in 1959 by PESTALOZZI in the Swiss literature and subsequently by BANASZAK et al. in the Anglo-American. Here a chronic form of this disease which led to pulmonary fibrosis is described: A 37-year-old woman who works in a cheese shop presented with dyspnea which had been progressive over two years, weight loss, a diffuse reticular pattern radiographically and a severe restrictive defect in lung function tests. Open lung biopsy revealed chronic interstitial and alveolar inflammation with non-caseating granulomas and fibrotic changes. Circulating immune complexes and precipitins against the contaminated humidifier water and cheese mites were found, but no antibodies suggesting legionnaires' disease. Two out of five otherwise healthy employees of this cheese shop, where a new humidifying system had been installed 7 years earlier, also had precipitins against the contaminated water from the humidifier and the cheese mites. Despite ending of exposure and longterm steroid and immunosuppressive therapy, the signs and symptoms of pulmonary fibrosis persisted. Contrary to the acute disease, this chronic form is termed "humidifier lung". The importance is stressed of investigating the possibility of exposure to contaminated humidifiers or air conditioning units in all cases of newly detected pulmonary fibrosis.

  8. Atezolizumab versus docetaxel in patients with previously treated non-small-cell lung cancer (OAK): a phase 3, open-label, multicentre randomised controlled trial.

    PubMed

    Rittmeyer, Achim; Barlesi, Fabrice; Waterkamp, Daniel; Park, Keunchil; Ciardiello, Fortunato; von Pawel, Joachim; Gadgeel, Shirish M; Hida, Toyoaki; Kowalski, Dariusz M; Dols, Manuel Cobo; Cortinovis, Diego L; Leach, Joseph; Polikoff, Jonathan; Barrios, Carlos; Kabbinavar, Fairooz; Frontera, Osvaldo Arén; De Marinis, Filippo; Turna, Hande; Lee, Jong-Seok; Ballinger, Marcus; Kowanetz, Marcin; He, Pei; Chen, Daniel S; Sandler, Alan; Gandara, David R

    2017-01-21

    Atezolizumab is a humanised antiprogrammed death-ligand 1 (PD-L1) monoclonal antibody that inhibits PD-L1 and programmed death-1 (PD-1) and PD-L1 and B7-1 interactions, reinvigorating anticancer immunity. We assessed its efficacy and safety versus docetaxel in previously treated patients with non-small-cell lung cancer. We did a randomised, open-label, phase 3 trial (OAK) in 194 academic or community oncology centres in 31 countries. We enrolled patients who had squamous or non-squamous non-small-cell lung cancer, were 18 years or older, had measurable disease per Response Evaluation Criteria in Solid Tumors, and had an Eastern Cooperative Oncology Group performance status of 0 or 1. Patients had received one to two previous cytotoxic chemotherapy regimens (one or more platinum based combination therapies) for stage IIIB or IV non-small-cell lung cancer. Patients with a history of autoimmune disease and those who had received previous treatments with docetaxel, CD137 agonists, anti-CTLA4, or therapies targeting the PD-L1 and PD-1 pathway were excluded. Patients were randomly assigned (1:1) to intravenously receive either atezolizumab 1200 mg or docetaxel 75 mg/m(2) every 3 weeks by permuted block randomisation (block size of eight) via an interactive voice or web response system. Coprimary endpoints were overall survival in the intention-to-treat (ITT) and PD-L1-expression population TC1/2/3 or IC1/2/3 (≥1% PD-L1 on tumour cells or tumour-infiltrating immune cells). The primary efficacy analysis was done in the first 850 of 1225 enrolled patients. This study is registered with ClinicalTrials.gov, number NCT02008227. Between March 11, 2014, and April 29, 2015, 1225 patients were recruited. In the primary population, 425 patients were randomly assigned to receive atezolizumab and 425 patients were assigned to receive docetaxel. Overall survival was significantly longer with atezolizumab in the ITT and PD-L1-expression populations. In the ITT population, overall

  9. Brief and Rare Mental "Breaks" Keep You Focused: Deactivation and Reactivation of Task Goals Preempt Vigilance Decrements

    ERIC Educational Resources Information Center

    Ariga, Atsunori; Lleras, Alejandro

    2011-01-01

    We newly propose that the vigilance decrement occurs because the cognitive control system fails to maintain active the goal of the vigilance task over prolonged periods of time (goal habituation). Further, we hypothesized that momentarily deactivating this goal (via a switch in tasks) would prevent the activation level of the vigilance goal from…

  10. Learning to ignore: a modeling study of a decremental cholinergic pathway and its influence on attention and learning.

    PubMed

    Oros, Nicolas; Chiba, Andrea A; Nitz, Douglas A; Krichmar, Jeffrey L

    2014-01-17

    Learning to ignore irrelevant stimuli is essential to achieving efficient and fluid attention, and serves as the complement to increasing attention to relevant stimuli. The different cholinergic (ACh) subsystems within the basal forebrain regulate attention in distinct but complementary ways. ACh projections from the substantia innominata/nucleus basalis region (SI/nBM) to the neocortex are necessary to increase attention to relevant stimuli and have been well studied. Lesser known are ACh projections from the medial septum/vertical limb of the diagonal band (MS/VDB) to the hippocampus and the cingulate that are necessary to reduce attention to irrelevant stimuli. We developed a neural simulation to provide insight into how ACh can decrement attention using this distinct pathway from the MS/VDB. We tested the model in behavioral paradigms that require decremental attention. The model exhibits behavioral effects such as associative learning, latent inhibition, and persisting behavior. Lesioning the MS/VDB disrupts latent inhibition, and drastically increases perseverative behavior. Taken together, the model demonstrates that the ACh decremental pathway is necessary for appropriate learning and attention under dynamic circumstances and suggests a canonical neural architecture for decrementing attention.

  11. The vigilance decrement in executive function is attenuated when individual chronotypes perform at their optimal time of day.

    PubMed

    Lara, Tania; Madrid, Juan Antonio; Correa, Ángel

    2014-01-01

    Time of day modulates our cognitive functions, especially those related to executive control, such as the ability to inhibit inappropriate responses. However, the impact of individual differences in time of day preferences (i.e. morning vs. evening chronotype) had not been considered by most studies. It was also unclear whether the vigilance decrement (impaired performance with time on task) depends on both time of day and chronotype. In this study, morning-type and evening-type participants performed a task measuring vigilance and response inhibition (the Sustained Attention to Response Task, SART) in morning and evening sessions. The results showed that the vigilance decrement in inhibitory performance was accentuated at non-optimal as compared to optimal times of day. In the morning-type group, inhibition performance decreased linearly with time on task only in the evening session, whereas in the morning session it remained more accurate and stable over time. In contrast, inhibition performance in the evening-type group showed a linear vigilance decrement in the morning session, whereas in the evening session the vigilance decrement was attenuated, following a quadratic trend. Our findings imply that the negative effects of time on task in executive control can be prevented by scheduling cognitive tasks at the optimal time of day according to specific circadian profiles of individuals. Therefore, time of day and chronotype influences should be considered in research and clinical studies as well as real-word situations demanding executive control for response inhibition.

  12. [Role of dopamine-dependent negative feedback in the hippocampal--basal ganglia--thalamo---hippocampal loop in response decrement].

    PubMed

    Sil'kis, I G

    2007-03-01

    The mechanism of response decrement in hippocampal and dopaminergic neurons on repeating stimuli based on the dopamine-dependent negative feedback in the hippocampal--basal ganglia--thalamo--hippocampal loop is suggested. Activation of hippocampal neurons caused by new stimulus facilitates occurrence of reaction of dopaminergic cells due to their disinhibition through striatopallidal cells of nucleus accumbens and ventral pallidum. However, increase in dopamine level and activation accumbens and ventral pallidum. However, increase in dopamine level and activation of D2 receptors on the striatopallidal cell, while promoting depression of hippocampal inputs, prevents disinhibition of dopaminergic cells, and their reactions start their decrement. The subsequent decrease in D1 receptor activation leads to reduction of efficiency of neuron excitation in the hippocampal CA1 fields, as well as in striatonigral cells of nucleus accumbens. This leads to a decrease of disinhibition through a direct pathway via the basal ganglia of thalamic nucleus reunions which activates neurons of the CA1 field. This effect causes decrement of reactions of the hippocampal neurons, a subsequent reduction of dopaminergic cell disinhibition, and further decrement of their responses.

  13. The Vigilance Decrement in Executive Function Is Attenuated When Individual Chronotypes Perform at Their Optimal Time of Day

    PubMed Central

    Lara, Tania; Madrid, Juan Antonio; Correa, Ángel

    2014-01-01

    Time of day modulates our cognitive functions, especially those related to executive control, such as the ability to inhibit inappropriate responses. However, the impact of individual differences in time of day preferences (i.e. morning vs. evening chronotype) had not been considered by most studies. It was also unclear whether the vigilance decrement (impaired performance with time on task) depends on both time of day and chronotype. In this study, morning-type and evening-type participants performed a task measuring vigilance and response inhibition (the Sustained Attention to Response Task, SART) in morning and evening sessions. The results showed that the vigilance decrement in inhibitory performance was accentuated at non-optimal as compared to optimal times of day. In the morning-type group, inhibition performance decreased linearly with time on task only in the evening session, whereas in the morning session it remained more accurate and stable over time. In contrast, inhibition performance in the evening-type group showed a linear vigilance decrement in the morning session, whereas in the evening session the vigilance decrement was attenuated, following a quadratic trend. Our findings imply that the negative effects of time on task in executive control can be prevented by scheduling cognitive tasks at the optimal time of day according to specific circadian profiles of individuals. Therefore, time of day and chronotype influences should be considered in research and clinical studies as well as real-word situations demanding executive control for response inhibition. PMID:24586404

  14. Fast Versus Slow Recruitment Maneuver at Different Degrees of Acute Lung Inflammation Induced by Experimental Sepsis.

    PubMed

    Santos, Raquel S; Moraes, Lillian; Samary, Cynthia S; Santos, Cíntia L; Ramos, Maíra B A; Vasconcellos, Ana P; Horta, Lucas F; Morales, Marcelo M; Capelozzi, Vera L; Garcia, Cristiane S N B; Marini, John J; Gama de Abreu, Marcelo; Pelosi, Paolo; Silva, Pedro L; Rocco, Patricia R M

    2016-04-01

    Large tidal volume (VT) breaths or "recruitment maneuvers" (RMs) are used commonly to open collapsed lungs, but their effectiveness may depend on how the RM is delivered. We hypothesized that a stepped approach to RM delivery ("slow" RM) compared with a nonstepped ("fast" RM), when followed by decremental positive end-expiratory pressure (PEEP) titration to lowest dynamic elastance, would (1) yield a more homogeneous inflation of the lungs, thus reducing the PEEP obtained during post-RM titration; (2) produce less lung morphofunctional injury, regardless of the severity of sepsis-induced acute lung inflammation; and (3) result in less biological damage in severe, but not in moderate, acute lung inflammation. Sepsis was induced by cecal ligation and puncture surgery in 51 Wistar rats. After 48 hours, animals were anesthetized, mechanically ventilated (VT = 6 mL/kg), and stratified by PO2/fraction of inspired oxygen ratio into moderate (≥300) and severe (<300) acute lung inflammation groups. Each group was then subdivided randomly into 3 subgroups: (1) nonrecruited; (2) RM with continuous positive airway pressure (30 cm H2O for 30 seconds; CPAPRM or fast RM); and (3) RM with stepwise airway pressure increase (5 cm H2O/step, 8.5 seconds/step, 6 steps, 51 seconds; STEPRM or slow RM), with a maximum pressure hold for 10 seconds. All animals underwent decremental PEEP titration to determine the level of PEEP required to optimize dynamic compliance after RM and were then ventilated for 60 minutes with VT = 6 mL/kg, respiratory rate = 80 bpm, fraction of inspired oxygen = 0.4, and the newly adjusted PEEP for each animal. Respiratory mechanics, hemodynamics, and arterial blood gases were measured before and at the end of 60-minute mechanical ventilation. Lung histology and biological markers of inflammation and damage inflicted to endothelial cells were evaluated at the end of the 60-minute mechanical ventilation. Respiratory system mean airway pressure was lower in

  15. Meta-analyses of published epidemiological studies, 1979-2006, point to open causal questions in silica-silicosis-lung cancer research.

    PubMed

    Erren, T C; Morfeld, P; Glende, Christine B; Piekarski, C; Cocco, P

    2011-01-01

    Following up on a previous meta-analysis of lung cancer risk in individuals without silicosis, we provide more detailed results of silica associated lung cancer risk in both silicotics and non-silicotics. The objective was to examine in depth whether current data allows to answer the pressing question "does silica cause lung cancer in the absence of silicosis"? We updated earlier meta-analyses of silicosis and lung cancer and compared the results with our 2009 meta-analysis of risks in individuals without silicosis. We performed fixed (FE) and random (RE) effects meta-analyses, calculated heterogeneity statistics, stratified the study material, performed sensitivity analyses with modified study results and meta-regressions to detect effect modification. In silicotics, lung cancer risks were found to be doubled in 38 studies (FE: RR = 2.1; 95% CI = 2.0-2.3). In non-silicotics, eight studies without smoking adjustment suggested marginally elevated risks (FE: RR = 1.2; 95% CI = 1.1-1.3; RE: RR = 1.2; 95% CI =1.0-1.4) but three studies which were controlled for smoking showed null results (FE and RE: RR = 1.0; 95% CI = 0.8-1.3). Heterogeneity was substantial but could be linked to study characteristics, like sector of industry, and other second-level data in meta-regression. As no excess was observe dfor other smoking-related effects in studies ofllung cancer among non-silicotics, smoking was not considered to be an important confounder or modifier. CONCLUSIONn: Our meta-analyses further substantiate evidence of a strong association between silicosis and lung cancer. However, questions remain regarding lung cancer caused by silica in non-silicotics. Ideally, future investigations should consider the entire exposure-response range between silica exposure, silicosis development and lung cancer occurrence, and analyze data in terms of processes taking intermediate confounding into account.

  16. Lung Transplant

    MedlinePlus

    Lung transplant Overview By Mayo Clinic Staff A lung transplant is a surgical procedure to replace a diseased or ... lung, usually from a deceased donor. A lung transplant is reserved for people who have tried other ...

  17. Lung surgery

    MedlinePlus

    ... lung tissue that is diseased or damaged from emphysema or bronchiectasis Remove blood or blood clots ( hemothorax ) ... Editorial team. Related MedlinePlus Health Topics Collapsed Lung Emphysema Lung Cancer Lung Diseases Pleural Disorders Browse the ...

  18. Lung Emergencies

    MedlinePlus

    ... Emergencies Cardiac Emergencies Eye Emergencies Lung Emergencies Surgeries Lung Emergencies People with Marfan syndrome can be at ... should be considered an emergency. Symptoms of sudden lung collapse (pneumothorax) Symptoms of a sudden lung collapse ...

  19. Lung Cancer

    MedlinePlus

    ... version of this page please turn Javascript on. Lung Cancer What is Lung Cancer? How Tumors Form The body is made ... button on your keyboard.) Two Major Types of Lung Cancer There are two major types of lung ...

  20. Generalization decrement and not overshadowing by associative competition among pairs of landmarks in a navigation task.

    PubMed

    Chamizo, Victoria D; Rodríguez, Clara A; Espinet, Alfredo; Mackintosh, N J

    2012-07-01

    When they are trained in a Morris water maze to find a hidden platform, whose location is defined by a number of equally spaced visual landmarks round the circumference of the pool, rats are equally able to find the platform when tested with any two of the landmarks (Prados, & Trobalon, 1998; Rodrigo, Chamizo, McLaren, & Mackintosh, 1997). This suggests that none of the landmarks was completely overshadowed by any of the others. In Experiment 1 one pair of groups was trained with four equally salient visual landmarks spaced at equal intervals around the edge of the pool, while a second pair was trained with two landmarks only, either relatively close to or far from the hidden platform. After extensive training, both male and female rats showed a reciprocal overshadowing effect: on a test with two landmarks only (either close to or far from the platform), rats trained with four landmarks spent less time in the platform quadrant than those trained with only two. Experiment 2 showed that animals trained with two landmarks and then tested with four also performed worse on test than those trained and tested with two landmarks only. This suggests that generalization decrement, rather than associative competition, provides a sufficient explanation for the overshadowing observed in Experiment 1. Experiment 3 provided a within-experiment replication of the results of Experiments 1 and 2. Finally, Experiment 4 showed that rats trained with a configuration of two landmarks learn their identity.

  1. rTMS over bilateral inferior parietal cortex induces decrement of spatial sustained attention

    PubMed Central

    Lee, Jeyeon; Ku, Jeonghun; Han, Kiwan; Park, Jinsick; Lee, Hyeongrae; Kim, Kyung Ran; Lee, Eun; Husain, Masud; Yoon, Kang Jun; Kim, In Young; Jang, Dong Pyo; Kim, Sun I.

    2013-01-01

    Sustained attention is an essential brain function that enables a subject to maintain attention level over the time of a task. In previous work, the right inferior parietal lobe (IPL) has been reported as one of the main brain regions related to sustained attention, however, the right lateralization of vigilance/sustained attention is unclear because information about the network for sustained attention is traditionally provided by neglect patients who typically have right brain damage. Here, we investigated sustained attention by applying a virtual lesion technique, transcranial magnetic stimulation (TMS), over the left and right superior parietal lobe (SPL) and IPL. We used two different types of visual sustained attention tasks: spatial (location based) and non-spatial (feature based). When the participants performed the spatial task, repetitive TMS (rTMS) over either the right or left IPL induced a significant decrement of sustained attention causing a progressive increment of errors and response time. In contrast, participants' performance was not changed by rTMS on the non-spatial task. Also, omission errors (true negative) gradually increased with time on right and left IPL rTMS conditions, while commission errors (false positive) were relatively stable. These findings suggest that the maintenance of attention, especially in tasks regarding spatial location, is not uniquely lateralized to the right IPL, but may also involve participation of the left IPL. PMID:23403477

  2. Glove attributes and their contribution to force decrement and increased effort in power grip.

    PubMed

    Willms, Kirsten; Wells, Richard; Carnahan, Heather

    2009-12-01

    To determine the contribution of the loss of tactile sensitivity, glove flexibility, glove thickness, and changes in finger geometry to force decrement and increased effort during gloved power grip. Gloved work has been shown to increase the effort required to perform manual tasks. A battery of maximal and submaximal gripping tasks was performed while grip force and surface electromyography of seven forearm muscles were recorded. Participants performed power grips while wearing three different thicknesses of rubber gloves (differing only in thickness; maximum 3.1 mm), wearing interdigital spacers between the fingers (matched to the glove thicknesses), and with a bare hand. Decreases in maximum grip force compared with the bare hand were observed for the thickest glove (-31.0 +/- 6.8%, p < .05) and for the thickest interdigital spacers (-9.7 +/- 5.9%, p < .05). Participants increased their grip force with increasing glove thickness for a submaximal object-lifting task (p < .01). To maintain an unloaded grip posture and to create a fixed submaximal force, participants increased muscle activation (p < .05) for all muscles with increasing glove thickness. Decreases in maximal grip force and increased effort in submaximal tasks could be attributed to a combination of reduced tactile sensitivity, the effort to bend the gloves, and interdigital separation. Although the values obtained are specific to the rubber gloves tested, the results give insights into factors important in the design and selection of gloves.

  3. rTMS over bilateral inferior parietal cortex induces decrement of spatial sustained attention.

    PubMed

    Lee, Jeyeon; Ku, Jeonghun; Han, Kiwan; Park, Jinsick; Lee, Hyeongrae; Kim, Kyung Ran; Lee, Eun; Husain, Masud; Yoon, Kang Jun; Kim, In Young; Jang, Dong Pyo; Kim, Sun I

    2013-01-01

    Sustained attention is an essential brain function that enables a subject to maintain attention level over the time of a task. In previous work, the right inferior parietal lobe (IPL) has been reported as one of the main brain regions related to sustained attention, however, the right lateralization of vigilance/sustained attention is unclear because information about the network for sustained attention is traditionally provided by neglect patients who typically have right brain damage. Here, we investigated sustained attention by applying a virtual lesion technique, transcranial magnetic stimulation (TMS), over the left and right superior parietal lobe (SPL) and IPL. We used two different types of visual sustained attention tasks: spatial (location based) and non-spatial (feature based). When the participants performed the spatial task, repetitive TMS (rTMS) over either the right or left IPL induced a significant decrement of sustained attention causing a progressive increment of errors and response time. In contrast, participants' performance was not changed by rTMS on the non-spatial task. Also, omission errors (true negative) gradually increased with time on right and left IPL rTMS conditions, while commission errors (false positive) were relatively stable. These findings suggest that the maintenance of attention, especially in tasks regarding spatial location, is not uniquely lateralized to the right IPL, but may also involve participation of the left IPL.

  4. Memory load as a cognitive antidote to performance decrements in data entry.

    PubMed

    Chapman, Mary J; Healy, Alice F; Kole, James A

    2016-10-01

    In two experiments, subjects trained in data entry, typing one 4-digit number at a time. At training, subjects either typed the numbers immediately after they appeared (immediate) or typed the previous number from memory while viewing the next number (delayed). In Experiment 2 stimulus presentation time was limited and either nothing or a space (gap) was inserted between the second and third digits. In both experiments after training, all subjects completed a test with no gap and typed numbers immediately. Training with a memory load improved speed across training blocks (Experiment 1) and eliminated the decline in accuracy across training blocks (Experiment 2), thus serving as a cognitive antidote to performance decrements. An analysis of each keystroke revealed different underlying processes and strategies for the two training conditions, including when encoding took place. Chunking (in which the first and last two digits are treated separately) was more evident in the immediate than in the delayed condition and was exaggerated with a gap, even at test when there was no gap. These results suggest that such two-digit chunking is due to stimulus encoding and motor planning processes as well as memory, and those processes transferred from training to testing.

  5. The effects of incentive framing on performance decrements for large monetary outcomes: behavioral and neural mechanisms.

    PubMed

    Chib, Vikram S; Shimojo, Shinsuke; O'Doherty, John P

    2014-11-05

    There is a nuanced interplay between the provision of monetary incentives and behavioral performance. Individuals' performance typically increases with increasing incentives only up to a point, after which larger incentives may result in decreases in performance, a phenomenon known as "choking." We investigated the influence of incentive framing on choking effects in humans: in one condition, participants performed a skilled motor task to obtain potential monetary gains; in another, participants performed the same task to avoid losing a monetary amount. In both the gain and loss frame, the degree of participants' behavioral loss aversion was correlated with their susceptibility to choking effects. However, the effects were markedly different in the gain and loss frames: individuals with higher loss aversion were susceptible to choking for large prospective gains and not susceptible to choking for large prospective losses, whereas individuals with low loss aversion choked for large prospective losses but not for large prospective gains. Activity in the ventral striatum was predictive of performance decrements in both the gain and loss frames. Moreover, a mediation analysis revealed that behavioral loss aversion hindered performance via the influence of ventral striatal activity on motor performance. Our findings indicate that the framing of an incentive has a profound effect on an individual's susceptibility to choking effects, which is contingent on their loss aversion. Furthermore, we demonstrate that the ventral striatum serves as an interface between incentive-driven motivation and instrumental action, regardless of whether incentives are framed in terms of potential losses or gains.

  6. Choking under pressure: the neuropsychological mechanisms of incentive-induced performance decrements

    PubMed Central

    Yu, Rongjun

    2015-01-01

    In contrast to the assumption of efficiency wage models, which state that wage incentives should be positively correlated with productivity, high incentives may produce performance decrements in real life scenarios. Such a “choking under pressure” phenomenon exemplifies how psychological stress can profoundly shape human behavior, for good or for bad. Previous theories suggest that individual choking under pressure because that high pressure may distract individuals’ attention away from the task (the distraction account), raise the attention paid to step-by-step skill processes (the explicit monitoring account), or elevate the arousal in general (the over-arousal account). Recent neuroimaging studies have shown that several brain regions implicated in motivation and top-down control of attention also play a key role in stress-induced choking, supporting for the over-arousal and distraction theories of choking. This review aims to identify psychological factors that determine choking and the neural underpinnings of these processes. Insights into how incentives influence performance may aid engineering training regimens and interventions that equip individuals to better handle high-stakes-induced psychological stress, and to thrive under stress. PMID:25713517

  7. Discovery of Variable Hydrogen Balmer Absorption Lines with Inverse Decrement in PG 1411+442

    NASA Astrophysics Data System (ADS)

    Shi, Xi-Heng; Pan, Xiang; Zhang, Shao-Hua; Sun, Lu-Ming; Wang, Jian-Guo; Ji, Tuo; Yang, Chen-Wei; Liu, Bo; Jiang, Ning; Zhou, Hong-Yan

    2017-07-01

    We present new optical spectra of the well-known broad absorption line (BAL) quasar PG 1411+442, using the DBSP spectrograph at the Palomar 200 inch telescope in 2014 and 2017 and the YFOSC spectrograph at the Lijiang 2.4 m telescope in 2015. A blueshifted narrow absorption line system is clearly revealed in 2014 and 2015 consisting of hydrogen Balmer series and metastable He i lines. The velocity of these lines is similar to the centroid velocity of the UV BALs, suggesting that both originate from the outflow. The Balmer lines vary significantly between the two observations and vanished in 2017. They were also absent in the archived spectra obtained before 2001. The variation is thought to be driven by photoionization change. Besides, the absorption lines show inversed Balmer decrement, i.e., the apparent optical depths of higher-order Balmer absorption lines are larger than those of lower-order lines, which is inconsistent with the oscillator strengths of the transitions. We suggest that such anomalous line ratios can be naturally explained by the thermal structure of a background accretion disk, which allows the obscured part of the disk to contribute differently to the continuum flux at different wavelengths. High-resolution spectroscopic and photometric monitoring would be very useful to probe the structure of the accretion disk as well as the geometry and physical conditions of the outflow.

  8. Separation of structural modes and harmonic frequencies in Operational Modal Analysis using random decrement

    NASA Astrophysics Data System (ADS)

    Modak, S. V.

    2013-12-01

    Operational Modal Analysis (OMA) is used to extract modal parameters of a structure on the basis of their output response measured during operation. OMA, when applied to mechanical engineering structures is often faced with the problem of harmonics present in the output response. A complex structure may have many dominant frequency components in its response frequency spectrum. These may contain frequency components associated with resonant frequencies of the structure, which and the associated mode shapes and the damping factors represent the data of interest, but may also contain frequencies or harmonics associated with the excitation sources. Since in OMA the characteristics of the excitation sources are not known, one of the problems lies in separating the resonant frequencies from the harmonic excitation frequencies. Any error in this regard may lead to an error in modal identification with the consequence that a harmonic may be construed as a structural mode and vice versa. This issue is addressed in this paper and a method is presented for separating resonant frequencies from harmonic excitation frequencies using random decrement of the response. The principle of the method is presented using an analytical study on a single degree of freedom system. The effectiveness of the method is then demonstrated through numerical studies on a lumped parameter multi-degree of freedom system and a simulated plate structure. Detection of single and multiple harmonics in the response that are well separated as well as close to resonant frequencies are considered.

  9. Harmonics elimination algorithm for operational modal analysis using random decrement technique

    NASA Astrophysics Data System (ADS)

    Modak, S. V.; Rawal, Chetan; Kundra, T. K.

    2010-05-01

    Operational modal analysis (OMA) extracts modal parameters of a structure using their output response, during operation in general. OMA, when applied to mechanical engineering structures is often faced with the problem of harmonics present in the output response, and can cause erroneous modal extraction. This paper demonstrates for the first time that the random decrement (RD) method can be efficiently employed to eliminate the harmonics from the randomdec signatures. Further, the research work shows effective elimination of large amplitude harmonics also by proposing inclusion of additional random excitation. This obviously need not be recorded for analysis, as is the case with any other OMA method. The free decays obtained from RD have been used for system modal identification using eigen-system realization algorithm (ERA). The proposed harmonic elimination method has an advantage over previous methods in that it does not require the harmonic frequencies to be known and can be used for multiple harmonics, including periodic signals. The theory behind harmonic elimination is first developed and validated. The effectiveness of the method is demonstrated through a simulated study and then by experimental studies on a beam and a more complex F-shape structure, which resembles in shape to the skeleton of a drilling or milling machine tool. Cases with presence of single and multiple harmonics in the response are considered.

  10. Effects of chronotype and time of day on the vigilance decrement during simulated driving.

    PubMed

    Correa, Angel; Molina, Enrique; Sanabria, Daniel

    2014-06-01

    The current study tested for the first time the effect of individual differences in circadian rhythmicity (chronotype) on both driving performance and its evolution along time on task. Morning-type and evening-type female participants were tested in morning (8 am) and evening (8 pm) sessions, in which we controlled for prior sleep duration and prior wake. Measures of body temperature, subjective activation and affect, reaction times (RT) in the Psychomotor Vigilance Task (PVT), behavioral performance (error position) and EEG alpha power during simulated driving were collected. The main result showed strong linear increments of mean and standard deviation of error position along time on task (vigilance decrement) when evening-type participants drove at their non-optimal time of day, that is, during the morning session. In contrast, driving performance in the morning-type group remained stable over time on task and was not affected by time of day. This finding can be due to differences in personality traits (e.g., conscientiousness, sensation seeking) and task appraisal associated to extreme chronotypes. The consideration of chronotype in vigilance and driving tasks can enhance safety and human performance by promoting work schedules and countermeasures to prevent failures in the accomplishment of tasks under non-optimal circadian conditions.

  11. Lung cancer

    SciTech Connect

    Aisner, J.

    1985-01-01

    This book contains 13 chapters. Some of the chapter titles are: The Pathology of Lung Cancer; Radiotherapy for Non-Small-Cell Cancer of the Lung; Chemotherapy for Non-Small-Cell Lung Cancer; Immunotherapy in the Management of Lung Cancer; Preoperative Staging and Surgery for Non-Small-Cell Lung Cancer; and Prognostic Factors in Lung Cancer.

  12. Consistently lower narcotics consumption after video-assisted thoracoscopic surgery for early stage non-small cell lung cancer when compared to open surgery: a one-year follow-up study.

    PubMed

    Fang, Hsin-Yuan; Chen, Chih-Yi; Wang, Yao-Ching; Wang, Pin-Hui; Shieh, Shwn-Huey; Chien, Chun-Ru

    2013-04-01

    Video-assisted thoracoscopic surgery (VATS) is possibly associated with reduced acute pain and narcotics consumption when compared to open surgery, but little is known about the long-term effect. The goal of our study was to evaluate whether narcotics consumption is consistently lower after VATS for early stage non-small cell lung cancer (NSCLC), as compared to open surgery, during one-year follow-up. This nationwide retrospective cohort study was conducted using data relating to cancer registry and national compulsory comprehensive claims in Taiwan. Our study cases were those newly diagnosed with clinical Stage I NSCLC, who underwent primary lung resection in the year 2007. The date of the admission during which index surgery was performed was used as the index date. We compared the use of narcotics, between the VATS and open surgery groups, over a period of one year following the index date. We defined narcotics as either Level 1 or 2 drugs as regulated in Taiwan. We also used an equiananalgesic dose chart to convert drug consumption into a uniform narcotics equivalent dose. Chi-square and t-tests were used for statistical analysis. We identified 329 cases (114 for VATS and 215 for open surgery). These two groups were balanced for most clinical variables. VATS was associated with lower narcotics consumption during the index admission (mean equivalent dose of intravenous morphine: 54.6 vs 71.4 mg) and this trend extended to the period covering the 2nd to 12th month after index date (73.8 vs 149.5mg). Narcotics consumption is consistently lower after VATS for early stage NSCLC, as compared to open surgery. Further prospective studies would be of great value in validating this finding.

  13. Transient decrements in mood during energy deficit are independent of dietary protein-to-carbohydrate ratio.

    PubMed

    Karl, J Philip; Thompson, Lauren A; Niro, Philip J; Margolis, Lee M; McClung, James P; Cao, Jay J; Whigham, Leah D; Combs, Gerald F; Young, Andrew J; Lieberman, Harris R; Pasiakos, Stefan M

    2015-02-01

    Energy deficit and dietary macronutrient intake are thought to independently modulate cognition, mood and sleep. To what extent manipulating the dietary ratio of protein-to-carbohydrate affects mood, cognition and sleep during short-term energy deficit is undetermined. Using a randomized, block design, 39 non-obese young adults (21±1 years, BMI 25±1 kg/m(2)) consumed diets containing 0.8 g, 1.6 g or 2.4 g protein per kg body weight per day for 31 days. Carbohydrate intake was reduced to accommodate higher protein intakes while dietary fat was maintained at 30% of total energy intake. Cognitive performance, mood, self-reported sleep quality, and plasma amino acid concentrations were periodically assessed during a 10-day energy balance period and a subsequent 21-day, 40% energy deficit period. Anger, tension and total mood disturbance increased during the initial ten days of energy deficit (P<0.05), but by the end of the energy deficit returned to levels not different from those measured during energy balance. No effects of dietary protein-to-carbohydrate ratio on cognitive performance, mood or self-reported sleep quality were observed during energy balance or energy deficit. Thus, high-protein, low-carbohydrate, moderate-fat diets do not appear to benefit or impair cognition, mood or sleep in non-obese adults during energy deficit. These findings suggest that energy deficit may initially be psychologically difficult for non-obese individuals attempting to lose weight, but that these changes are transient. Employing strategies that alleviate decrements in mood during this initial period of adaptation may help sustain weight loss efforts. Published by Elsevier Inc.

  14. Sleep deprivation and time-on-task performance decrement in the rat psychomotor vigilance task.

    PubMed

    Oonk, Marcella; Davis, Christopher J; Krueger, James M; Wisor, Jonathan P; Van Dongen, Hans P A

    2015-03-01

    The rat psychomotor vigilance task (rPVT) was developed as a rodent analog of the human psychomotor vigilance task (hPVT). We examined whether rPVT performance displays time-on-task effects similar to those observed on the hPVT. The rPVT requires rats to respond to a randomly presented light stimulus to obtain a water reward. Rats were water deprived for 22 h prior to each 30-min rPVT session to motivate performance. We analyzed rPVT performance over time on task and as a function of the response-stimulus interval, at baseline and after sleep deprivation. The study was conducted in an academic research vivarium. Male Long-Evans rats were trained to respond to a 0.5 sec stimulus light within 3 sec of stimulus onset. Complete data were available for n = 20 rats. Rats performed the rPVT for 30 min at baseline and after 24 h total sleep deprivation by gentle handling. Compared to baseline, sleep deprived rats displayed increased performance lapses and premature responses, similar to hPVT lapses of attention and false starts. However, in contrast to hPVT performance, the time-on-task performance decrement was not significantly enhanced by sleep deprivation. Moreover, following sleep deprivation, rPVT response times were not consistently increased after short response-stimulus intervals. The rPVT manifests similarities to the hPVT in global performance outcomes, but not in post-sleep deprivation effects of time on task and response-stimulus interval. © 2015 Associated Professional Sleep Societies, LLC.

  15. Design of flattening filters for the fast-neutron beam at TAMVEC by use of decrement lines.

    PubMed

    Otte, V A; Smathers, J B; Wright, R E

    1976-01-01

    Isodose distributions in a tissue-equivalent phantom produced by fast neutrons from 50-MeV deuterons incident on a thick beryllium target exhibit strong forward peaking, particularly for large fields. The design by use of decrement lines and the construction of polyethylene filters used to "flatten" those distributions are discussed and the results are illustrated. Also, the compromises of central-axis attenuation versus effective filter width and of off-axis peaking versus depth of "flattening" are discussed.

  16. Hippocampal damage in rats disrupts decrements in the processing of an intramaze landmark in a spatial task.

    PubMed

    Ramos, J M

    2001-05-18

    Using a four-arm plus-shaped maze, rats with neurotoxic lesions in the dorsal hippocampus were trained in a spatial reference memory task in which both the extramaze constellation of stimuli and an intramaze landmark (a piece of sandpaper covering the floor of the goal) indicated the location of the goal arm. After reaching criterion, animals were given two transfer tests in order to investigate how much they had learned about the intra and extramaze cues. Results showed that during the intramaze transfer, based exclusively on the intramaze cue, hippocampal rats produced a performance clearly superior to that of the controls. Importantly, the average percentage of correct responses recorded in the hippocampal group during the extra versus the intramaze transfer test was similar. Thus, no decremental processing of the intramaze cue was detected in the lesioned group. In contrast, control rats showed a decremental processing of the intramaze landmark performing worse during the intramaze transfer as compared with the extramaze transfer. These results support the view that the hippocampus regulates decremental changes in the processing of normally irrelevant stimuli, extending this claim into a spatial domain.

  17. Differences in lung function and prevalence of pneumoconiosis between two kaolin plants.

    PubMed Central

    Baser, M E; Kennedy, T P; Dodson, R; Rawlings, W; Rao, N V; Hoidal, J R

    1989-01-01

    To investigate the origin of differences in previously published pulmonary function studies of workers in kaolin plants in Georgia, spirometric and radiographic data collected in a cross sectional survey of two large plants were analysed. As compared with workers in plant 2, workers in plant 1 had a 2.7-fold greater prevalence of pneumoconiosis and a mean 0.361 decrement in adjusted forced vital capacity. Our previous finding that exposure to kaolin was not associated with a decrement in lung function may have resulted from failure to consider differences between the plants. PMID:2590641

  18. Risk of Performance Decrement and Crew Illness Due to an Inadequate Food System

    NASA Technical Reports Server (NTRS)

    Douglas, Grace L.; Cooper, Maya; Bermudez-Aguirre, Daniela; Sirmons, Takiyah

    2016-01-01

    evidence for the Risk of Performance Decrement and Crew Illness Due to an Inadequate Food System and the gaps in relation to exploration, as identified by the NASA Human Research Program (HRP). The research reviewed here indicates strategies to establish methods, technologies, and requirements that increase food stability, support adequate nutrition, quality, and variety, enable supplementation with grow-pick-and-eat salad crops, ensure safety, and reduce resource use. Obtaining the evidence to establish an adequate food system is essential, as the resources allocated to the food system may be defined based on the data relating nutritional stability and food quality requirements to crew performance and health.

  19. Risk of Adverse Health Outcomes and Decrements in Performance Due to In-flight Medical Conditions

    NASA Technical Reports Server (NTRS)

    Antonsen,Erik

    2017-01-01

    The drive to undertake long-duration space exploration missions at greater distances from Earth gives rise to many challenges concerning human performance under extreme conditions. At NASA, the Human Research Program (HRP) has been established to investigate the specific risks to astronaut health and performance presented by space exploration, in addition to developing necessary countermeasures and technology to reduce risk and facilitate safer, more productive missions in space (NASA Human Research Program 2009). The HRP is divided into five subsections, covering behavioral health, space radiation, habitability, and other areas of interest. Within this structure is the ExMC Element, whose research contributes to the overall development of new technologies to overcome the challenges of expanding human exploration and habitation of space. The risk statement provided by the HRP to the ExMC Element states: "Given that medical conditions/events will occur during human spaceflight missions, there is a possibility of adverse health outcomes and decrements in performance in mission and for long term health" (NASA Human Research Program 2016). Within this risk context, the Exploration Medical Capabilities (ExMC) Element is specifically concerned with establishing evidenced-based methods of monitoring and maintaining astronaut health. Essential to completing this task is the advancement in techniques that identify, prevent, and treat any health threats that may occur during space missions. The ultimate goal of the ExMC Element is to develop and demonstrate a pathway for medical system integration into vehicle and mission design to mitigate the risk of medical issues. Integral to this effort is inclusion of an evidence-based medical and data handling system appropriate for long-duration, exploration-class missions. This requires a clear Concept of Operations, quantitative risk metrics or other tools to address changing risk throughout a mission, and system scoping and system

  20. Lung Transplantation

    MedlinePlus

    ... who have severe COPD Cystic fibrosis Idiopathic pulmonary fibrosis Alpha-1 antitrypsin deficiency Pulmonary hypertension Complications of lung transplantation include rejection of the transplanted lung and infection. NIH: National Heart, Lung, and Blood Institute

  1. Lung disease

    MedlinePlus

    ... the lungs to take in oxygen and release carbon dioxide. People with this type of lung disorder often ... the lungs to take up oxygen and release carbon dioxide. These diseases may also affect heart function. An ...

  2. Collapsed Lung

    MedlinePlus

    A collapsed lung happens when air enters the pleural space, the area between the lung and the chest wall. If it is a ... is called pneumothorax. If only part of the lung is affected, it is called atelectasis. Causes of ...

  3. Significant CMAP decrement by repetitive nerve stimulation is more frequent in median than ulnar nerves of patients with amyotrophic lateral sclerosis.

    PubMed

    Yamashita, Satoshi; Sakaguchi, Hideya; Mori, Akira; Kimura, En; Maeda, Yasushi; Hirano, Teruyuki; Uchino, Makoto

    2012-03-01

    Several studies have shown a significant amplitude decrement in compound muscle action potentials (CMAPs) on repetitive nerve stimulation (RNS) of muscles involved in amyotrophic lateral sclerosis (ALS). In ALS, muscle wasting preferentially affects the thenar muscles (APB) rather than the hypothenar muscles (ADM). We performed RNS studies in the APB and ADM muscles of 32 ALS patients to determine whether the effect of RNS differs between the median and ulnar nerves. The decremental responses to RNS were greater in the APB than in the ADM. Reduced CMAP amplitude was negatively correlated with CMAP decrement in median but not in ulnar nerves. The greater CMAP decrement in median nerve is attributable to preferential involvement of the APB in the pathophysiology of ALS or some underlying difference in the biology of the two muscles/nerves. Further investigations will better our understanding of the pathophysiology of ALS. Copyright © 2011 Wiley Periodicals, Inc.

  4. Nivolumab alone and nivolumab plus ipilimumab in recurrent small-cell lung cancer (CheckMate 032): a multicentre, open-label, phase 1/2 trial.

    PubMed

    Antonia, Scott J; López-Martin, José A; Bendell, Johanna; Ott, Patrick A; Taylor, Matthew; Eder, Joseph Paul; Jäger, Dirk; Pietanza, M Catherine; Le, Dung T; de Braud, Filippo; Morse, Michael A; Ascierto, Paolo A; Horn, Leora; Amin, Asim; Pillai, Rathi N; Evans, Jeffry; Chau, Ian; Bono, Petri; Atmaca, Akin; Sharma, Padmanee; Harbison, Christopher T; Lin, Chen-Sheng; Christensen, Olaf; Calvo, Emiliano

    2016-07-01

    Treatments for small-cell lung cancer (SCLC) after failure of platinum-based chemotherapy are limited. We assessed safety and activity of nivolumab and nivolumab plus ipilimumab in patients with SCLC who progressed after one or more previous regimens. The SCLC cohort of this phase 1/2 multicentre, multi-arm, open-label trial was conducted at 23 sites (academic centres and hospitals) in six countries. Eligible patients were 18 years of age or older, had limited-stage or extensive-stage SCLC, and had disease progression after at least one previous platinum-containing regimen. Patients received nivolumab (3 mg/kg bodyweight intravenously) every 2 weeks (given until disease progression or unacceptable toxicity), or nivolumab plus ipilimumab (1 mg/kg plus 1 mg/kg, 1 mg/kg plus 3 mg/kg, or 3 mg/kg plus 1 mg/kg, intravenously) every 3 weeks for four cycles, followed by nivolumab 3 mg/kg every 2 weeks. Patients were either assigned to nivolumab monotherapy or assessed in a dose-escalating safety phase for the nivolumab/ipilimumab combination beginning at nivolumab 1 mg/kg plus ipilimumab 1 mg/kg. Depending on tolerability, patients were then assigned to nivolumab 1 mg/kg plus ipilimumab 3 mg/kg or nivolumab 3 mg/kg plus ipilimumab 1 mg/kg. The primary endpoint was objective response by investigator assessment. All analyses included patients who were enrolled at least 90 days before database lock. This trial is ongoing; here, we report an interim analysis of the SCLC cohort. This study is registered with ClinicalTrials.gov, number NCT01928394. Between Nov 18, 2013, and July 28, 2015, 216 patients were enrolled and treated (98 with nivolumab 3 mg/kg, three with nivolumab 1 mg/kg plus ipilimumab 1 mg/kg, 61 with nivolumab 1 mg/kg plus ipilimumab 3 mg/kg, and 54 with nivolumab 3 mg/kg plus ipilimumab 1 mg/kg). At database lock on Nov 6, 2015, median follow-up for patients continuing in the study (including those who had died or discontinued treatment) was 198·5 days (IQR 163

  5. Atezolizumab versus docetaxel for patients with previously treated non-small-cell lung cancer (POPLAR): a multicentre, open-label, phase 2 randomised controlled trial.

    PubMed

    Fehrenbacher, Louis; Spira, Alexander; Ballinger, Marcus; Kowanetz, Marcin; Vansteenkiste, Johan; Mazieres, Julien; Park, Keunchil; Smith, David; Artal-Cortes, Angel; Lewanski, Conrad; Braiteh, Fadi; Waterkamp, Daniel; He, Pei; Zou, Wei; Chen, Daniel S; Yi, Jing; Sandler, Alan; Rittmeyer, Achim

    2016-04-30

    Outcomes are poor for patients with previously treated, advanced or metastatic non-small-cell lung cancer (NSCLC). The anti-programmed death ligand 1 (PD-L1) antibody atezolizumab is clinically active against cancer, including NSCLC, especially cancers expressing PD-L1 on tumour cells, tumour-infiltrating immune cells, or both. We assessed efficacy and safety of atezolizumab versus docetaxel in previously treated NSCLC, analysed by PD-L1 expression levels on tumour cells and tumour-infiltrating immune cells and in the intention-to-treat population. In this open-label, phase 2 randomised controlled trial, patients with NSCLC who progressed on post-platinum chemotherapy were recruited in 61 academic medical centres and community oncology practices across 13 countries in Europe and North America. Key inclusion criteria were Eastern Cooperative Oncology Group performance status 0 or 1, measurable disease by Response Evaluation Criteria In Solid Tumors version 1.1 (RECIST v1.1), and adequate haematological and end-organ function. Patients were stratified by PD-L1 tumour-infiltrating immune cell status, histology, and previous lines of therapy, and randomly assigned (1:1) by permuted block randomisation (with a block size of four) using an interactive voice or web system to receive intravenous atezolizumab 1200 mg or docetaxel 75 mg/m(2) once every 3 weeks. Baseline PD-L1 expression was scored by immunohistochemistry in tumour cells (as percentage of PD-L1-expressing tumour cells TC3≥50%, TC2≥5% and <50%, TC1≥1% and <5%, and TC0<1%) and tumour-infiltrating immune cells (as percentage of tumour area: IC3≥10%, IC2≥5% and <10%, IC1≥1% and <5%, and IC0<1%). The primary endpoint was overall survival in the intention-to-treat population and PD-L1 subgroups at 173 deaths. Biomarkers were assessed in an exploratory analysis. We assessed safety in all patients who received at least one dose of study drug. This study is registered with ClinicalTrials.gov, number NCT

  6. Expectations induced by natural-like temporal fluctuations are independent of attention decrement: evidence from behavior and early visual evoked potentials.

    PubMed

    Derosiere, Gerard; Farrugia, Nicolas; Perrey, Stéphane; Ward, Tomas; Torre, Kjerstin

    2015-01-01

    Temporal expectations and attention decrement affect human behavior in opposing ways: the former positively, the latter negatively yet both exhibit similar neural signatures - i.e., reduction in the early event-related potential components' amplitude - despite different underlying mechanisms. Furthermore, there is a significant and growing debate in the literature regarding the putative role of attention in the encoding of expectations in perception. The question then arises as to what are the behavioral and neural consequences, if any, of attention decrement on temporal expectations and related enhancement of sensory information processing. Here, we investigated behavioral performance and visual N1a, N1p and P1 components during a sustained attention reaction time task inducing attention decrement under two conditions. In one condition, the inter-stimulus intervals (ISIs) were randomly distributed to impede expectation effects while for the other, the ISI exhibited natural-like long-term correlations supposed to induce temporal expectations. Behavioral results show that natural-like fluctuations in ISI indeed induced faster RT due to temporal expectations. These temporal expectations were beneficial even under attention decrement circumstances. Further, temporal expectations were associated with reduced N1a amplitude while attention decrement was associated with reduced N1p amplitude. Our findings provide evidence that the effects of temporal expectations and attention decrement induced in a single task can be independent at the behavioral level, and are supported at separate information processing stages at the neural level in vision. Copyright © 2014 Elsevier Inc. All rights reserved.

  7. Cloud-Based NoSQL Open Database of Pulmonary Nodules for Computer-Aided Lung Cancer Diagnosis and Reproducible Research.

    PubMed

    Ferreira Junior, José Raniery; Oliveira, Marcelo Costa; de Azevedo-Marques, Paulo Mazzoncini

    2016-12-01

    Lung cancer is the leading cause of cancer-related deaths in the world, and its main manifestation is pulmonary nodules. Detection and classification of pulmonary nodules are challenging tasks that must be done by qualified specialists, but image interpretation errors make those tasks difficult. In order to aid radiologists on those hard tasks, it is important to integrate the computer-based tools with the lesion detection, pathology diagnosis, and image interpretation processes. However, computer-aided diagnosis research faces the problem of not having enough shared medical reference data for the development, testing, and evaluation of computational methods for diagnosis. In order to minimize this problem, this paper presents a public nonrelational document-oriented cloud-based database of pulmonary nodules characterized by 3D texture attributes, identified by experienced radiologists and classified in nine different subjective characteristics by the same specialists. Our goal with the development of this database is to improve computer-aided lung cancer diagnosis and pulmonary nodule detection and classification research through the deployment of this database in a cloud Database as a Service framework. Pulmonary nodule data was provided by the Lung Image Database Consortium and Image Database Resource Initiative (LIDC-IDRI), image descriptors were acquired by a volumetric texture analysis, and database schema was developed using a document-oriented Not only Structured Query Language (NoSQL) approach. The proposed database is now with 379 exams, 838 nodules, and 8237 images, 4029 of them are CT scans and 4208 manually segmented nodules, and it is allocated in a MongoDB instance on a cloud infrastructure.

  8. Nursing Performance and Mobile Phone Use: Are Nurses Aware of Their Performance Decrements?

    PubMed Central

    2015-01-01

    Background Prior research has documented the effect of concurrent mobile phone use on medical care. This study examined the extent of hospital registered nurses’ awareness of their mobile-phone-associated performance decrements. Objective The objective of this study was to compare self-reported performance with reported observed performance of others with respect to mobile phone use by hospital registered nurses. Methods In March 2014, a previously validated survey was emailed to the 10,978 members of the Academy of Medical Surgical Nurses. The responses were analyzed using a two-proportion z test (alpha=.05, two-tailed) to examine whether self-reported and observed rates of error were significantly different. All possible demographic and employment confounders which could potentially contribute to self-reported and observed performance errors were tested for significance. Results Of the 950 respondents, 825 (8.68%, 825/950) met the inclusion criteria for analysis. The representativeness of the sample relative to the US nursing workforce was assessed using a two-proportion z test. This indicated that sex and location of primary place of employment (urban/rural) were represented appropriately in the study sample. Respondents in the age groups <40 years old were underrepresented, while age groups >55 years old were overrepresented. Whites, American Indians/Alaskan natives, and Native Hawaiian or Pacific Islanders were underrepresented, while Hispanic and multiple/other ethnicities were overrepresented. It was decided to report the unweighted, rather than the weighted survey data, with the recognition that the results, while valuable, may not be generalizable to the entire US registered nursing workforce. A significant difference was found between registered nurses’ self-reported and observed rates of errors associated with concurrent mobile phone use in following three categories (1) work performance (z=−26.6142, P<.001, Fisher’s exact test), (2) missing

  9. Nursing Performance and Mobile Phone Use: Are Nurses Aware of Their Performance Decrements?

    PubMed

    McBride, Deborah; LeVasseur, Sandra A; Li, Dongmei

    2015-04-23

    Prior research has documented the effect of concurrent mobile phone use on medical care. This study examined the extent of hospital registered nurses' awareness of their mobile-phone-associated performance decrements. The objective of this study was to compare self-reported performance with reported observed performance of others with respect to mobile phone use by hospital registered nurses. In March 2014, a previously validated survey was emailed to the 10,978 members of the Academy of Medical Surgical Nurses. The responses were analyzed using a two-proportion z test (alpha=.05, two-tailed) to examine whether self-reported and observed rates of error were significantly different. All possible demographic and employment confounders which could potentially contribute to self-reported and observed performance errors were tested for significance. Of the 950 respondents, 825 (8.68%, 825/950) met the inclusion criteria for analysis. The representativeness of the sample relative to the US nursing workforce was assessed using a two-proportion z test. This indicated that sex and location of primary place of employment (urban/rural) were represented appropriately in the study sample. Respondents in the age groups <40 years old were underrepresented, while age groups >55 years old were overrepresented. Whites, American Indians/Alaskan natives, and Native Hawaiian or Pacific Islanders were underrepresented, while Hispanic and multiple/other ethnicities were overrepresented. It was decided to report the unweighted, rather than the weighted survey data, with the recognition that the results, while valuable, may not be generalizable to the entire US registered nursing workforce. A significant difference was found between registered nurses' self-reported and observed rates of errors associated with concurrent mobile phone use in following three categories (1) work performance (z=-26.6142, P<.001, Fisher's exact test), (2) missing important clinical information (z=-13.9882, P

  10. Carotid flow pulsatility is higher in women with greater decrement in gait speed during multi-tasking.

    PubMed

    Gonzales, Joaquin U; James, C Roger; Yang, Hyung Suk; Jensen, Daniel; Atkins, Lee; Al-Khalil, Kareem; O'Boyle, Michael

    2017-05-01

    Central arterial hemodynamics is associated with cognitive impairment. Reductions in gait speed during walking while performing concurrent tasks known as dual-tasking (DT) or multi-tasking (MT) is thought to reflect the cognitive cost that exceeds neural capacity to share resources. We hypothesized that central vascular function would associate with decrements in gait speed during DT or MT. Gait speed was measured using a motion capture system in 56 women (30-80y) without mild-cognitive impairment. Dual-tasking was considered walking at a fast-pace while balancing a tray. Multi-tasking was the DT condition plus subtracting by serial 7's. Applanation tonometry was used for measurement of aortic stiffness and central pulse pressure. Doppler-ultrasound was used to measure blood flow velocity and β-stiffness index in the common carotid artery. The percent change in gait speed was larger for MT than DT (14.1±11.2 vs. 8.7±9.6%, p <0.01). Tertiles were formed based on the percent change in gait speed for each condition. No vascular parameters differed across tertiles for DT. In contrast, carotid flow pulsatility (1.85±0.43 vs. 1.47±0.42, p=0.02) and resistance (0.75±0.07 vs. 0.68±0.07, p=0.01) indices were higher in women with more decrement (third tertile) as compared to women with less decrement (first tertile) in gait speed during MT after adjusting for age, gait speed, and task error. Carotid pulse pressure and β-stiffness did not contribute to these tertile differences. Elevated carotid flow pulsatility and resistance are characteristics found in healthy women that show lower cognitive capacity to walk and perform multiple concurrent tasks. Copyright © 2017 Elsevier B.V. All rights reserved.

  11. An integrated physiology model to study regional lung damage effects and the physiologic response

    PubMed Central

    2014-01-01

    Background This work expands upon a previously developed exercise dynamic physiology model (DPM) with the addition of an anatomic pulmonary system in order to quantify the impact of lung damage on oxygen transport and physical performance decrement. Methods A pulmonary model is derived with an anatomic structure based on morphometric measurements, accounting for heterogeneous ventilation and perfusion observed experimentally. The model is incorporated into an existing exercise physiology model; the combined system is validated using human exercise data. Pulmonary damage from blast, blunt trauma, and chemical injury is quantified in the model based on lung fluid infiltration (edema) which reduces oxygen delivery to the blood. The pulmonary damage component is derived and calibrated based on published animal experiments; scaling laws are used to predict the human response to lung injury in terms of physical performance decrement. Results The augmented dynamic physiology model (DPM) accurately predicted the human response to hypoxia, altitude, and exercise observed experimentally. The pulmonary damage parameters (shunt and diffusing capacity reduction) were fit to experimental animal data obtained in blast, blunt trauma, and chemical damage studies which link lung damage to lung weight change; the model is able to predict the reduced oxygen delivery in damage conditions. The model accurately estimates physical performance reduction with pulmonary damage. Conclusions We have developed a physiologically-based mathematical model to predict performance decrement endpoints in the presence of thoracic damage; simulations can be extended to estimate human performance and escape in extreme situations. PMID:25044032

  12. Risk of Performance Decrements and Adverse Health Outcomes Resulting from Sleep Loss, Circadian Desynchronization, and Work Overload

    NASA Technical Reports Server (NTRS)

    Evans-Flynn, Erin; Gregory, Kevin; Arsintescu, Lucia; Whitmire, Alexandra; Leveton, Lauren B.; Vessey, William

    2015-01-01

    Sleep loss, circadian desynchronization, and work overload occur to some extent for ground and flight crews, prior to and during spaceflight missions. Ground evidence indicates that such risk factors may lead to performance decrements and adverse health outcomes, which could potentially compromise mission objectives. Efforts are needed to identify the environmental and mission conditions that interfere with sleep and circadian alignment, as well as individual differences in vulnerability and resiliency to sleep loss and circadian desynchronization. Specifically, this report highlights a collection of new evidence to better characterize the risk and reveals new gaps in this risk.

  13. Bacterial lipopolysaccharide increases tyrosine phosphorylation of zonula adherens proteins and opens the paracellular pathway in lung microvascular endothelia through TLR4, TRAF6, and src family kinase activation

    USDA-ARS?s Scientific Manuscript database

    Objective: LPS is a key mediator in vascular leak syndromes associated with Gram-negative bacterial infections and opens the pulmonary vascular endothelial paracellular pathway through protein tyrosine kinase (PTK) activation. We asked which PTKs and signaling molecules mediate LPS-induced endothel...

  14. Beginnings of open-heart surgery in Gdansk – double role of the Pemco heart-lung machine and new facts about Dutch-Polish cooperation

    PubMed Central

    2016-01-01

    The first open-heart surgery in Gdansk took place in 1975. It was possible thanks to the gift of a Pemco extracorporeal circulation machine from the Netherlands to the Surgery Institute of the Medical Academy of Gdansk. The article presents additional, unpublished informations which enable a new interpretation of the previously known facts. PMID:27516801

  15. Topographical distribution of decrements and recovery in muscarinic receptors from rat brains repeatedly exposed to sublethal doses of soman

    SciTech Connect

    Churchill, L.; Pazdernik, T.L.; Jackson, J.L.; Nelson, S.R.; Samson, F.E.; McDonough, J.H. Jr.

    1984-08-01

    (3H)Quinuclidinyl benzilate binding to rat brain muscarinic receptors decreased after repeated exposure to soman, a potent organophosphorus cholinesterase inhibitor. The topographical distribution of this decrement was analyzed by quantitative receptor autoradiography. After 4 weeks of soman, three times a week, quinuclidinyl benzilate binding decreased to 67 to 80% of control in frontal and parietal cortex, caudate-putamen, lateral septum, hippocampal body, dentate gyrus, superior colliculus, nucleus of the fifth nerve, and central grey. Minor or no decreases were observed in thalamic or hypothalamic nuclei, reticular formation, pontine nuclei, inferior colliculus, nucleus of the seventh nerve, and cerebellum. Scatchard analyses of saturation curves using frontal cortex sections from soman-treated rats revealed a decrease in maximal quinuclidinyl benzilate binding from that in control rats and a return toward control levels by 24 days without any significant change in affinity. These brain areas showing significant decrements in muscarinic receptors recovered with a similar time course. An estimate of the time for 50% recovery for some of the brain areas was 14 days for superior colliculus, 16 days for cortex, and 19 days for hippocampal body. The application of quantitative receptor autoradiography to analyze receptor alterations has been valuable in localizing the telencephalon as a region more susceptible to change in receptor concentration.

  16. Use and abuse of lung biopsy.

    PubMed

    Gal, Anthony A

    2005-07-01

    The lung biopsy is widely recognized as a valuable tool for the diagnosis and management of diverse pulmonary disorders. The transbronchial lung biopsy, open lung biopsy, and video assisted thoracoscopic surgery biopsy are the principal tools that have been developed for obtaining lung tissue for histopathological examination. Whereas these various types of lung biopsies are highly sensitive and specific tests available for diagnosis, they may be fraught with potential problems. This review hopes to inform the reader of the indications and limitations of the lung biopsy.

  17. Effects of positive end-expiratory pressure titration and recruitment maneuver on lung inflammation and hyperinflation in experimental acid aspiration-induced lung injury.

    PubMed

    Ambrosio, Aline M; Luo, Rubin; Fantoni, Denise T; Gutierres, Claudia; Lu, Qin; Gu, Wen-Jie; Otsuki, Denise A; Malbouisson, Luiz M S; Auler, Jose O C; Rouby, Jean-Jacques

    2012-12-01

    In acute lung injury positive end-expiratory pressure (PEEP) and recruitment maneuver are proposed to optimize arterial oxygenation. The aim of the study was to evaluate the impact of such a strategy on lung histological inflammation and hyperinflation in pigs with acid aspiration-induced lung injury. Forty-seven pigs were randomly allocated in seven groups: (1) controls spontaneously breathing; (2) without lung injury, PEEP 5 cm H2O; (3) without lung injury, PEEP titration; (4) without lung injury, PEEP titration + recruitment maneuver; (5) with lung injury, PEEP 5 cm H2O; (6) with lung injury, PEEP titration; and (7) with lung injury, PEEP titration + recruitment maneuver. Acute lung injury was induced by intratracheal instillation of hydrochloric acid. PEEP titration was performed by incremental and decremental PEEP from 5 to 20 cm H2O for optimizing arterial oxygenation. Three recruitment maneuvers (pressure of 40 cm H2O maintained for 20 s) were applied to the assigned groups at each PEEP level. Proportion of lung inflammation, hemorrhage, edema, and alveolar wall disruption were recorded on each histological field. Mean alveolar area was measured in the aerated lung regions. Acid aspiration increased mean alveolar area and produced alveolar wall disruption, lung edema, alveolar hemorrhage, and lung inflammation. PEEP titration significantly improved arterial oxygenation but simultaneously increased lung inflammation in juxta-diaphragmatic lung regions. Recruitment maneuver during PEEP titration did not induce additional increase in lung inflammation and alveolar hyperinflation. In a porcine model of acid aspiration-induced lung injury, PEEP titration aimed at optimizing arterial oxygenation, substantially increased lung inflammation. Recruitment maneuvers further improved arterial oxygenation without additional effects on inflammation and hyperinflation.

  18. Lung transplant

    MedlinePlus

    ... diseases that may require a lung transplant are: Cystic fibrosis Damage to the arteries of the lung because ... BC; Clinical Practice Guidelines for Pulmonary Therapies Committee; ... Therapies Committee. Cystic fibrosis pulmonary guidelines: ...

  19. PRD (power-reactivity-decrement) components of a homogeneous U10Zr-fueled 900 MWt LMR

    SciTech Connect

    Meneghetti, D.; Kucera, D.A.

    1988-01-01

    The linear and Doppler feedback components of the regional contributions of the power-reactivity-decrement (PRD) for a representative 900 MWt homogeneous U10Zr-fueled sodium-cooled reactor are calculated. The PRD is the reactivity required to bring the reactor from zero-power hot-critical condition to a given power level. These components are further separated into power dependent and power-to-flow dependent parts. The values are compared with corresponding quantities calculated for the Experimental Breeder Reactor II (EBR-II). The implications of these comparisons upon inherent safety characteristics of metal-fueled sodium-cooled reactors are discussed. The effects of fuel axial restraint on feedback, resulting from possible fuel-clad interactions due to burnup are also calculated. The possible enhancement of desirable feedbacks by use of appropriately designed subassembly-duct bowing feedback characteristics is estimated.

  20. Necitumumab plus Gemcitabine and Cisplatin as First-Line Therapy in Patients with Stage IV EGFR- Expressing Squamous Non-Small-Cell Lung Cancer: German Subgroup Data from an Open-Label, Randomized Controlled Phase 3 Study (SQUIRE).

    PubMed

    Reck, Martin; Thomas, Michael; Kropf-Sanchen, Cornelia; Mezger, Jörg; Socinski, Mark A; Depenbrock, Henrik; Soldatenkova, Victoria; Brown, Jacqueline; Krause, Thomas; Thatcher, Nick

    2016-01-01

    In the SQUIRE study, adding the anti-epidermal growth factor receptor (EGFR) IgG1 antibody necitumumab to first-line gemcitabine and cisplatin (GC + N) in advanced squamous non-small-cell lung cancer (sqNSCLC) significantly improved overall survival (OS); the safety profile was acceptable. We explored data for the German subpopulation (N = 96) of SQUIRE patients with EGFR-expressing tumors. Patients with stage IV sqNSCLC were randomized 1:1 to up to 6 cycles of open-label GC + N or GC alone. GC + N patients with no progression continued on necitumumab monotherapy until disease progression or intolerable toxicity. The primary endpoint was OS; the secondary endpoints included progression-free survival (PFS), safety and health-related quality of life (EQ-5D, Lung Cancer Symptom Scale (LCSS)). The 96 German SQUIRE patients with EGFR-expressing tumors (GC + N 42, GC 54) received a median of 4 GC cycles; the GC + N patients received 5 cycles of necitumumab. Adding necitumumab was associated with 41% risk reduction of death (hazard ratio (HR) 0.59, 95% confidence interval (CI) 0.37-0.94, p = 0.026) and 44% risk reduction of progression (HR 0.56, 95% CI 0.33-0.95, p = 0.029). Adverse events typically associated with EGFR antibody treatment (including rash, hypomagnesemia) were more common with GC + N. The time to deterioration of the EQ-5D and LCSS scores showed no notable differences between the treatment arms, except for appetite loss (delayed for GC + N). The survival benefit from adding necitumumab to first-line GC was more pronounced in the German SQUIRE subpopulation with EGFR-expressing tumors than in the overall (intention-to-treat) population; toxicity was manageable and consistent with the overall population. © 2016 S. Karger GmbH, Freiburg.

  1. Dabrafenib in patients with BRAF(V600E)-positive advanced non-small-cell lung cancer: a single-arm, multicentre, open-label, phase 2 trial.

    PubMed

    Planchard, David; Kim, Tae Min; Mazieres, Julien; Quoix, Elisabeth; Riely, Gregory; Barlesi, Fabrice; Souquet, Pierre-Jean; Smit, Egbert F; Groen, Harry J M; Kelly, Ronan J; Cho, B C; Socinski, Mark A; Pandite, Lini; Nase, Christine; Ma, Bo; D'Amelio, Anthony; Mookerjee, Bijoyesh; Curtis, C Martin; Johnson, Bruce E

    2016-05-01

    Activating BRAF(V600E) (Val600Glu) mutations are found in about 1-2% of lung adenocarcinomas, which might provide an opportunity for targeted treatment in these patients. Dabrafenib is an oral selective inhibitor of BRAF kinase. We did a trial to assess the clinical activity of dabrafenib in patients with advanced non-small-cell lung cancer (NSCLC) positive for the BRAF(V600E) mutation. In this phase 2, multicentre, non-randomised, open-label study, we enrolled previously treated and untreated patients with stage IV metastatic BRAF(V600E)-positive NSCLC. Patients received oral dabrafenib 150 mg twice daily. The primary endpoint was investigator-assessed overall response, which was assessed in patients who had received at least one dose of dabrafenib; safety was also assessed in this population. The study is ongoing but not enrolling patients in this cohort. This trial is registered with ClinicalTrials.gov, number NCT01336634. Between Aug 3, 2011, and Feb 25, 2014, 84 patients were enrolled, six of whom had not previously received systemic treatment for NSCLC. 26 of the 78 previously treated patients achieved an investigator-assessed overall response (33% [95% CI 23-45]). Four of the six previously untreated patients had an objective response. One patient died from an intracranial haemorrhage that was judged by the investigator to be due to the study drug. Serious adverse events were reported in 35 (42%) of 84 patients. The most frequent grade 3 or worse adverse events were cutaneous squamous-cell carcinoma in ten (12%), asthenia in four (5%), and basal-cell carcinoma in four (5%). Dabrafenib showed clinical activity in BRAF(V600E)-positive NSCLC. Our findings suggest that dabrafenib could represent a treatment option for a population of patients with limited therapeutic options. GlaxoSmithKline. Copyright © 2016 Elsevier Ltd. All rights reserved.

  2. Time-on-task decrement in vigilance is modulated by inter-individual vulnerability to homeostatic sleep pressure manipulation

    PubMed Central

    Maire, Micheline; Reichert, Carolin F.; Gabel, Virginie; Viola, Antoine U.; Krebs, Julia; Strobel, Werner; Landolt, Hans-Peter; Bachmann, Valérie; Cajochen, Christian; Schmidt, Christina

    2014-01-01

    Under sleep loss, vigilance is reduced and attentional failures emerge progressively. It becomes difficult to maintain stable performance over time, leading to growing performance variability (i.e., state instability) in an individual and among subjects. Task duration plays a major role in the maintenance of stable vigilance levels, such that the longer the task, the more likely state instability will be observed. Vulnerability to sleep-loss-dependent performance decrements is highly individual and is also modulated by a polymorphism in the human clock gene PERIOD3 (PER3). By combining two different protocols, we manipulated sleep-wake history by once extending wakefulness for 40 h (high sleep pressure condition) and once by imposing a short sleep-wake cycle by alternating 160 min of wakefulness and 80 min naps (low sleep pressure condition) in a within-subject design. We observed that homozygous carriers of the long repeat allele of PER3 (PER35/5) experienced a greater time-on-task dependent performance decrement (i.e., a steeper increase in the number of lapses) in the Psychomotor Vigilance Task compared to the carriers of the short repeat allele (PER34/4). These genotype-dependent effects disappeared under low sleep pressure conditions, and neither motivation, nor perceived effort accounted for these differences. Our data thus suggest that greater sleep-loss related attentional vulnerability based on the PER3 polymorphism is mirrored by a greater state instability under extended wakefulness in the short compared to the long allele carriers. Our results undermine the importance of time-on-task related aspects when investigating inter-individual differences in sleep loss-induced behavioral vulnerability. PMID:24639634

  3. Aging-related decrements during specific phases of the dual-task Timed Up-and-Go test.

    PubMed

    Porciuncula, Franchino S; Rao, Ashwini K; McIsaac, Tara L

    2016-02-01

    It is unclear how young and older adults modulate dual-task mobility under changing postural challenges. To examine age-related changes in dual-task processing during specific phases of dual-task Timed Up-and-Go (TUGdual-task). Healthy young and older adults performed the Timed Up-and-Go (TUG) with the following dual-task conditions: (1) serial-three subtractions, (2) carrying cup of water, (3) combined subtraction and carrying water, and (4) dialing cell phone. The primary outcome was the dual-task cost on performance of TUG (percent change from single- to dual-task) based on duration and peak trunk velocity of each phase: (a) straight-walk, (b) sit-to-stand, (c) turn, (d) turn-to-sit. Mixed-design univariate analysis of variance was performed for each type of task. Older adults had more pronounced mobility decrements than young adults during straight-ahead walking and turns when the secondary task engaged both cognitive and manual modalities. Simple cognitive or manual tasks during TUGdual-task did not differentiate young from older participants. Subtraction performance during simple and complex cognitive conditions differed by phase of the TUG. Manual task performance of carrying water did not vary by phase or age. Our findings suggest that dual-task processing is dynamic across phases of TUGdual-task. Aging-related dual-task decrements are demonstrated during straight-ahead walking and turning, particularly when the secondary task is more complex. Older adults are susceptible to reduced dual-task mobility during straight-ahead walking and turning particularly when attentional loading was increased.

  4. Within-session decrement of the emission of licking bursts following reward devaluation in rats licking for sucrose

    PubMed Central

    Galistu, Adriana

    2017-01-01

    We previously observed that dopamine D2-like receptor blockade in rats licking for sucrose produced a within-session decrement of the emission of licking bursts similar to the effect of either reward devaluation, or neuroleptics, on operant responding for different rewards, which, accordingly, we interpreted as an extinction-like effect. This implies that exposing animals to reward devaluation would result in a drop of burst number taking place only after the contact with the devalued reward. To test this prediction, we compared the difference in the within-session time course of burst number in response to high (10%) versus low (2%) concentration sucrose solutions, either in a condition of reward devaluation (exposure to 2% after daily 10%), or in a condition which does not involve changes in the reward value (two groups of subjects each repeatedly exposed to only one of the two concentrations). Reward devaluation resulted in a within-session decrement of the burst number, with the response rate dropping only after the contact with the devalued reward, as predicted. This response pattern was reliably observed only in subjects at their first devaluation experience. In contrast, exposure of separate groups of animals to the two different concentrations yielded lower levels of burst number in the low concentration group apparent since the beginning of the session, as previously observed with dopamine D1-like receptor blockade. These results show that the analysis of burst number, but not of burst size, reveals a specific activation pattern in response to reward devaluation, which differs from the pattern observed comparing the response to two different sucrose concentrations in separate groups of subjects, i.e. in a condition not involving reward devaluation. Finally, the characterisation of the experimental measures of the analysis of licking microstructure in behaviourally (and psychologically) meaningful functional terms, might be relevant for the investigation of

  5. Within-session decrement of the emission of licking bursts following reward devaluation in rats licking for sucrose.

    PubMed

    D'Aquila, Paolo S; Galistu, Adriana

    2017-01-01

    We previously observed that dopamine D2-like receptor blockade in rats licking for sucrose produced a within-session decrement of the emission of licking bursts similar to the effect of either reward devaluation, or neuroleptics, on operant responding for different rewards, which, accordingly, we interpreted as an extinction-like effect. This implies that exposing animals to reward devaluation would result in a drop of burst number taking place only after the contact with the devalued reward. To test this prediction, we compared the difference in the within-session time course of burst number in response to high (10%) versus low (2%) concentration sucrose solutions, either in a condition of reward devaluation (exposure to 2% after daily 10%), or in a condition which does not involve changes in the reward value (two groups of subjects each repeatedly exposed to only one of the two concentrations). Reward devaluation resulted in a within-session decrement of the burst number, with the response rate dropping only after the contact with the devalued reward, as predicted. This response pattern was reliably observed only in subjects at their first devaluation experience. In contrast, exposure of separate groups of animals to the two different concentrations yielded lower levels of burst number in the low concentration group apparent since the beginning of the session, as previously observed with dopamine D1-like receptor blockade. These results show that the analysis of burst number, but not of burst size, reveals a specific activation pattern in response to reward devaluation, which differs from the pattern observed comparing the response to two different sucrose concentrations in separate groups of subjects, i.e. in a condition not involving reward devaluation. Finally, the characterisation of the experimental measures of the analysis of licking microstructure in behaviourally (and psychologically) meaningful functional terms, might be relevant for the investigation of

  6. Rovalpituzumab tesirine, a DLL3-targeted antibody-drug conjugate, in recurrent small-cell lung cancer: a first-in-human, first-in-class, open-label, phase 1 study.

    PubMed

    Rudin, Charles M; Pietanza, M Catherine; Bauer, Todd M; Ready, Neal; Morgensztern, Daniel; Glisson, Bonnie S; Byers, Lauren A; Johnson, Melissa L; Burris, Howard A; Robert, Francisco; Han, Tae H; Bheddah, Sheila; Theiss, Noah; Watson, Sky; Mathur, Deepan; Vennapusa, Bharathi; Zayed, Hany; Lally, Satwant; Strickland, Donald K; Govindan, Ramaswamy; Dylla, Scott J; Peng, Stanford L; Spigel, David R

    2017-01-01

    Rovalpituzumab tesirine is a first-in-class antibody-drug conjugate directed against delta-like protein 3 (DLL3), a novel target identified in tumour-initiating cells and expressed in more than 80% of patients with small-cell lung cancer. We aimed to assess the safety and activity of rovalpituzumab tesirine in patients who progressed after one or more previous regimen. We conducted a phase 1 open-label study at ten cancer centres in the USA. Eligible patients were aged 18 years or older and had histologically or cytologically confirmed small-cell lung cancer or large-cell neuroendocrine tumours with progressive measurable disease (according to Response Evaluation Criteria in Solid Tumors [RECIST], version 1.1) previously treated with one or two chemotherapeutic regimens, including a platinum-based regimen. We assigned patients to dose-escalation or expansion cohorts, ranging from 0·05 mg/kg to 0·8 mg/kg rovalpituzumab tesirine intravenously every 3 weeks or every 6 weeks, followed by investigation of the dose schedules 0·3 mg/kg and 0·4 mg/kg every 6 weeks and 0·2 mg/kg every 3 weeks. Primary objectives were to assess the safety of rovalpituzumab tesirine, including the maximum tolerated dose and dose-limiting toxic effects. The primary activity endpoint was objective response by intention-to-treat analysis. This study is registered with ClinicalTrials.gov, number NCT01901653. The study is closed to enrolment; this report focuses on the cohort with small-cell lung cancer. Between July 22, 2013, and Aug 10, 2015, 82 patients were enrolled, including 74 patients with small-cell lung cancer and eight with large-cell neuroendocrine carcinoma, all of whom received at least one dose of rovalpituzumab tesirine. Dose-limiting toxic effects of rovalpituzumab tesirine occurred at a dose of 0·8 mg/kg every 3 weeks, including grade 4 thrombocytopenia (in two of two patients at that dose level) and grade 4 liver function test abnormalities (in one patient). The most

  7. Lung Parenchymal Mechanics

    PubMed Central

    Suki, Béla; Stamenovic, Dimitrije; Hubmayr, Rolf

    2014-01-01

    The lung parenchyma comprises a large number of thin-walled alveoli, forming an enormous surface area, which serves to maintain proper gas exchange. The alveoli are held open by the transpulmonary pressure, or prestress, which is balanced by tissues forces and alveolar surface film forces. Gas exchange efficiency is thus inextricably linked to three fundamental features of the lung: parenchymal architecture, prestress, and the mechanical properties of the parenchyma. The prestress is a key determinant of lung deformability that influences many phenomena including local ventilation, regional blood flow, tissue stiffness, smooth muscle contractility, and alveolar stability. The main pathway for stress transmission is through the extracellular matrix. Thus, the mechanical properties of the matrix play a key role both in lung function and biology. These mechanical properties in turn are determined by the constituents of the tissue, including elastin, collagen, and proteoglycans. In addition, the macroscopic mechanical properties are also influenced by the surface tension and, to some extent, the contractile state of the adherent cells. This article focuses on the biomechanical properties of the main constituents of the parenchyma in the presence of prestress and how these properties define normal function or change in disease. An integrated view of lung mechanics is presented and the utility of parenchymal mechanics at the bedside as well as its possible future role in lung physiology and medicine are discussed. PMID:23733644

  8. Lung parenchymal mechanics.

    PubMed

    Suki, Béla; Stamenović, Dimitrije; Hubmayr, Rolf

    2011-07-01

    The lung parenchyma comprises a large number of thin-walled alveoli, forming an enormous surface area, which serves to maintain proper gas exchange. The alveoli are held open by the transpulmonary pressure, or prestress, which is balanced by tissues forces and alveolar surface film forces. Gas exchange efficiency is thus inextricably linked to three fundamental features of the lung: parenchymal architecture, prestress, and the mechanical properties of the parenchyma. The prestress is a key determinant of lung deformability that influences many phenomena including local ventilation, regional blood flow, tissue stiffness, smooth muscle contractility, and alveolar stability. The main pathway for stress transmission is through the extracellular matrix. Thus, the mechanical properties of the matrix play a key role both in lung function and biology. These mechanical properties in turn are determined by the constituents of the tissue, including elastin, collagen, and proteoglycans. In addition, the macroscopic mechanical properties are also influenced by the surface tension and, to some extent, the contractile state of the adherent cells. This chapter focuses on the biomechanical properties of the main constituents of the parenchyma in the presence of prestress and how these properties define normal function or change in disease. An integrated view of lung mechanics is presented and the utility of parenchymal mechanics at the bedside as well as its possible future role in lung physiology and medicine are discussed.

  9. Lung Organogenesis

    PubMed Central

    Warburton, David; El-Hashash, Ahmed; Carraro, Gianni; Tiozzo, Caterina; Sala, Frederic; Rogers, Orquidea; De Langhe, Stijn; Kemp, Paul J.; Riccardi, Daniela; Torday, John; Bellusci, Saverio; Shi, Wei; Lubkin, Sharon R; Jesudason, Edwin

    2011-01-01

    Developmental lung biology is a field that has the potential for significant human impact: lung disease at the extremes of age continues to cause major morbidity and mortality worldwide. Understanding how the lung develops holds the promise that investigators can use this knowledge to aid lung repair and regeneration. In the decade since the “molecular embryology” of the lung was first comprehensively reviewed, new challenges have emerged—and it is on these that we focus the current review. Firstly, there is a critical need to understand the progenitor cell biology of the lung in order to exploit the potential of stem cells for the treatment of lung disease. Secondly, the current familiar descriptions of lung morphogenesis governed by growth and transcription factors need to be elaborated upon with the reinclusion and reconsideration of other factors, such as mechanics, in lung growth. Thirdly, efforts to parse the finer detail of lung bud signaling may need to be combined with broader consideration of overarching mechanisms that may be therapeutically easier to target: in this arena, we advance the proposal that looking at the lung in general (and branching in particular) in terms of clocks may yield unexpected benefits. PMID:20691848

  10. Lung-protective ventilation in neonatology.

    PubMed

    van Kaam, Anton

    2011-01-01

    Ventilator-induced lung injury (VILI) is considered an important risk factor in the development of bronchopulmonary dysplasia (BPD) and is primarily caused by overdistension (volutrauma) and repetitive opening and collapse (atelectrauma) of terminal lung units. Lung-protective ventilation should therefore aim to reduce tidal volumes, and recruit and stabilize atelectatic lung units (open lung ventilation strategy). This review will summarize the available evidence on lung-protective ventilation in neonatology, discussing both high-frequency ventilation (HFV) and positive pressure ventilation (PPV). It shows that HFV does not appear to have a clear benefit over PPV, although most studies failed to apply a true open lung ventilation strategy during HFV. The evidence on the optimal tidal volume, positive end-expiratory pressure and the role for lung recruitment during lung-protective PPV is extremely limited. Volume-targeted ventilation seems to be a promising mode in terms of lung protection, but more studies are needed. Due to the lack of convincing evidence, lung-protective ventilation and modes seem to be implemented in daily clinical practice at a slow pace.

  11. Transient receptor potential cation channel A1 (TRPA1) mediates decrements in cardiac mechanical function and dysrhythmia caused by a single air pollution exposure in mice

    EPA Science Inventory

    This work, which will be presented at SOT 2014, demonstrates that a single exposure to either ozone or acrolein causes decrements in cardiac function and altered electrical activity (i.e. arrhythmia). The results suggest that this effect is mediated by the airway sensor TRPA1. ...

  12. Predicting Radiation Induced Performance Decrements of AH-1 Helicopter Crews. Volume 1. Predicted Versus Actual Performance of AH-1 Crews Induced with Symptons Simulating Radiation Sickness

    DTIC Science & Technology

    1993-07-01

    principal method under study was the Performance Decrement Questionnaire, developed as part of DNA’s Intermediate Dose Program. A secondary aspect of...3) Develop MicroSAINT models of AH-1 crew performance based on simulation data and PDQ estimates, and (4) Evaluate the relationship between Walter...48 5.2 Approach ...................................................................................................... 49 5.3 Model Development

  13. Transient receptor potential cation channel A1 (TRPA1) mediates decrements in cardiac mechanical function and dysrhythmia caused by a single air pollution exposure in mice

    EPA Science Inventory

    This work, which will be presented at SOT 2014, demonstrates that a single exposure to either ozone or acrolein causes decrements in cardiac function and altered electrical activity (i.e. arrhythmia). The results suggest that this effect is mediated by the airway sensor TRPA1. ...

  14. Cholesterol, lipoproteins and subclinical interstitial lung disease: the MESA study.

    PubMed

    Podolanczuk, Anna J; Raghu, Ganesh; Tsai, Michael Y; Kawut, Steven M; Peterson, Eric; Sonti, Rajiv; Rabinowitz, Daniel; Johnson, Craig; Barr, R Graham; Hinckley Stukovsky, Karen; Hoffman, Eric A; Carr, J Jeffrey; Ahmed, Firas S; Jacobs, David R; Watson, Karol; Shea, Steven J; Lederer, David J

    2017-01-27

    We investigated associations of plasma lipoproteins with subclinical interstitial lung disease (ILD) by measuring high attenuation areas (HAA: lung voxels between -600 and -250 Hounsfield units) in 6700 adults and serum MMP-7 and SP-A in 1216 adults age 45-84 without clinical cardiovascular disease in Multi-Ethnic Study of Atherosclerosis. In cross-sectional analyses, each SD decrement in high density lipoprotein cholesterol (HDL-C) was associated with a 2.12% HAA increment (95% CI 1.44% to 2.79%), a 3.53% MMP-7 increment (95% CI 0.93% to 6.07%) and a 6.37% SP-A increment (95% CI 1.35% to 11.13%), independent of demographics, smoking and inflammatory biomarkers. These findings support a novel hypothesis that HDL-C might influence subclinical lung injury and extracellular matrix remodelling.

  15. Brain injury requires lung protection

    PubMed Central

    Lopez-Aguilar, Josefina

    2015-01-01

    The paper entitled “The high-mobility group protein B1-Receptor for advanced glycation endproducts (HMGB1-RAGE) axis mediates traumatic brain injury (TBI)-induced pulmonary dysfunction in lung transplantation” published recently in Science Translational Medicine links lung failure after transplantation with alterations in the axis HMGB1-RAGE after TBI, opening a new field for exploring indicators for the early detection of patients at risk of developing acute lung injury (ALI). The lung is one of the organs most vulnerable to the inflammatory cascade triggered by TBI. HMGB1 is an alarm in that can be released from activated immune cells in response to tissue injury. Increased systemic HMGB1 concentration correlates with poor lung function before and after lung transplant, confirming its role in acute ALI after TBI. HMGB1 exerts its influence by interacting with several receptors, including the RAGE receptor. RAGE also plays an important role in the onset of innate immune inflammatory responses, and systemic levels of RAGE are strongly associated with ALI and clinical outcomes in ventilator-induced lung injury. RAGE ligation to HMGB1 triggers the amplification of the inflammatory cascade involving nuclear factor-κB (NF-κB) activation. Identifying early biomarkers that mediate pulmonary dysfunction will improve outcomes not only in lung transplantation, but also in other scenarios. These novel findings show that upregulation of the HMGB1-RAGE axis plays an important role in brain-lung crosstalk. PMID:26046092

  16. A cGMP-Dependent Protein Kinase Gene, foraging, Modifies Habituation-Like Response Decrement of the Giant Fiber Escape Circuit in Drosophila

    PubMed Central

    Engel, Jeff E.; Xie, Xian-Jin; Sokolowski, Marla B.; Wu, Chun-Fang

    2000-01-01

    The Drosophila giant fiber jump-and-flight escape response is a model for genetic analysis of both the physiology and the plasticity of a sensorimotor behavioral pathway. We previously established the electrically induced giant fiber response in intact tethered flies as a model for habituation, a form of nonassociative learning. Here, we show that the rate of stimulus-dependent response decrement of this neural pathway in a habituation protocol is correlated with PKG (cGMP-Dependent Protein Kinase) activity and foraging behavior. We assayed response decrement for natural and mutant rover and sitter alleles of the foraging (for) gene that encodes a Drosophila PKG. Rover larvae and adults, which have higher PKG activities, travel significantly farther while foraging than sitters with lower PKG activities. Response decrement was most rapid in genotypes previously shown to have low PKG activities and sitter-like foraging behavior. We also found differences in spontaneous recovery (the reversal of response decrement during a rest from stimulation) and a dishabituation-like phenomenon (the reversal of response decrement evoked by a novel stimulus). This electrophysiological study in an intact animal preparation provides one of the first direct demonstrations that PKG can affect plasticity in a simple learning paradigm. It increases our understanding of the complex interplay of factors that can modulate the sensitivity of the giant fiber escape response, and it defines a new adult-stage phenotype of the foraging locus. Finally, these results show that behaviorally relevant neural plasticity in an identified circuit can be influenced by a single-locus genetic polymorphism existing in a natural population of Drosophila. PMID:11040266

  17. Haemodynamic Effects of Lung Recruitment Manoeuvres

    PubMed Central

    Szakmány, Tamás

    2015-01-01

    Atelectasis caused by lung injury leads to increased intrapulmonary shunt, venous admixture, and hypoxaemia. Lung recruitment manoeuvres aim to quickly reverse this scenario by applying increased airway pressures for a short period of time which meant to open the collapsed alveoli. Although the procedure can improve oxygenation, but due to the heart-lung and right and left ventricle interactions elevated intrathoracic pressures can inflict serious effects on the cardiovascular system. The purpose of this paper is to give an overview on the pathophysiological background of the heart-lung interactions and the best way to monitor these changes during lung recruitment. PMID:26682219

  18. [The lung].

    PubMed

    Martinod, Emmanuel; Uzunhan, Yurdagül; Radu, Dana M; Seguin, Agathe; Boddaert, Guillaume; Valeyre, Dominique; Planès, Carole; Carpentier, Alain

    2011-10-01

    Lung transplantation is still the only curative treatment for end-stage pulmonary diseases. The results remain poor, however, because of the limited availability of lung donors, chronic rejection, and complications related to immunosuppressive therapy. The use of a bioartificial lung generated from autologous cells could offer a solution. We have demonstrated that in vivo epithelial and cartilage regeneration of the airways is feasible with the use of an aortic tissue matrix. Other studies show that in vitro and in vivo airway regeneration, respectively, can be obtained by using bio-engineering and heterotopic allograft implantation. A more complex challenge is the creation of an artificial lung Indeed, this would require the use of an elastic matrix that can promote regeneration of the different lung components (airways, alveoli, vessels) over a large surface area, thus allowing ventilation, blood perfusion and gas exchanges. Recent studies have demonstrated the possibility of in vitro and in vivo regeneration of lung tissue from autologous cells, and especially stem cells. This emerging research field is currently dominated by the use of decellularized lung matrices and autologous epithelial and endothelial cells. Implantation of such a recellularized matrix in animals has proved the feasibility of a functional bio-artificial lung. The first human transplantation of a bio-artificial lung should be possible within 10-20 years.

  19. High-frequency oscillation combined with arteriovenous extracorporeal lung assist reduces lung injury.

    PubMed

    Muellenbach, Ralf M; Kredel, Markus; Wilhelm, Jochen; Küstermann, Julian; Fink, Ludger; Siebenlist, Gregor; Siebenliest, Gregor; Klosterhalfen, Bernd; Foerster, Carola Y; Kranke, Peter; Wunder, Christian; Roewer, Norbert; Brederlau, Jörg

    2010-04-01

    In order to optimize the lung-protective potential of high-frequency oscillatory ventilation (HFOV), it is currently recommended to maximize oscillatory frequencies. However, very high frequencies may lead to insufficient CO(2) elimination with severe respiratory acidosis. Arteriovenous extracorporeal lung assist (av-ECLA) allows near total CO(2) removal, thereby allowing for maximization of the lung-protective potential of HFOV. The aim of this study was to determine the impact of HFOV and av-ECLA on lung inflammation and function compared to conventional lung-protective ventilation. In a porcine surfactant depletion model of lung injury, the authors randomly assigned 16 female pigs to conventional lung-protective ventilation and HFOV/ECLA. Both strategies were combined with an "open-lung" approach. Gas exchange and hemodynamic parameters were measured at intervals during the 24-hour study period. Postmortem, lung tissue was analyzed to determine histological damage and lung inflammation. The authors found that the combination of HFOV and av-ECLA (1) allows significant reductions in mean and peak airway pressures; and (2) reduces histological signs of lung inflammation in the basal regions of the lung. HFOV/av-ECLA reduces histological signs of lung inflammation compared to conventional lung-protective ventilation strategies. Thus, combination of HFOV and av-ECLA might be a further lung-protective tool if conventional ventilation strategies are failing.

  20. [Diameter decrement of abdominal aorta and redistribution of systemic blood flow in non-ambulant Duchenne muscular dystrophy patients].

    PubMed

    Shinoe, T; Kawai, M

    1996-10-01

    Cardiomyopathy is a major life-threatening complication in Duchenne muscular dystrophy (DMD). Cardiac output is always low in advanced stage patients. Impaired muscles presumably require extremely low circulation, while blood flow to brain and internal organs is probably maintained. Therefore, the redistribution of systemic circulation must be another important factor which determines whether or not the cardiomyopathy results in fatal heart failure. Although great efforts have been focused on the cardiac function, this problem has seldom attracted attentions. Assuming that diameter of blood vessels reflects blood flow, we measured the diameter of abdominal aorta on CT at four levels: 1) beginning of the abdominal aorta, 2) before and 3) after the branching of renal arteries, 4) before bifurcation of the common iliac arteries. Six bed-ridden DMD patients were compared with 10 ambulant patients suffering from other neurological and non-neurological diseases. We obtained following results. First, the diameter of abdominal aorta is significantly smaller in DMD patients. Second, the decrement is most prominent between before and after the branching of the renal arteries. These results clearly showed predilection of renointestinal circulation at the sacrifice of lower extremities. This narrowing of distal aorta was also observed in Kugelberg-Welander disease and understood as a sequelae of longstanding abolition of lower extremity functions.

  1. Phenotypic and Molecular Evidence Suggest That Decrements in Morning and Evening Energy Are Distinct But Related Symptoms

    PubMed Central

    Aouizerat, Bradley E.; Dhruva, Anand; Paul, Steven M.; Cooper, Bruce A.; Kober, Kord M.; Miaskowski, Christine

    2015-01-01

    Context Little is known about energy levels in oncology patients and their family caregivers (FCs). Objectives This study sought to identify latent classes of participants, based on self-reported energy levels and to evaluate for differences in phenotypic and genotypic characteristics between these classes. Methods Energy subscale scores from the Lee Fatigue Scale were used to determine latent class membership. Morning and evening energy scores were obtained just prior to, during, and for four months following the completion of radiation therapy. Genetic associations were evaluated for fifteen pro- and anti-inflammatory cytokine genes. Results Two latent classes with distinct morning energy trajectories were identified. Participants who were younger, female, not married/partnered, Black, and had more comorbidities, and a lower functional status were more likely to be in the Low Morning Energy class. Two polymorphisms (IL2 rs1479923, NFKB1 rs4648110) were associated with morning energy latent class membership. Two latent classes with distinct evening energy trajectories were identified. Participants who were younger and male and who had more comorbidities, decreased body weight, and a lower functional status were more likely to be in the Moderate Evening Energy class. Five different polymorphisms (IL1R2 rs4141134, IL6 rs4719714, IL17A rs8193036, NFKB2 rs1056890, TNFA rs1800683) were associated with evening energy latent class membership. Conclusion This study provides preliminary evidence that decrements in morning and evening energy are associated with different phenotypic risk factors as well as cytokine gene variations. PMID:26031709

  2. Whole-Body Vibration Training and Its Application to Age-Related Performance Decrements: An Exploratory Analysis.

    PubMed

    Hawkey, Adam; Griffiths, Katie; Babraj, John; Cobley, James N

    2016-02-01

    Middle age is associated with a pronounced decline in power and flexibility. Whilst whole-body vibration training (WBVT) improves performance in a range of populations, whether WBVT can improve muscle power and flexibility in a middle-aged population is not known. The present study aimed to determine the influence of 5 weeks progressive WBVT in middle-aged (45-55 years) and younger (20-30 years) recreationally active females. Participants in each age group were randomly allocated to an intervention (WBVT) or control group. The WBVT groups trained for 5 weeks on a vibration platform, while the control groups performed identical exercises, with no vibration. Prior to, and after, the 5-week study vertical countermovement jump (VCMJ) and range of motion (ROM) performance were measured. WBVT significantly (p = 0.001) improved VCMJ performance when compared to the control groups. This improvement was significantly (p = 0.001) greater in the middle-aged compared with the younger WBVT group. WBVT significantly (p = 0.001) improved ROM irrespective of age. Taken together, these results suggest that WBVT can off-set age related performance decrements, which has therapeutic implications for musculoskeletal aging. Therefore, WBVT could be undertaken to minimise age-related performance deterioration in middle-aged female populations.

  3. Damage detection using transient trajectories in phase-space with extended random decrement technique under non-stationary excitations

    NASA Astrophysics Data System (ADS)

    Liu, Gang; Mao, Zhu; Todd, Michael

    2016-11-01

    This paper proposes a damage detection method based on the geometrical variation of transient trajectories in phase-space, and the proposed methodology is compatible with non-stationary excitations (e.g., earthquake-induced ground motion). The work presented assumes zero-mean non-stationary excitation, and extends the random decrement technique to convert non-stationary response signals of the structure into free-vibration data. Transient trajectories of the structure are reconstructed via the embedding theorem from the converted free-vibration data, and trajectories are mapped successively into phase-space to enhance statistical analysis. Based upon the characterized system dynamics in terms of phase-space, the time prediction error is adopted as the damage index. To identify the presence and severity of damage in a statistically rigorous way, receiver operating characteristic curves and the Bhattacharyya distance are employed. The results from both numerical simulations and experiments validate the proposed framework, when the test structures are subject to non-stationary excitations. The extension achieved in this paper enables the phase-space damage detection approach to be compatible with non-stationary scenarios, such as traffic, wind, and earthquake loadings. Moreover, the results indicate that this phase-state-based method is able to identify damage-induced nonlinearity in response, which is an intrinsic characteristic associated with most structural damage types.

  4. Frontal P300 decrements, childhood conduct disorder, family history, and the prediction of relapse among abstinent cocaine abusers.

    PubMed

    Bauer, L O

    1997-01-10

    P300 event related brain potentials were studied in 49 cocaine dependent patients, abstinent for 1-5 months, and 20 healthy, non-drug-dependent controls. Patients were assigned to one of two subgroups based on the presence/absence of a DSM-IIIR diagnosis of antisocial personality disorder (ASPD). Analyses of P300s recorded during a visual selective attention task revealed reduced amplitudes at frontal electrode sites among patients with ASPD, relative to the ASPD negative patient and control groups. The frontal P300 decrement was significantly correlated with the number of childhood conduct disorder symptoms, but not with the presence/absence of a family history of alcoholism. A secondary analysis examined the relationship between P300 amplitude among cocaine dependent patients and their future behavior, i.e., relapse versus continued abstinence. Discriminant function analysis revealed that P300 amplitude alone accurately identified 70.6% of the patients who later relapsed, and 53.3% of the patients who did not.

  5. Protection of rhesus monkeys against Soman and prevention of performance decrement by pretreatment with acetylcholinesterase. (Reannouncement with new availability information)

    SciTech Connect

    Maxwell, D.M.; Castro, C.A.; De La Hoz, D.M.; Gentry, M.K.; Gold, M.B.

    1992-12-31

    The ability of acetylcholinesterase from fetal bovine serum (FBS AChE) to protect against soman, a highly toxic organophosphorus (OP) compound, was tested in rhesus monkeys. Intravenous administration of FBS AChE produced a minimal behavioral effect on the serial probe recognition task, a sensitive test of cognitive function and short-term memory. Pharmacokinetic studies of injected FBS AChE indicated a plasma half-life of 40 hr for FBS AChE in monkeys. Both in vitro and in vivo titration of FBS AChE with soman produced a 1:1 stoichiometry between organophosphate-inhibited FBS AChE and the cumulative dose of the toxic stereoisomers of soman. Administration of FBS AChE protected monkeys against the lethal effects of up to 2.7 LD50 of soman and prevented any signs of organophosphate intoxication, e.g., excessive secretions, respiratory depression, muscle fasciculations, or convulsions. In addition, monkeys pretreated with FBS AChE were devoid of any behavioral incapacitation after soman challenge, as measured by the serial probe recognition task. Compared to the current multicomponent drug treatment against soman, which does not prevent the signs or the behavioral deficits resulting from OP intoxication, use of FBS AChE as a single pretreatment drug provides significantly effective protection against both the lethal and the behavioral effects of soman.... Pretreatment, Nonhuman primate, Performance decrements, Acetylcholinesterase, Soman, Nerve agents.

  6. Power reactivity decrement components of a homogeneous UPu10Zr-fueled 900-MW(thermal) liquid metal reactor

    SciTech Connect

    Meneghetti, D.; Kucera, D.A.

    1989-01-01

    Linear and Doppler feedback components of the power reactivity decrement (PRD) for a 900-MW(thermal) homogeneous UPu10Zr-fueled sodium-cooled reactor have been calculated. (The PRD is the negative of the reactivity required to bring the reactor from a zero-power hot-critical condition to a given power level.) The components are further separated into power-dependent and power-to-flow-dependent parts. These delineations enhance understanding of the contributions of the components to the feedback process. The delineation also enables the PRDs for other values of coolant flows to be estimated. The linear and Doppler components of the PRD are obtained using the EBRPOCO code, which calculates detailed axially delineated contributions of the components for every subassembly of a loading configuration. Separation of the components into power and power-to-flow parts is made by calculations of the components, assuming infinite thermal conductivities to obtain the power-to-flow values. Subtractions of these from the corresponding PRD quantities give the power-dependent parts. The values of the various feedback components are compared with corresponding quantities reported for an analogous U10Zr-fueled case.

  7. Lung transplantation

    PubMed Central

    Afonso, José Eduardo; Werebe, Eduardo de Campos; Carraro, Rafael Medeiros; Teixeira, Ricardo Henrique de Oliveira Braga; Fernandes, Lucas Matos; Abdalla, Luis Gustavo; Samano, Marcos Naoyuki; Pêgo-Fernandes, Paulo Manuel

    2015-01-01

    ABSTRACT Lung transplantation is a globally accepted treatment for some advanced lung diseases, giving the recipients longer survival and better quality of life. Since the first transplant successfully performed in 1983, more than 40 thousand transplants have been performed worldwide. Of these, about seven hundred were in Brazil. However, survival of the transplant is less than desired, with a high mortality rate related to primary graft dysfunction, infection, and chronic graft dysfunction, particularly in the form of bronchiolitis obliterans syndrome. New technologies have been developed to improve the various stages of lung transplant. To increase the supply of lungs, ex vivo lung reconditioning has been used in some countries, including Brazil. For advanced life support in the perioperative period, extracorporeal membrane oxygenation and hemodynamic support equipment have been used as a bridge to transplant in critically ill patients on the waiting list, and to keep patients alive until resolution of the primary dysfunction after graft transplant. There are patients requiring lung transplant in Brazil who do not even come to the point of being referred to a transplant center because there are only seven such centers active in the country. It is urgent to create new centers capable of performing lung transplantation to provide patients with some advanced forms of lung disease a chance to live longer and with better quality of life. PMID:26154550

  8. Lung Diseases

    MedlinePlus

    When you breathe, your lungs take in oxygen from the air and deliver it to the bloodstream. The cells in your body need oxygen to ... you breathe nearly 25,000 times. People with lung disease have difficulty breathing. Millions of people in ...

  9. Lung Cancer

    MedlinePlus

    Lung cancer is one of the most common cancers in the world. It is a leading cause of cancer death in men and women in the United States. Cigarette smoking causes most lung cancers. The more cigarettes you smoke per day and ...

  10. Necitumumab plus gemcitabine and cisplatin versus gemcitabine and cisplatin alone as first-line therapy in patients with stage IV squamous non-small-cell lung cancer (SQUIRE): an open-label, randomised, controlled phase 3 trial.

    PubMed

    Thatcher, Nick; Hirsch, Fred R; Luft, Alexander V; Szczesna, Aleksandra; Ciuleanu, Tudor E; Dediu, Mircea; Ramlau, Rodryg; Galiulin, Rinat K; Bálint, Beatrix; Losonczy, György; Kazarnowicz, Andrzej; Park, Keunchil; Schumann, Christian; Reck, Martin; Depenbrock, Henrik; Nanda, Shivani; Kruljac-Letunic, Anamarija; Kurek, Raffael; Paz-Ares, Luis; Socinski, Mark A

    2015-07-01

    Necitumumab is a second-generation, recombinant, human immunoglobulin G1 EGFR antibody. In this study, we aimed to compare treatment with necitumumab plus gemcitabine and cisplatin versus gemcitabine and cisplatin alone in patients with previously untreated stage IV squamous non-small-cell lung cancer. We did this open-label, randomised phase 3 study at 184 investigative sites in 26 countries. Patients aged 18 years or older with histologically or cytologically confirmed stage IV squamous non-small-cell lung cancer, with an Eastern Cooperative Oncology Group (ECOG) performance status of 0-2 and adequate organ function and who had not received previous chemotherapy for their disease were eligible for inclusion. Enrolled patients were randomly assigned centrally 1:1 to a maximum of six 3-week cycles of gemcitabine and cisplastin chemotherapy with or without necitumumab according to a block randomisation scheme (block size of four) by a telephone-based interactive voice response system or interactive web response system. Chemotherapy was gemcitabine 1250 mg/m(2) administered intravenously over 30 min on days 1 and 8 of a 3-week cycle and cisplatin 75 mg/m(2) administered intravenously over 120 min on day 1 of a 3-week cycle. Necitumumab 800 mg, administered intravenously over a minimum of 50 min on days 1 and 8, was continued after the end of chemotherapy until disease progression or intolerable toxic side-effects occurred. Randomisation was stratified by ECOG performance status and geographical region. Neither physicians nor patients were masked to group assignment because of the expected occurrence of acne-like rash--a class effect of EGFR antibodies--that would have unmasked most patients and investigators to treatment. The primary endpoint was overall survival, analysed by intention to treat. We report the final clinical analysis. This study is registered with ClinicalTrials.gov, number NCT00981058. Between Jan 7, 2010, and Feb 22, 2012, we enrolled 1093 patients

  11. The Open University Opens.

    ERIC Educational Resources Information Center

    Tunstall, Jeremy, Ed.

    Conceived by the British Labor Government in the 1960's the Open University was viewed as a way to extend higher education to Britain's working class, but enrollment figures in classes that represent traditional academic disciplines show that the student population is predominantly middle class. Bringing education into the home presents numerous…

  12. What Is Lung Cancer?

    MedlinePlus

    ... Graphics Infographic Stay Informed Cancer Home What Is Lung Cancer? Language: English Español (Spanish) Recommend on Facebook Tweet ... cancer starts in the lungs, it is called lung cancer. Lung cancer begins in the lungs and may ...

  13. Lung Cancer Screening

    MedlinePlus

    ... Treatment Lung Cancer Prevention Lung Cancer Screening Research Lung Cancer Screening (PDQ®)–Patient Version What is screening? ... These are called diagnostic tests . General Information About Lung Cancer Key Points Lung cancer is a disease ...

  14. Lung Cancer Prevention

    MedlinePlus

    ... Treatment Lung Cancer Prevention Lung Cancer Screening Research Lung Cancer Prevention (PDQ®)–Patient Version What is prevention? ... to keep cancer from starting. General Information About Lung Cancer Key Points Lung cancer is a disease ...

  15. A systematic review of the association between pleural plaques and changes in lung function

    PubMed Central

    Kopylev, Leonid; Christensen, Krista Yorita; Brown, James S; Cooper, Glinda S

    2015-01-01

    Objectives To conduct a systematic review of changes in lung function in relation to presence of pleural plaques in asbestos-exposed populations. Methods Database searches of PubMed and Web of Science were supplemented by review of papers’ reference lists and journals’ tables of contents. Methodological features (eg, consideration of potential confounding by smoking) of identified articles were reviewed by ≥two reviewers. Meta-analyses of 20 studies estimated a summary effect of the decrements in per cent predicted (%pred) forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV1) associated with presence of pleural plaques. Results Among asbestos-exposed workers, the presence of pleural plaques was associated with statistically significant decrements in FVC (4.09%pred, 95% CI 2.31 to 5.86) and FEV1 (1.99%pred, 95% CI 0.22 to 3.77). Effects of similar magnitude were seen when stratifying by imaging type (X-ray or high-resolution CT) and when excluding studies with potential methodological limitations. Undetected asbestosis was considered as an unlikely explanation of the observed decrements. Several studies provided evidence of an association between size of pleural plaques and degree of pulmonary decrease, and presence of pleural plaques and increased rate or degree of pulmonary impairment. Conclusions The presence of pleural plaques is associated with a small, but statistically significant mean difference in FVC and FEV1 in comparison to asbestos-exposed individuals without plaques or other abnormalities. From a public health perspective, small group mean decrements in lung function coupled with an increased rate of decline in lung function of the exposed population may be consequential. PMID:25504898

  16. The utility of open lung biopsy in patients with diffuse pulmonary infiltrates as related to respiratory distress, its impact on decision making by urgent intervention, and the diagnostic accuracy based on the biopsy location.

    PubMed

    Chuang, Ming-Lung; Lin, I-Feng; Tsai, Ying-Huang; Vintch, Janine R E; Pang, Leuo-Chuan

    2003-01-01

    Patients with diffuse pulmonary infiltrates (DPI), especially those who present with respiratory distress (RD), may benefit from early open lung biopsy (OLB) to guide management. Benefits of urgent OLB would be expected by saving the time to reach accurate specific diagnoses. The objectives of this study were (1) to evaluate the impact of OLB between patients presenting with and without RD, (2) to focus on the impact of an urgent OLB as compared to an elective OLB, and (3) to compare the different yields of specific diagnoses in the middle lobe or lingula as compared to the other lobes. Thirty-four patients (17 patients presented with RD and 17 patients did not) with an average age of 43 years who presented with DPI were selected to undergo an OLB. An urgent OLB was performed in 11 unselected patients. Twelve specimens from the middle lobe or lingula were compared to 25 specimens from the other lobes. The impact of the OLB results on decision making did not differ significantly between patients with and without RD. Patients with RD suffered a higher in-hospital mortality rate, OLB-related complications, and longer mechanical ventilation requirements than the patients without RD. The impact on decision making and complications between urgent OLB and elective OLB was comparable. The diagnostic yield from biopsy sites in the middle lobe or lingula resembled those specimens from the other lobes. The authors conclude that OLB may play a role in decision making for patients with DPI. However, OLB makes no difference in decision making between patients with and without RD. Patients with RD undergoing OLB procedures may suffer a poorer outcome. Urgent OLB may not benefit patients with DPI in decision making. The biopsy site does not appear to affect the accuracy of the diagnostic yield from an OLB procedure.

  17. Bevacizumab beyond disease progression after first-line treatment with bevacizumab plus chemotherapy in advanced nonsquamous non-small cell lung cancer (West Japan Oncology Group 5910L): An open-label, randomized, phase 2 trial.

    PubMed

    Takeda, Masayuki; Yamanaka, Takeharu; Seto, Takashi; Hayashi, Hidetoshi; Azuma, Koichi; Okada, Morihito; Sugawara, Shunichi; Daga, Haruko; Hirashima, Tomonori; Yonesaka, Kimio; Urata, Yoshiko; Murakami, Haruyasu; Saito, Haruhiro; Kubo, Akihito; Sawa, Toshiyuki; Miyahara, Eiji; Nogami, Naoyuki; Nakagawa, Kazuhiko; Nakanishi, Yoichi; Okamoto, Isamu

    2016-04-01

    Bevacizumab combined with platinum-based chemotherapy has been established as a standard treatment option in the first-line setting for advanced nonsquamous non-small cell lung cancer (NSCLC). However, there has been no evidence to support the use of bevacizumab beyond disease progression in such patients. West Japan Oncology Group 5910L was designed as a multicenter, open-label, randomized, phase 2 trial of docetaxel versus docetaxel plus bevacizumab every 3 weeks for patients with recurrent or metastatic nonsquamous NSCLC whose disease had progressed after first-line treatment with bevacizumab plus a platinum-based doublet. The primary endpoint was progression-free survival (PFS). One hundred patients were randomly assigned to receive docetaxel (n = 50) or docetaxel plus bevacizumab (n = 50), and this yielded median PFS times of 3.4 and 4.4 months, respectively, with a hazard ratio (HR) of 0.71 and a stratified log-rank P value of .058, which met the predefined criterion for statistical significance (P < .2). The median overall survival also tended to be longer in the docetaxel plus bevacizumab group (13.1 months; 95% confidence interval [CI], 10.6-21.4 months) versus the docetaxel group (11.0 months; 95% CI, 7.6-16.1 months) with an HR of 0.74 (95% CI, 0.46-1.19; stratified log-rank P = .11). No unexpected or severe adverse events were recorded. Further evaluation of bevacizumab beyond disease progression is warranted for patients with advanced NSCLC whose disease has progressed after treatment with bevacizumab plus a platinum-based doublet. © 2016 American Cancer Society.

  18. Lung flooding enables efficient lung sonography and tumour imaging in human ex vivo and porcine in vivo lung cancer model

    PubMed Central

    2013-01-01

    Background Sonography has become the imaging technique of choice for guiding intraoperative interventions in abdominal surgery. Due to artefacts from residual air content, however, videothoracoscopic and open intraoperative ultrasound-guided thermoablation of lung malignancies are impossible. Lung flooding is a new method that allows complete ultrasound imaging of lungs and their tumours. Methods Fourteen resected tumourous human lung lobes were examined transpleurally with B-mode ultrasound before (in atelectasis) and after lung flooding with isotonic saline solution. In two swine, the left lung was filled with 15 ml/kg isotonic saline solution through the left side of a double-lumen tube. Lung tumours were simulated by transthoracic ultrasound-guided injection of 5 ml of purified bovine serum albumin in glutaraldehyde, centrally into the left lower lung lobe. The rate of tumour detection, the severity of disability caused by residual gas, and sonomorphology of the lungs and tumours were assessed. Results The ex vivo tumour detection rate was 100% in flooded human lung lobes and 43% (6/14) in atelectatic lungs. In all cases of atelectasis, sonographic tumour imaging was impaired by residual gas. Tumours and atelectatic tissue were isoechoic. In 28% of flooded lungs, a little residual gas was observed that did not impair sonographic tumour imaging. In contrast to tumours, flooded lung tissue was hyperechoic, homogeneous, and of fine-grained structure. Because of the bronchial wall three-laminar structure, sonographic differentiation of vessels and bronchi was possible. In all cases, malignant tumours in the flooded lung appeared well-demarcated from the lung parenchyma. Adenocarcinoma, squamous, and large cell carcinomas were hypoechoic. Bronchioloalveolar cell carcinoma was slightly hyperechoic. Transpleural sonography identifies endobronchial tumour growth and bronchial wall destruction. With transthoracic sonography, the flooded animal lung can be completely

  19. Random Decrement Method and Modeling H/V Spectral Ratios: An Application for Soft Shallow Layers Characterization

    NASA Astrophysics Data System (ADS)

    Song, H.; Huerta-Lopez, C. I.; Martinez-Cruzado, J. A.; Rodriguez-Lozoya, H. E.; Espinoza-Barreras, F.

    2009-05-01

    Results of an ongoing study to estimate the ground response upon weak and moderate earthquake excitations are presented. A reliable site characterization in terms of its soil properties and sub-soil layer configuration are parameters required in order to do a trustworthy estimation of the ground response upon dynamic loads. This study can be described by the following four steps: (1) Ambient noise measurements were collected at the study site where a bridge was under construction between the cities of Tijuana and Ensenada in Mexico. The time series were collected using a six channels recorder with an ADC converter of 16 bits within a maximum voltage range of ± 2.5 V, the recorder has an optional settings of: Butterworth/Bessel filters, gain and sampling rate. The sensors were a three orthogonal component (X, Y, Z) accelerometers with a sensitivity of 20 V/g, flat frequency response between DC to 200 Hz, and total full range of ±0.25 of g, (2) experimental H/V Spectral Ratios were computed to estimate the fundamental vibration frequency at the site, (3) using the time domain experimental H/V spectral ratios as well as the original recorded time series, the random decrement method was applied to estimate the fundamental frequency and damping of the site (system), and (4) finally the theoretical H/V spectral ratios were obtained by means of the stiffness matrix wave propagation method.. The interpretation of the obtained results was then finally compared with a geotechnical study available at the site.

  20. Probing cosmology and galaxy cluster structure with the Sunyaev-Zel'dovich decrement versus X-ray temperature scaling relation

    NASA Astrophysics Data System (ADS)

    Shang, Cien; Haiman, Zoltán; Verde, Licia

    2009-12-01

    Scaling relations among galaxy cluster observables, which will become available in large future samples of galaxy clusters, could be used to constrain not only cluster structure, but also cosmology. We study the utility of this approach, employing a physically motivated parametric model to describe cluster structure and applying it to the expected relation between the Sunyaev-Zel'dovich decrement (Sν) and the emission-weighted X-ray temperature (Tew). The slope and normalization of the entropy profile, the concentration of the dark matter potential, the pressure at the virial radius and the level of non-thermal pressure support as well as the mass and redshift dependence of these quantities are described by free parameters. With a suitable choice of fiducial parameter values, the cluster model satisfies several existing observational constraints. We employ a Fisher matrix approach to estimate the joint errors on cosmological and cluster structure parameters from a measurement of Sν versus Tew in a future survey. We find that different cosmological parameters affect the scaling relation differently: predominantly through the baryon fraction (Ωm and Ωb), the virial overdensity (w0 and wa for low-z clusters) and the angular diameter distance (w0 and wa for high-z clusters; ΩDE and h). We find that the cosmology constraints from the scaling relation are comparable to those expected from the number counts (dN/dz) of the same clusters. The scaling-relation approach is relatively insensitive to selection effects and it offers a valuable consistency check; combining the information from the scaling relation and dN/dz is also useful to break parameter degeneracies and help disentangle cluster physics from cosmology. Our work suggests that scaling relations should be a useful component in extracting cosmological information from large future cluster surveys.

  1. Decrements in health-related quality of life associated with gender nonconformity among U.S. adolescents and young adults.

    PubMed

    Gordon, Allegra R; Krieger, Nancy; Okechukwu, Cassandra A; Haneuse, Sebastien; Samnaliev, Mihail; Charlton, Brittany M; Austin, S Bryn

    2017-08-01

    Gender nonconformity, that is, transgressing conventionally "masculine" vs. "feminine" characteristics, is often stigmatized. Stigmatization and discrimination are social stressors that raise risk of adverse mental and physical health outcomes and may drive health inequities. However, little is known about the relationship between such social stressors and health-related quality of life (HRQOL). This paper aimed to examine associations between perceived gender nonconformity and HRQOL in a cohort of U.S. adolescents and young adults. Using data from 8408 participants (18-31 years) in the U.S. Growing Up Today Study (93% white, 88% middle-to-high income), we estimated risk ratios (RRs) for the association of gender nonconformity (three levels: highly gender conforming, moderately conforming, and gender nonconforming) and HRQOL using the EuroQol questionnaire (EQ-5D-5L). Models were adjusted for demographic characteristics, including sexual orientation identity. Gender nonconformity was independently associated with increased risk of having problems with mobility [RR (95% confidence interval): 1.76 (1.16, 2.68)], usual activities [2.29 (1.67, 3.13)], pain or discomfort [1.59, (1.38, 1.83)], and anxiety or depression [1.72 (1.39, 2.13)], after adjusting for sexual orientation and demographic characteristics. Decrements in health utility by gender nonconformity were observed: compared to persons who were highly gender conforming, mean health utility was lower for the moderately gender conforming [beta (SE): -0.011 (.002)] and lowest for the most gender nonconforming [-0.034 (.005)]. In our study, HRQOL exhibited inequities by gender nonconformity. Future studies, including in more diverse populations, should measure the effect of gender-related harassment, discrimination, and violence victimization on health and HRQOL.

  2. Heavy alcohol use, marijuana use, and concomitant use by adolescents are associated with unique and shared cognitive decrements.

    PubMed

    Winward, Jennifer L; Hanson, Karen L; Tapert, Susan F; Brown, Sandra A

    2014-09-01

    To assess recovery of cognitive effects, we investigated neuropsychological performance after 1 month of monitored abstinence in teens with histories of heavy episodic drinking, protracted marijuana use, or concomitant use of alcohol and marijuana. Adolescents (ages 16-18 years) with histories of heavy episodic drinking (HED; n=24), marijuana use (MJ; n=20), both heavy alcohol and marijuana use (HED+MJ; n=29), and socio-demographically similar control teens (CON; n=55) completed a neuropsychological battery following 4 weeks of monitored abstinence. Groups were similar on 5th grade standardized test scores, suggesting comparable academic functioning before onset of substance use. Relative to CON, HED showed poorer cognitive flexibility (p=.006), verbal recall (p=.024), semantic clustering (p=.011), and reading skills (p=.018). MJ performed worse than CON on inhibition task accuracy (p=.015), cued verbal memory (p=.031), and psychomotor speed (p=.027). Similar to HED youth, HED+MJ showed differences relative to CON on cognitive flexibility (p=.024) and verbal recall (p=.049). As with MJ teens, HED+MJ showed poorer task accuracy (p=.020). Unique to the HED+MJ group was poorer working memory (p=.012) relative to CON. For all substance using participants, worse performance across domains correlated with more lifetime use of alcohol and of marijuana, more withdrawal symptoms from alcohol, and earlier age of onset of marijuana use (ps<.05). Heavy alcohol use, marijuana use, and concomitant use of both substances during adolescence appear to be associated with decrements in cognitive functioning, and each substance (or combination of substances) may be linked to poorer performance in specific cognitive domains.

  3. [A case of occupational lung disease (welder lung) in a mechanical worker].

    PubMed

    Di Lorenzo, L; Trabucco, S; Massola, A; Corfiati, M; Bello, A; Soleo, L

    2007-01-01

    A case of welder's lung is reported in a male hard smoker who had worked as welder-carpenter for almost 30 years. In order to establish an etiologic diagnosis, given the informed consent from the worker, open lung biopsy was performed that allowed to obtain sufficiently large specimens of affected lung to make histological, immunohistochemical and mineralogical examination. In such a way the pathologic features were accurately defined and a multidisciplinary approach was applied to differential diagnosis. The worker is recommended to undergo a strict health surveillance because of the reported association of welder's lung with lung cancer, especially in smokers.

  4. Systematic review of pleural plaques and lung function

    PubMed Central

    Kerper, Laura E.; Lynch, Heather N.; Zu, Ke; Tao, Ge; Utell, Mark J.

    2015-01-01

    Abstract Context US EPA proposed a Reference Concentration for Libby amphibole asbestos based on the premise that pleural plaques are adverse and cause lung function deficits. Objective We conducted a systematic review to evaluate whether there is an association between pleural plaques and lung function and ascertain whether results were dependent on the method used to identify plaques. Methods Using the PubMed database, we identified studies that evaluated pleural plaques and lung function. We assessed each study for quality, then integrated evidence and assessed associations based on the Bradford Hill guidelines. We also compared the results of HRCT studies to those of X-ray studies. Results We identified 16 HRCT and 36 X-ray studies. We rated six HRCT and 16 X-ray studies as higher quality based on a risk-of-bias analysis. Half of the higher quality studies reported small but statistically significant mean lung function decrements associated with plaques. None of the differences were clinically significant. Many studies had limitations, such as inappropriate controls and/or insufficient adjustment for confounders. There was little consistency in the direction of effect for the most commonly reported measurements. X-ray results were more variable than HRCT results. Pleural plaques were not associated with changes in lung function over time in longitudinal studies. Conclusion The weight of evidence indicates that pleural plaques do not impact lung function. Observed associations are most likely due to unidentified abnormalities or other factors. PMID:25518994

  5. Modest decrements in plasma glucose concentration cause early impairment in cognitive function and later activation of glucose counterregulation in the absence of hypoglycemic symptoms in normal man.

    PubMed Central

    De Feo, P; Gallai, V; Mazzotta, G; Crispino, G; Torlone, E; Perriello, G; Ventura, M M; Santeusanio, F; Brunetti, P; Bolli, G B

    1988-01-01

    To establish the glycemic threshold for onset of neuroglycopenia (impaired cognitive function, measured by the latency of the P300 wave), activation of hormonal counterregulation and hypoglycemic symptoms, 12 normal subjects were studied either under conditions of insulin-induced, glucose-controlled plasma glucose decrements, or during maintenance of euglycemia. A decrement in plasma glucose concentration from 88 +/- 3 to 80 +/- 1 mg/dl for 150 min did not result in changes in the latency of the P300 wave nor in an activation of counterregulatory hormonal response. In contrast, a greater decrement in plasma glucose concentration from 87 +/- 3 to 72 +/- 1 mg/dl for 120 min caused an increase in the latency of the P300 wave (from 301 +/- 12 to 348 +/- 20 ms, P less than 0.01), a subsequent increase in all counterregulatory hormones but no hypoglycemic symptoms. Finally, when plasma glucose concentration was decreased in a stepwise manner from 88 +/- 2 to 50 +/- 1 mg/dl within 75 min, the increase in the latency of the P300 wave was correlated with the corresponding plasma glucose concentration (r = -0.76, P less than 0.001). The glycemic threshold for hypoglycemic symptoms was 49 +/- 2 mg/dl. Thus, in normal man the glycemic threshold for neuroglycopenia (72 +/- 1 mg/dl) is greater than currently thought; the hormonal counterregulation follows the onset of neuroglycopenia; the hypoglycemic symptoms are a late indicator of advanced neuroglycopenia. PMID:3403713

  6. Lung cancer

    MedlinePlus

    ... Sputum test to look for cancer cells Thoracentesis (sampling of fluid buildup around the lung) In most ... quitting, talk with your provider. There are many methods to help you quit, from support groups to ...

  7. Lung Transplant

    MedlinePlus

    ... will recover in the hospital’s intensive care unit (ICU) before moving to a hospital room for one to three weeks. Your doctor may recommend pulmonary rehabilitation after your lung transplant surgery to help you ...

  8. OXIDANTS AND THE PATHOGENESIS OF LUNG DISEASES

    PubMed Central

    Ciencewicki, Jonathan; Trivedi, Shweta; Kleeberger, Steven R.

    2009-01-01

    The increasing number of population-based and epidemiological associations between oxidant pollutant exposures and cardiopulmonary disease exacerbation, decrements in pulmonary function, and mortality underscores the important detrimental effects of oxidants on public health. Because inhaled oxidants initiate a number of pathologic processes, including inflammation of the airways which may contribute to the pathogenesis and/or exacerbation of airways disease, it is critical to understand the mechanisms through which exogenous and endogenous oxidants interact with molecules in the cells, tissues, and epithelial lining fluid (ELF) of the lung. Furthermore, it is clear that inter-individual variation in response to a given exposure also exists across an individual lifetime. Because of the potential impact that oxidant exposures may have on reproductive outcomes and infant, child, and adult health, identification of the intrinsic and extrinsic factors that may influence susceptibility to oxidants remains an important issue. In this review, we discuss mechanisms of oxidant stress in the lung, the role of oxidants in lung disease pathogenesis and exacerbation (e.g. asthma, COPD, and ARDS), and the potential risk factors (e.g. age, genetics) for enhanced susceptibility to oxidant-induced disease. PMID:18774381

  9. Unexpandable lung.

    PubMed

    Pereyra, Marco F; Ferreiro, Lucía; Valdés, Luis

    2013-02-01

    Unexpandable lung is a mechanical complication by which the lung does not expand to the chest wall, impeding a normal apposition between the two pleural layers. The main mechanism involved is the restriction of the visceral pleura due to the formation of a fibrous layer along this pleural membrane. This happens because of the presence of an active pleural disease (lung entrapment), which can be resolved if proper therapeutic measures are taken, or a remote disease (trapped lung), in which an irreversible fibrous pleural layer has been formed. The clinical suspicion arises with the presence of post-thoracocentesis hydropneumothorax or a pleural effusion that cannot be drained due to the appearance of thoracic pain. The diagnosis is based on the analysis of the pleural liquid, the determination of pleural pressures as we drain the effusion and on air-contrast chest CT. As both represent the continuity of one same process, the results will depend on the time at which these procedures are done. If, when given a lung that is becoming entrapped, the necessary therapeutic measures are not taken, the final result will be a trapped lung. In this instance, most patients are asymptomatic or have mild exertional dyspnea and therefore they do not require treatment. Nevertheless, in cases of incapacitating dyspnea, it may be necessary to use pleural decortication in order to resolve the symptoms. Copyright © 2012 SEPAR. Published by Elsevier Espana. All rights reserved.

  10. [Epidemiology of lung cancer].

    PubMed

    Becker, N

    2010-08-01

    Lung cancer is by far the most common form of cancer worldwide and in Germany is now "only" still the commonest cause of death from cancer. The most important single risk factor is smoking but in selected population groups, for example in the professional area, other factors can also play a role which cannot be ignored and open up a corresponding potential for prevention. Effective early detection procedures are at present unknown. The most promising, however, is multislice computed tomography (MSCT) which for this reason is presently being tested for effectiveness in several large research projects. The results are not expected for some years. Until then the early detection of lung cancer with MSCT cannot be considered suitable for routine use but can only be justified within the framework of research studies.

  11. Updated survival analysis in patients with stage IIIB or IV non-small-cell lung cancer receiving BLP25 liposome vaccine (L-BLP25): phase IIB randomized, multicenter, open-label trial.

    PubMed

    Butts, Charles; Maksymiuk, Andrew; Goss, Glenwood; Soulières, Denis; Marshall, Ernie; Cormier, Yvon; Ellis, Peter M; Price, Allan; Sawhney, Ravinder; Beier, Frank; Falk, Martin; Murray, Nevin

    2011-09-01

    To present an updated survival analysis of an open-label, parallel-group, phase IIB trial of BLP25 liposome vaccine (L-BLP25) in patients with stage IIIB or IV non-small-cell lung cancer (NSCLC). Patients were randomized to either L-BLP25 plus best supportive care (BSC) or BSC alone. Patients in the L-BLP25 arm received subcutaneous vaccinations of L-BLP25 930 μg weekly for 8 weeks, followed by maintenance vaccinations at 6-week intervals. Median survival time was 4.2 months longer in patients receiving L-BLP25 plus BSC (n = 88) than in those receiving BSC alone (n = 83; 17.2 months vs. 13.0 months, respectively; hazard ratio [HR] 0.745, 95% confidence interval [CI] 0.533-1.042). The 3-year survival rate was 31% in patients receiving L-BLP25 plus BSC and 17% in those receiving BSC (P = 0.035). In the stratified subset of patients with stage IIIB loco-regional (LR) disease, median survival time was 17.3 months longer in patients receiving L-BLP25 plus BSC (n = 35) than in those receiving BSC (n = 30; 30.6 months vs. 13.3 months, respectively; HR 0.548, 95% CI 0.301-0.999). In this subgroup, 3-year survival was 49% in patients receiving L-BLP25 plus BSC and 27% in those receiving BSC (P = 0.070). Confirming the initial results, further follow-up continues to show that survival time for patients with stage IIIB/IV NSCLC was longer with L-BLP25 plus BSC compared with BSC alone, with the greatest difference seen in patients with stage IIIB LR disease.

  12. Open reading frame 3 of genotype 1 hepatitis E virus inhibits nuclear factor-κappa B signaling induced by tumor necrosis factor-α in human A549 lung epithelial cells.

    PubMed

    Xu, Jian; Wu, Fan; Tian, Deying; Wang, Jingjing; Zheng, Zizheng; Xia, Ningshao

    2014-01-01

    Hepatitis E virus (HEV) is one of the primary causative agents of acute hepatitis, and represents a major cause of severe public health problems in developing countries. The pathogenesis of HEV is not well characterized, however, primarily due to the lack of well-defined cell and animal models. Here, we investigated the effects of genotype 1 HEV open reading frame 3 (ORF3) on TNF-α-induced nucleus factor-κappa B (NF-κB) signaling. Human lung epithelial cells (A549) were transiently transfected with ORF3 containing plasmids. These cells were then stimulated with TNF-α and the nucleus translocation of the p65 NF-κB subunit was assessed using western blot and laser confocal microscopy. DNA-binding activity of p65 was also examined using electrophoretic mobility shift assay (EMSA), and the suppression of NF-κB target genes were detected using real-time RT-PCR and ELISA. These results enabled us to identify the decreased phosphorylation levels of IKBα. We focused on the gene of negative regulation of NF-κB, represented by TNF-α-induced protein 3 (TNFAIP3, also known as A20). Reducing the levels of A20 with siRNAs significantly enhances luciferase activation of NF-κB. Furthermore, HEV ORF3 regulated A20 primarily via activating transcription factor 6 (ATF6), involved in unfolded protein response (UPR), resulting in the degradation or inactivation of the receptor interacting protein 1 (RIP1), a major upstream activator of IKB kinase compounds (IKKs). Consequently, the phosphorylation of IKBα and the nucleus translocation of p65 are blocked, which contributes to diminished NF-κB DNA-binding activation and NF-κB-dependent gene expression. The findings suggest that genotype 1 HEV, through ORF3, may transiently activate NF-κB through UPR in early stage, and subsequently inhibit TNF-α-induced NF-κB signaling in late phase so as to create a favorable virus replication environment.

  13. First-line erlotinib versus gemcitabine/cisplatin in patients with advanced EGFR mutation-positive non-small-cell lung cancer: analyses from the phase III, randomized, open-label, ENSURE study.

    PubMed

    Wu, Y-L; Zhou, C; Liam, C-K; Wu, G; Liu, X; Zhong, Z; Lu, S; Cheng, Y; Han, B; Chen, L; Huang, C; Qin, S; Zhu, Y; Pan, H; Liang, H; Li, E; Jiang, G; How, S H; Fernando, M C L; Zhang, Y; Xia, F; Zuo, Y

    2015-09-01

    The phase III, randomized, open-label ENSURE study (NCT01342965) evaluated first-line erlotinib versus gemcitabine/cisplatin (GP) in patients from China, Malaysia and the Philippines with epidermal growth factor receptor (EGFR) mutation-positive non-small-cell lung cancer (NSCLC). Patients ≥18 years old with histologically/cytologically confirmed stage IIIB/IV EGFR mutation-positive NSCLC and Eastern Cooperative Oncology Group performance status 0-2 were randomized 1:1 to receive erlotinib (oral; 150 mg once daily until progression/unacceptable toxicity) or GP [G 1250 mg/m(2) i.v. days 1 and 8 (3-weekly cycle); P 75 mg/m(2) i.v. day 1, (3-weekly cycle) for up to four cycles]. Primary end point: investigator-assessed progression-free survival (PFS). Other end points include objective response rate (ORR), overall survival (OS), and safety. A total of 217 patients were randomized: 110 to erlotinib and 107 to GP. Investigator-assessed median PFS was 11.0 months versus 5.5 months, erlotinib versus GP, respectively [hazard ratio (HR), 0.34, 95% confidence interval (CI) 0.22-0.51; log-rank P < 0.0001]. Independent Review Committee-assessed median PFS was consistent (HR, 0.42). Median OS was 26.3 versus 25.5 months, erlotinib versus GP, respectively (HR, 0.91, 95% CI 0.63-1.31; log-rank P = .607). ORR was 62.7% for erlotinib and 33.6% for GP. Treatment-related serious adverse events (AEs) occurred in 2.7% versus 10.6% of erlotinib and GP patients, respectively. The most common grade ≥3 AEs were rash (6.4%) with erlotinib, and neutropenia (25.0%), leukopenia (14.4%), and anemia (12.5%) with GP. These analyses demonstrate that first-line erlotinib provides a statistically significant improvement in PFS versus GP in Asian patients with EGFR mutation-positive NSCLC (NCT01342965). © The Author 2015. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: journals.permissions@oup.com.

  14. Pembrolizumab for patients with melanoma or non-small-cell lung cancer and untreated brain metastases: early analysis of a non-randomised, open-label, phase 2 trial.

    PubMed

    Goldberg, Sarah B; Gettinger, Scott N; Mahajan, Amit; Chiang, Anne C; Herbst, Roy S; Sznol, Mario; Tsiouris, Apostolos John; Cohen, Justine; Vortmeyer, Alexander; Jilaveanu, Lucia; Yu, James; Hegde, Upendra; Speaker, Stephanie; Madura, Matthew; Ralabate, Amanda; Rivera, Angel; Rowen, Elin; Gerrish, Heather; Yao, Xiaopan; Chiang, Veronica; Kluger, Harriet M

    2016-07-01

    Immunotherapy targeting the PD-1 axis has activity in several tumour types. We aimed to establish the activity and safety of the PD-1 inhibitor pembrolizumab in patients with untreated brain metastases from melanoma or non-small-cell lung cancer (NSCLC). In this non-randomised, open-label, phase 2 trial, we enrolled patients aged 18 years or older with melanoma or NSCLC with untreated brain metastases from the Yale Cancer Center. Patients had at least one untreated or progressive brain metastasis between 5 and 20 mm in diameter without associated neurological symptoms or the need for corticosteroids. Patients with NSCLC had tumour tissue positive for PD-L1 expression; this was not required for patients with melanoma. Patients were given 10 mg/kg pembrolizumab every 2 weeks until progression. The primary endpoint was brain metastasis response assessed in all treated patients. The trial is ongoing and here we present an early analysis. The study is registered with ClinicalTrials.gov, number NCT02085070. Between March 31, 2014, and May 31, 2015, we screened 52 patients with untreated or progressive brain metastases (18 with melanoma, 34 with NSCLC), and enrolled 36 (18 with melanoma, 18 with NSCLC). A brain metastasis response was achieved in four (22%; 95% CI 7-48) of 18 patients with melanoma and six (33%; 14-59) of 18 patients with NSCLC. Responses were durable, with all but one patient with NSCLC who responded showing an ongoing response at the time of data analysis on June 30, 2015. Treatment-related serious and grade 3-4 adverse events were grade 3 elevated aminotransferases (n=1 [6%]) in the melanoma cohort, and grade 3 colitis (n=1 [6%]), grade 3 pneumonitis (n=1 [6%]), grade 3 fatigue (n=1 [6%]), grade 4 hyperkalemia (n=1 [6%]), and grade 2 acute kidney injury (n=1 [6%]) in the NSCLC cohort. Clinically significant neurological adverse events included transient grade 3 cognitive dysfunction and grade 1-2 seizures (n=3 [17%]) in the melanoma cohort

  15. Video-assisted thoracoscopic surgery versus open lobectomy for primary non-small-cell lung cancer: a propensity-matched analysis of outcome from the European Society of Thoracic Surgeon database.

    PubMed

    Falcoz, Pierre-Emmanuel; Puyraveau, Marc; Thomas, Pascal-Alexandre; Decaluwe, Herbert; Hürtgen, Martin; Petersen, René Horsleben; Hansen, Henrik; Brunelli, Alessandro

    2016-02-01

    Video-assisted thoracoscopic anatomical resections are increasingly used in Europe to manage primary lung cancer. The purpose of this study was to compare the outcome following thoracoscopic versus open lobectomy in case-matched groups of patients from the European Society of Thoracic Surgeon (ESTS) database. All patients having lobectomy as the primary procedure via thoracoscopy [video-assisted thoracoscopic surgery (VATS)-L)] or thoracotomy (TH-L) were identified in the ESTS database (January 2007 to December 2013). A propensity score was constructed using several patients' baseline characteristics. The matching using the propensity score was responsible for the minimization of selection bias. A propensity score-matched analysis was performed to compare the incidence of postoperative major complications (according to the ESTS database definitions) and mortality at hospital discharge between the matched groups. After exclusions, 28 771 patients were identified: 26 050 having thoracotomy and 2721 having thoracoscopy. Propensity score yielded two well-matched groups of 2721 patients. Numeric variables were compared by Student's t-tests and categorical variables were compared by McNemar's tests. Compared with TH-L, VATS-L was associated with a lower incidence of total complications [n = 792 (29.1%) vs 863 (31.7%), P = 0.0357], major cardiopulmonary complications [n = 316 (15.9%) vs 435 (19.6%), P = 0.0094], atelectasis requiring bronchoscopy [n = 65 (2.4%) vs 150 (5.5%), P < 0.0001], initial ventilation >48 h [n = 18 (0.7%) vs 38 (1.4%), P = 0.0075] and wound infection [n = 6 (0.2%) vs 17 (0.6%), P = 0.0218]. There was no difference in the incidence of postoperative atrial fibrillation between the two groups (P = 0.14). Postoperative hospital stay was 2 days shorter in the VATS-L patients (mean: 7.8 vs 9.8 days; P = 0.0003). In terms of outcome at hospital discharge, there were 27 deaths in the VATS-L group (1%) versus 50 in the TH-L group (1.9%, P = 0.0201). Data

  16. First-line ceritinib versus platinum-based chemotherapy in advanced ALK-rearranged non-small-cell lung cancer (ASCEND-4): a randomised, open-label, phase 3 study.

    PubMed

    Soria, Jean-Charles; Tan, Daniel S W; Chiari, Rita; Wu, Yi-Long; Paz-Ares, Luis; Wolf, Juergen; Geater, Sarayut L; Orlov, Sergey; Cortinovis, Diego; Yu, Chong-Jen; Hochmair, Maximillian; Cortot, Alexis B; Tsai, Chun-Ming; Moro-Sibilot, Denis; Campelo, Rosario G; McCulloch, Tracey; Sen, Paramita; Dugan, Margaret; Pantano, Serafino; Branle, Fabrice; Massacesi, Cristian; de Castro, Gilberto

    2017-03-04

    The efficacy of ceritinib in patients with untreated anaplastic lymphoma kinase (ALK)-rearranged non-small-cell lung cancer (NSCLC) is not known. We assessed the efficacy and safety of ceritinib versus platinum-based chemotherapy in these patients. This randomised, open-label, phase 3 study in untreated patients with stage IIIB/IV ALK-rearranged non-squamous NSCLC was done in 134 centres across 28 countries. Eligible patients were assigned via interactive response technology to oral ceritinib 750 mg/day or platinum-based chemotherapy ([cisplatin 75 mg/m(2) or carboplatin AUC 5-6 plus pemetrexed 500 mg/m(2)] every 3 weeks for four cycles followed by maintenance pemetrexed); randomisation was stratified by World Health Organization performance status (0 vs 1-2), previous neoadjuvant or adjuvant chemotherapy, and presence of brain metastases as per investigator's assessment at screening. Investigators and patients were not masked to treatment assignment. The primary endpoint was blinded independent review committee assessed progression-free survival, based on all randomly assigned patients (the full analysis set). Efficacy analyses were done based on the full analysis set. All safety analyses were done based on the safety set, which included all patients who received at least one dose of study drug. This trial is registered with ClinicalTrials.gov, number NCT01828099. Between Aug 19, 2013, and May 11, 2015, 376 patients were randomly assigned to ceritinib (n=189) or chemotherapy (n=187). Median progression-free survival (as assessed by blinded independent review committee) was 16·6 months (95% CI 12·6-27·2) in the ceritinib group and 8·1 months (5·8-11·1) in the chemotherapy group (hazard ratio 0·55 [95% CI 0·42-0·73]; p<0·00001). The most common adverse events were diarrhoea (in 160 [85%] of 189 patients), nausea (130 [69%]), vomiting (125 [66%]), and an increase in alanine aminotransferase (114 [60%]) in the ceritinib group and nausea (in 97 [55%] of 175

  17. Rheumatoid lung disease

    MedlinePlus

    Lung disease - rheumatoid arthritis; Rheumatoid nodules; Rheumatoid lung ... Lung problems are common in rheumatoid arthritis. They often cause no symptoms. The cause of lung disease associated with rheumatoid arthritis is unknown. Sometimes, the medicines used to ...

  18. Nutrition for Lung Cancer

    MedlinePlus

    ... by zip code or Select your state State Lung Cancer www.lung.org > Lung Health and Diseases > ... I Stay Healthy Share this page: Nutrition for Lung Cancer Key Points There is no prescribed diet ...

  19. Lung Nodules: Overview

    MedlinePlus

    ... Research & Science Education & Training Home Conditions Lung Nodules Lung Nodules Make an Appointment Find a Doctor Ask ... Kern, MD (June 01, 2016) What is a lung nodule? A lung nodule is also called a ...

  20. Eosinophilic Lung Disorders

    MedlinePlus

    ... Education & Training Home Conditions Eosinophilic Lung Disorders Eosinophilic Lung Disorders Make an Appointment Find a Doctor Ask ... Rafeul Alam, MD, PhD (July 01, 2012) Eosinophilic lung disorders are a category of lung problems characterized ...

  1. Lung Nodules: Overview

    MedlinePlus

    ... Research & Science Education & Training Home Conditions Lung Nodules Lung Nodules Make an Appointment Find a Doctor Ask ... Kern, MD (June 01, 2016) What is a lung nodule? A lung nodule is also called a ...

  2. Lung Cancer Screening

    MedlinePlus

    Lung cancer screening Overview By Mayo Clinic Staff Lung cancer screening is a process that's used to detect the presence ... with a high risk of lung cancer. Lung cancer screening is recommended for older adults who are longtime ...

  3. Lung cancer - small cell

    MedlinePlus

    Cancer - lung - small cell; Small cell lung cancer; SCLC ... About 15% of all lung cancer cases are SCLC. Small cell lung cancer is slightly more common in men than women. Almost all cases of SCLC are ...

  4. Furrier's lung

    PubMed Central

    Pimentel, J. Cortez

    1970-01-01

    As is known, the inhalation of animal hairs can provoke immunological reactions in the respiratory tract affecting the naso-tracheo-bronchial sector and giving rise to asthma-like syndromes. Another form of disease, found in furriers with long exposure to `hair dust', is described. It is characterized by a granulomatous interstitial pneumonia, of the tuberculoid type, very similar to that described in other diseases related to the inhalation of organic dusts, both vegetable and animal, such as `farmer's lung' and `bird fancier's lung'. This new disease—which we experimentally reproduced—can be diagnosed from the occupational history together with the finding on lung biopsy of hair shafts within granulomatous lesions (birefringence and histo-chemical reactions). As in other diseases of this type, a host factor of probable immunological nature is suggested. Attention is drawn to the need to protect workers in the furrier's trade. Images PMID:5484998

  5. Tsunami lung.

    PubMed

    Inoue, Yoshihiro; Fujino, Yasuhisa; Onodera, Makoto; Kikuchi, Satoshi; Shozushima, Tatsuyori; Ogino, Nobuyoshi; Mori, Kiyoshi; Oikawa, Hirotaka; Koeda, Yorihiko; Ueda, Hironobu; Takahashi, Tomohiro; Terui, Katsutoshi; Nakadate, Toshihide; Aoki, Hidehiko; Endo, Shigeatsu

    2012-04-01

    We encountered three cases of lung disorders caused by drowning in the recent large tsunami that struck following the Great East Japan Earthquake. All three were females, and two of them were old elderly. All segments of both lungs were involved in all the three patients, necessitating ICU admission and endotracheal intubation and mechanical ventilation. All three died within 3 weeks. In at least two cases, misswallowing of oil was suspected from the features noted at the time of the detection. Sputum culture for bacteria yielded isolation of Stenotrophomonas maltophilia, Legionella pneumophila, Burkholderia cepacia, and Pseudomonas aeruginosa. The cause of tsunami lung may be a combination of chemical induced pneumonia and bacterial pneumonia.

  6. Lung imaging.

    PubMed

    Ley, Sebastian

    2015-06-01

    Imaging of the lung is a mainstay of respiratory medicine. It provides local information about morphology and function of the lung parenchyma that is unchallenged by other noninvasive techniques. During the 2014 European Respiratory Society International Congress in Munich, Germany, a Clinical Year in Review session was held focusing on the latest developments in pulmonary imaging. This review summarises some of the main findings of peer-reviewed articles that were published in the 12-month period prior to the 2014 International Congress. Copyright ©ERS 2015.

  7. The Association of Pipe and Cigar Use with Cotinine Levels, Lung Function and Airflow Obstruction: a Cross-sectional Study

    PubMed Central

    Rodriguez, Josanna; Jiang, Rui; Johnson, W. Craig; MacKenzie, Barbara A; Smith, Lewis J.; Barr, R. Graham

    2010-01-01

    Background Cigarette smoking is the major cause of chronic obstructive pulmonary disease but studies on the contribution of other smoking techniques are sparse. Objective We hypothesized that pipe and cigar smoking was associated with elevated cotinine levels, decrements in lung function and increased odds of airflow obstruction. Design Cross-sectional study. Setting Population-based sample from six US communities. Participants The Multi-Ethnic Study of Atherosclerosis (MESA) recruited men and women ages 45-84 years without clinical cardiovascular disease. Measurements The MESA Lung Study measured spirometry following American Thoracic Society guidelines and urinary cotinine levels by immunoassay. Pipe-years and cigar-years were calculated as years from self-reported age of starting to quitting (or to current age among current users) × pipefuls or cigars per day. Results Of 3,528 participants, 8% reported pipe smoking (median 15 pipe-years), 11% reported cigar smoking (median 6 cigar-years), and 52% reported cigarette smoking (median 18 pack-years). Self-reported current pipe and cigar smokers had elevated urinary cotinine levels compared to never smokers. Pipe-years were associated with decrements in the forced expiratory volume in one second (FEV1) and cigar-years were associated with decrements in the FEV1 and the ratio of the FEV1 to the forced vital capacity. Participants who smoked pipes or cigars had an increased odds of airflow obstruction whether they had also smoked cigarettes (Odds ratio 3.43; 95% CI: 1.75, 6.71; P<0.001) or had never smoked cigarettes (Odds ratio 2.31; 95% CI: 1.04, 5.11; P=0.039) compared to participants with no smoking history. Limitations Cross-sectional design. Conclusions Pipe and cigar smoking increased urinary cotinine levels and was associated with decrements in lung function and increased odds of airflow obstruction, even among participants who never smoked cigarettes. PMID:20157134

  8. The Commonality Between Approaches to Determine Jump Fatigue During Basketball Activity in Junior Players: In-Game Versus Across-Game Decrements.

    PubMed

    Scanlan, Aaron T; Fox, Jordan L; Borges, Nattai R; Dalbo, Vincent J

    2017-02-01

    Declines in high-intensity activity during game play (in-game approach) and performance tests measured pre- and postgame (across-game approach) have been used to assess player fatigue in basketball. However, a direct comparison of these approaches is not available. Consequently, this study examined the commonality between in- and across-game jump fatigue during simulated basketball game play. Australian, state-level, junior male basketball players (n = 10; 16.6 ± 1.1 y, 182.4 ± 4.3 cm, 68.3 ± 10.2 kg) completed 4 × 10-min standardized quarters of simulated basketball game play. In-game jump height during game play was measured using video analysis, while across-game jump height was determined pre-, mid-, and postgame play using an in-ground force platform. Jump height was determined using the flight-time method, with jump decrement calculated for each approach across the first half, second half, and entire game. A greater jump decrement was apparent for the in-game approach than for the across-game approach in the first half (37.1% ± 11.6% vs 1.7% ± 6.2%; P = .005; d = 3.81, large), while nonsignificant, large differences were evident between approaches in the second half (d = 1.14) and entire game (d = 1.83). Nonsignificant associations were evident between in-game and across-game jump decrement, with shared variances of 3-26%. Large differences and a low commonality were observed between in- and across-game jump fatigue during basketball game play, suggesting that these approaches measure different constructs. Based on our findings, it is not recommended that basketball coaches use these approaches interchangeably to monitor player fatigue across the season.

  9. Fast concurrent array-based stacks, queues and deques using fetch-and-increment-bounded, fetch-and-decrement-bounded and store-on-twin synchronization primitives

    DOEpatents

    Chen, Dong; Gara, Alana; Heidelberger, Philip; Kumar, Sameer; Ohmacht, Martin; Steinmacher-Burow, Burkhard; Wisniewski, Robert

    2014-09-16

    Implementation primitives for concurrent array-based stacks, queues, double-ended queues (deques) and wrapped deques are provided. In one aspect, each element of the stack, queue, deque or wrapped deque data structure has its own ticket lock, allowing multiple threads to concurrently use multiple elements of the data structure and thus achieving high performance. In another aspect, new synchronization primitives FetchAndIncrementBounded (Counter, Bound) and FetchAndDecrementBounded (Counter, Bound) are implemented. These primitives can be implemented in hardware and thus promise a very fast throughput for queues, stacks and double-ended queues.

  10. Profusion of Opacities in Simple Coal Worker’s Pneumoconiosis Is Associated With Reduced Lung Function

    PubMed Central

    Laney, A. Scott; Halldin, Cara N.; Cohen, Robert A.

    2015-01-01

    BACKGROUND: A large body of evidence demonstrates dose-response relationships of cumulative coal mine dust exposure with lung function impairment and with small-opacity profusion. However, medical literature generally holds that simple coal worker’s pneumoconiosis (CWP) is not associated with lung function impairment. This study examines the relationship between small-opacity profusion and lung function in US underground coal miners with simple CWP. METHODS: Miners were examined during 2005 to 2013 as part of the Enhanced Coal Workers’ Health Surveillance Program. Work histories were obtained, and chest radiographs and spirometry were administered. Lung parenchymal abnormalities consistent with CWP were classified according to International Labor Organization guidelines, and reference values for FEV1 and FVC were calculated using reference equations derived from the third National Health and Nutrition Examination Survey. Differences in lung function were evaluated by opacity profusion, and regression models were fit to characterize associations between profusion and lung function. RESULTS: A total of 8,230 miners were eligible for analysis; 269 had category 1 or 2 simple CWP. Decrements in FEV1 % predicted were nearly consistent across profusion subcategories. Clear decrements in FVC % predicted and FEV1/FVC were also observed, although these were less consistent. Controlling for smoking status, BMI, and mining tenure, each 1-unit subcategory increase in profusion was associated with decreases of 1.5% (95% CI, 1.0%-1.9%), 1.0% (95% CI, 0.6%-1.3%), and 0.6% (95% CI, 0.4%-0.8%) in FEV1 % predicted, FVC % predicted, and FEV1/FVC, respectively. CONCLUSIONS: We observed progressively lower lung function across the range of small-opacity profusion. These findings address a long-standing question in occupational medicine and point to the importance of medical surveillance and respiratory disease prevention in this workforce. PMID:25996896

  11. Icotinib versus whole-brain irradiation in patients with EGFR-mutant non-small-cell lung cancer and multiple brain metastases (BRAIN): a multicentre, phase 3, open-label, parallel, randomised controlled trial.

    PubMed

    Yang, Jin-Ji; Zhou, Caicun; Huang, Yisheng; Feng, Jifeng; Lu, Sun; Song, Yong; Huang, Cheng; Wu, Gang; Zhang, Li; Cheng, Ying; Hu, Chengping; Chen, Gongyan; Zhang, Li; Liu, Xiaoqing; Yan, Hong Hong; Tan, Fen Lai; Zhong, Wenzhao; Wu, Yi-Long

    2017-09-01

    For patients with non-small-cell lung cancer (NSCLC) and multiple brain metastases, whole-brain irradiation (WBI) is a standard-of-care treatment, but its effects on neurocognition are complex and concerning. We compared the efficacy of an epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitor (TKI), icotinib, versus WBI with or without chemotherapy in a phase 3 trial of patients with EGFR-mutant NSCLC and multiple brain metastases. We did a multicentre, open-label, parallel randomised controlled trial (BRAIN) at 17 hospitals in China. Eligible participants were patients with NSCLC with EGFR mutations, who were naive to treatment with EGFR-TKIs or radiotherapy, and had at least three metastatic brain lesions. We randomly assigned participants (1:1) to either icotinib 125 mg orally (three times per day) or WBI (30 Gy in ten fractions of 3 Gy) plus concurrent or sequential chemotherapy for 4-6 cycles, until unacceptable adverse events or intracranial disease progression occurred. The randomisation was done by the Chinese Thoracic Oncology Group with a web-based allocation system applying the Pocock and Simon minimisation method; groups were stratified by EGFR gene mutation status, treatment line (first line or second line), brain metastases only versus both intracranial and extracranial metastases, and presence or absence of symptoms of intracranial hypertension. Clinicians and patients were not masked to treatment assignment, but individuals involved in the data analysis did not participate in the treatments and were thus masked to allocation. Patients receiving icotinib who had intracranial progression only were switched to WBI plus either icotinib or chemotherapy until further progression; those receiving icotinib who had extracranial progression only were switched to icotinib plus chemotherapy. Patients receiving WBI who progressed were switched to icotinib until further progression. Icotinib could be continued beyond progression if a clinical benefit

  12. Necitumumab plus pemetrexed and cisplatin as first-line therapy in patients with stage IV non-squamous non-small-cell lung cancer (INSPIRE): an open-label, randomised, controlled phase 3 study.

    PubMed

    Paz-Ares, Luis; Mezger, Jörg; Ciuleanu, Tudor E; Fischer, Jürgen R; von Pawel, Joachim; Provencio, Mariano; Kazarnowicz, Andrzej; Losonczy, György; de Castro, Gilberto; Szczesna, Aleksandra; Crino, Lucio; Reck, Martin; Ramlau, Rodryg; Ulsperger, Ernst; Schumann, Christian; Miziara, Jose Elias A; Lessa, Álvaro E; Dediu, Mircea; Bálint, Beatrix; Depenbrock, Henrik; Soldatenkova, Victoria; Kurek, Raffael; Hirsch, Fred R; Thatcher, Nick; Socinski, Mark A

    2015-03-01

    Necitumumab is a second-generation recombinant human immunoglobulin G1 EGFR monoclonal antibody that competitively inhibits ligand binding. We aimed to compare necitumumab plus pemetrexed and cisplatin with pemetrexed and cisplatin alone in patients with previously untreated, stage IV, non-squamous non-small-cell lung cancer (NSCLC). We did this randomised, open-label, controlled phase 3 study at 103 sites in 20 countries. Patients aged 18 years or older, with an Eastern Cooperative Oncology Group (ECOG) performance status of 0-2 and adequate organ function, were randomly assigned 1:1 to treatment with a block randomisation scheme (block size of four) via a telephone-based interactive voice-response system or interactive web-response system. Patients received either cisplatin 75 mg/m(2) and pemetrexed 500 mg/m(2) on day 1 of a 3-week cycle for a maximum of six cycles alone, or with necitumumab 800 mg on days 1 and 8. Necitumumab was continued after the end of chemotherapy until disease progression or unacceptable toxic effects. Randomisation was stratified by smoking history, ECOG performance status, disease histology, and geographical region. Patients and study investigators were not masked to group assignment. The primary endpoint was overall survival. Efficacy analyses were by intention to treat. This trial is registered with ClinicalTrials.gov, number NCT00982111. Between Nov 11, 2009, and Feb 2, 2011, we randomly assigned 633 patients to receive either necitumumab plus pemetrexed and cisplatin (n=315) or pemetrexed and cisplatin alone (n=318). Enrolment was stopped on Feb 2, 2011, after a recommendation from the independent data monitoring committee. There was no significant difference in overall survival between treatment groups, with a median overall survival of 11·3 months (95% CI 9·5-13·4) in the necitumumab plus pemetrexed and cisplatin group versus 11·5 months (10·1-13·1) in the pemetrexed and cisplatin group (hazard ratio 1·01 [95% CI 0·84-1·21

  13. Carboplatin and pemetrexed with or without pembrolizumab for advanced, non-squamous non-small-cell lung cancer: a randomised, phase 2 cohort of the open-label KEYNOTE-021 study.

    PubMed

    Langer, Corey J; Gadgeel, Shirish M; Borghaei, Hossein; Papadimitrakopoulou, Vassiliki A; Patnaik, Amita; Powell, Steven F; Gentzler, Ryan D; Martins, Renato G; Stevenson, James P; Jalal, Shadia I; Panwalkar, Amit; Yang, James Chih-Hsin; Gubens, Matthew; Sequist, Lecia V; Awad, Mark M; Fiore, Joseph; Ge, Yang; Raftopoulos, Harry; Gandhi, Leena

    2016-11-01

    Limited evidence exists to show that adding a third agent to platinum-doublet chemotherapy improves efficacy in the first-line advanced non-small-cell lung cancer (NSCLC) setting. The anti-PD-1 antibody pembrolizumab has shown efficacy as monotherapy in patients with advanced NSCLC and has a non-overlapping toxicity profile with chemotherapy. We assessed whether the addition of pembrolizumab to platinum-doublet chemotherapy improves efficacy in patients with advanced non-squamous NSCLC. In this randomised, open-label, phase 2 cohort of a multicohort study (KEYNOTE-021), patients were enrolled at 26 medical centres in the USA and Taiwan. Patients with chemotherapy-naive, stage IIIB or IV, non-squamous NSCLC without targetable EGFR or ALK genetic aberrations were randomly assigned (1:1) in blocks of four stratified by PD-L1 tumour proportion score (<1% vs ≥1%) using an interactive voice-response system to 4 cycles of pembrolizumab 200 mg plus carboplatin area under curve 5 mg/mL per min and pemetrexed 500 mg/m(2) every 3 weeks followed by pembrolizumab for 24 months and indefinite pemetrexed maintenance therapy or to 4 cycles of carboplatin and pemetrexed alone followed by indefinite pemetrexed maintenance therapy. The primary endpoint was the proportion of patients who achieved an objective response, defined as the percentage of patients with radiologically confirmed complete or partial response according to Response Evaluation Criteria in Solid Tumors version 1.1 assessed by masked, independent central review, in the intention-to-treat population, defined as all patients who were allocated to study treatment. Significance threshold was p<0·025 (one sided). Safety was assessed in the as-treated population, defined as all patients who received at least one dose of the assigned study treatment. This trial, which is closed for enrolment but continuing for follow-up, is registered with ClinicalTrials.gov, number NCT02039674. Between Nov 25, 2014, and Jan 25, 2016

  14. What Are Lung Carcinoid Tumors?

    MedlinePlus

    ... Carcinoid Tumor About Lung Carcinoid Tumors What Are Lung Carcinoid Tumors? Lung carcinoid tumors (also known as ... lungs, as well as the neuroendocrine system. The lungs The lungs are 2 sponge-like organs in ...

  15. Analysis of Lung Tissue Using Ion Beams

    NASA Astrophysics Data System (ADS)

    Alvarez, J. L.; Barrera, R.; Miranda, J.

    2002-08-01

    In this work a comparative study is presented of the contents of metals in lung tissue from healthy patients and with lung cancer, by means of two analytical techniques: Particle Induced X-ray Emission (PIXE) and Rutherford Backscattering Spectrometry (RBS). The samples of cancerous tissue were taken from 26 autopsies made to individuals died in the National Institute of Respiratory Disease (INER), 22 of cancer and 4 of other non-cancer biopsies. When analyzing the entirety of the samples, in the cancerous tissues, there were increments in the concentrations of S (4%), K (635%), Co (85%) and Cu (13%). Likewise, there were deficiencies in the concentrations of Cl (59%), Ca (6%), Fe (26%) and Zn (7%). Only in the cancerous tissues there were appearances of P, Ca, Ti, V, Cr, Mn, Ni, Br and Sr. The tissue samples were classified according to cancer types (adenocarcinomas, epidermoides and of small cell carcinoma), personal habits (smokers and alcoholic), genetic predisposition and residence place. There was a remarkable decrease in the concentration of Ca and a marked increment in the Cu in the epidermoide tissue samples with regard to those of adenocarcinoma or of small cells cancer. Also, decrements were detected in K and increments of Fe, Co and Cu in the sample belonging to people that resided in Mexico City with regard to those that resided in the State of Mexico.

  16. Open Content in Open Context

    ERIC Educational Resources Information Center

    Kansa, Sarah Whitcher; Kansa, Eric C.

    2007-01-01

    This article presents the challenges and rewards of sharing research content through a discussion of Open Context, a new open access data publication system for field sciences and museum collections. Open Context is the first data repository of its kind, allowing self-publication of research data, community commentary through tagging, and clear…

  17. How "Open" is Open Learning?

    ERIC Educational Resources Information Center

    Moisey, Susan D.

    1984-01-01

    The roots of the open learning system approach to education are explored and the relationship between its goals and the succeeding models/methodologies are examined in the context of open and closed systems theories. An open systems orientation to learning system development is recommended. (MSE)

  18. Use of the accelerating rotarod for assessment of motor performance decrement induced by potential anticonvulsant compounds in nerve agent poisoning. (Reannouncement with new availability information)

    SciTech Connect

    Capacio, B.R.; Harris, L.W.; Anderson, D.R.; Lennox, W.J.; Gales, V.

    1992-12-31

    The accelerating rotarod was used to assess motor performance decrement in rats after administration of candidate anticonvulsant compounds (acetazolamide, amitriptyline, chlordiazepoxide, diazepan, diazepam-lysine, lorazepam, loprazolam, midazolam, phenobarbital and scopolamine) against nerve agent poisoning. AH compounds were tested as the commercially available injectable preparation except for diazepam-lysine and loprazolam, which are not FDA approved. A peak effect time, as well as a dose to decrease performance time by 50% from control (PDD50), was determined. The calculated PDD50 (micrometer ol/kg) values and peak effect tunes were midazolam, 1.16 at 15 min; loprazolam, 1.17 at 15 min; diazepam-lysine, 4.17 at 30 min; lorazepwn, 4.98 at 15 min; diazepam, 5.27 at 15 min; phenobarbital, 101.49 at 45 min; chlordiazepoxide, 159.21 at 30 min; scopolamine, amitriptyline and acetazolamide did not demonstrate a performance decrement at any of the doses tested. The PDD50 values were compared with doses which have been utilized against nerve agent-induced convulsions or published ED50 values from standard anticonvulsant screening tests (maximal electroshock MES and subcutaneous pentylenetetrazol (scMET)). I serve agents, anticonvulsants, diazepam, accelerating rotarod, motor performance.

  19. Risk of Performance Decrements and Adverse Health Outcomes Resulting from Sleep Loss, Circadian Desynchronization, and Work Overload

    NASA Technical Reports Server (NTRS)

    Flynn-Evans, Erin; Gregory, Kevin; Arsintescu, Lucia; Whitmire, Alexandra

    2016-01-01

    Sleep loss, circadian desynchronization, and work overload occur to some extent for ground and flight crews, prior to and during spaceflight missions. Ground evidence indicates that such risk factors may lead to performance decrements and adverse health outcomes, which could potentially compromise mission objectives. Efforts are needed to identify the environmental and mission conditions that interfere with sleep and circadian alignment, as well as individual differences in vulnerability and resiliency to sleep loss and circadian desynchronization. Specifically, this report highlights a collection of new evidence to better characterize the risk and reveals new gaps in this risk as follows: Sleep loss is apparent during spaceflight. Astronauts consistently average less sleep during spaceflight relative to on the ground. The causes of this sleep loss remain unknown, however ground-based evidence suggests that the sleep duration of astronauts is likely to lead to performance impairment and short and long-term health consequences. Further research is needed in this area in order to develop screening tools to assess individual astronaut sleep need in order to quantify the magnitude of sleep loss during spaceflight; current and planned efforts in BHP's research portfolio address this need. In addition, it is still unclear whether the conditions of spaceflight environment lead to sleep loss or whether other factors, such as work overload lead to the reduced sleep duration. Future data mining efforts and continued data collection on the ISS will help to further characterize factors contributing to sleep loss. Sleep inertia has not been evaluated during spaceflight. Ground-based studies confirm that it takes two to four hours to achieve optimal performance after waking from a sleep episode. Sleep inertia has been associated with increased accidents and reduced performance in operational environments. Sleep inertia poses considerable risk during spaceflight when emergency

  20. Lung cancer in elderly patients

    PubMed Central

    Diso, Daniele; Onorati, Ilaria; Anile, Marco; Mantovani, Sara; Rendina, Erino A.

    2016-01-01

    There is a worldwide-accepted evidence of a population shift toward older ages. This shift favors an increased risk of developing lung cancer that is primarily a disease of older populations. Decision making is extremely difficult in elderly patients, since this group is under-represented in clinical trials with only 25% of them historically opening to patients older than 65 years. For all these reasons, a “customized” preoperative assessment to identify physiological or pathological frailty should be encouraged since standard tools may be less reliable. The work already done to improve patient selection for lung surgery in the elderly population clearly shows that surgical resection seems the treatment of choice for early stage lung cancer. Further studies are required to improve outcome by reducing postoperative morbidity and mortality. PMID:27942414

  1. Airway hyperresponsiveness with chest strapping: A matter of heterogeneity or reduced lung volume?

    PubMed

    Pellegrino, Riccardo; Pompilio, Pasquale P; Bruni, Giulia Innocenti; Scano, Giorgio; Crimi, Claudia; Biasco, Luigi; Coletta, Giuseppe; Cornara, Giuseppe; Torchio, Roberto; Brusasco, Vito; Dellacà, Raffaele L

    2009-03-31

    Chest wall strapping has been recently shown to be associated with an increase in airway responsiveness to methacholine. To investigate whether this is the result of the decreased lung volume or an increased heterogeneity due to chest wall distortion, ten healthy volunteers underwent a methacholine challenge at control conditions and after selective strapping of the rib cage, the abdomen or the whole chest wall resulting in similar decrements of functional residual capacity and total lung capacity but causing different distribution of the bronchoconstrictor. Methacholine during strapping reduced forced expiratory flow, dynamic compliance, and reactance at 5Hz and increased pulmonary resistance and respiratory resistance at 5Hz that were significantly greater than at control and associated with a blunted bronchodilator effect of the deep breath. However, no significant differences were observed between selective and total chest wall strapping, suggesting that the major mechanism for increasing airway responsiveness with chest wall strapping is the breathing at low lung volume rather than regional heterogeneities.

  2. Bronchoalveolar lavage in talc induced lung disease.

    PubMed Central

    Redondo, A A; Ettensohn, D B; Khan, M; Kessimian, N

    1988-01-01

    A 65 year old woman with a history of occupational talc inhalation presented with hypoxaemia, cough, and dyspnoea with a normal chest radiograph. Bronchoalveolar lavage showed considerable lymphocytosis, with a predominance of T8+ T lymphocytes, and open lung biopsy showed peribronchiolar granulomas containing talc crystals. Corticosteroid treatment resulted in dramatic improvement. Bronchoalveolar lavage may aid in the diagnosis of talc related lung injury. Images PMID:3238633

  3. Two-year efficacy and safety of AIR inhaled insulin in patients with type 1 diabetes: An open-label randomized controlled trial.

    PubMed

    Garg, Satish K; Mathieu, Chantal; Rais, Nadeem; Gao, Haitao; Tobian, Janet A; Gates, Jeffrey R; Ferguson, Jeffrey A; Webb, David M; Berclaz, Pierre-Yves

    2009-09-01

    Patients with type 1 diabetes require intensive insulin therapy for optimal glycemic control. AIR((R)) inhaled insulin (system from Eli Lilly and Company, Indianapolis, IN) (AIR is a registered trademark of Alkermes, Inc., Cambridge, MA) may be an efficacious and safe alternative to subcutaneously injected (SC) mealtime insulin. This was a Phase 3, 2-year, randomized, open-label, active-comparator, parallel-group study in 385 patients with type 1 diabetes who were randomly assigned to receive AIR insulin or SC insulin (regular human insulin or insulin lispro) at mealtimes. Both groups received insulin glargine once daily. Efficacy measures included mean change in hemoglobin A1C (A1C) from baseline to end point, eight-point self-monitored blood glucose profiles, and insulin dosage. Safety assessments included hypoglycemic events, pulmonary function tests, adverse events, and insulin antibody levels. In both treatment groups, only 20% of subjects reached the target of A1C <7.0%. A significant A1C difference of 0.44% was seen favoring SC insulin, with no difference between the groups in insulin doses or hypoglycemic events at end point. Patients in both treatment groups experienced progressive decreases in lung function, but larger (reversible) decrements in diffusing capacity of the lung for carbon monoxide (DL(CO)) were associated with AIR insulin treatment. Greater weight gain was seen with SC insulin treatment. The AIR inhaled insulin program was terminated by the sponsor prior to availability of any Phase 3 data for reasons unrelated to safety or efficacy. Despite early termination, this trial provides evidence that AIR insulin was less efficacious in lowering A1C and was associated with a greater decrease in DL(CO) and increased incidence of cough than SC insulin in patients with type 1 diabetes.

  4. Ventilator-induced Lung Injury

    PubMed Central

    Kneyber, Martin C. J.; Zhang, Haibo; Slutsky, Arthur S.

    2016-01-01

    It is well established that mechanical ventilation can injure the lung, producing an entity known as ventilator-induced lung injury (VILI). There are various forms of VILI, including volutrauma (i.e., injury caused by overdistending the lung), atelectrauma (injury due to repeated opening/closing of lung units), and biotrauma (release of mediators that can induce lung injury or aggravate pre-existing injury, potentially leading to multiple organ failure). Experimental data in the pediatric context are in accord with the importance of VILI, and appear to show age-related susceptibility to VILI, although a conclusive link between use of large Vts and mortality has not been demonstrated in this population. The relevance of VILI in the pediatric intensive care unit population is thus unclear. Given the physiological and biological differences in the respiratory systems of infants, children, and adults, it is difficult to directly extrapolate clinical practice from adults to children. This Critical Care Perspective analyzes the relevance of VILI to the pediatric population, and addresses why pediatric patients might be less susceptible than adults to VILI. PMID:25003705

  5. Wildlife openings

    Treesearch

    William M. Healy

    1989-01-01

    Openings provide important feeding areas for forest wildlife because herbaceous vegetation grows much more abundantly in the open than beneath a forest canopy. Herbage (grasses and forbs) is generally more nutritious and digestible than woody plant growth. Herbage is important in the diet of deer, especially in late winter and early spring. Voles and rabbits use...

  6. Open Access

    ERIC Educational Resources Information Center

    Suber, Peter

    2012-01-01

    The Internet lets us share perfect copies of our work with a worldwide audience at virtually no cost. We take advantage of this revolutionary opportunity when we make our work "open access": digital, online, free of charge, and free of most copyright and licensing restrictions. Open access is made possible by the Internet and copyright-holder…

  7. Open Access

    ERIC Educational Resources Information Center

    Suber, Peter

    2012-01-01

    The Internet lets us share perfect copies of our work with a worldwide audience at virtually no cost. We take advantage of this revolutionary opportunity when we make our work "open access": digital, online, free of charge, and free of most copyright and licensing restrictions. Open access is made possible by the Internet and copyright-holder…

  8. Reflux and Lung Disease

    MedlinePlus

    ... Healthy Eating Reflux and Lung Disease Reflux and Lung Disease Make an Appointment Ask a Question Find a Doctor Many people with chronic lung disease also suffer from gastroesophageal reflux (GERD). In this ...

  9. Interstitial Lung Disease

    MedlinePlus

    ... Conditions Interstitial Lung Disease (ILD)/Pulmonary Fibrosis Interstitial Lung Disease (ILD)/Pulmonary Fibrosis Make an Appointment Refer ... ILD clinical trials and most effective therapies. Interstitial Lung Disease Care at National Jewish Health At National ...

  10. MiRNA molecular profiles in human medical conditions: connecting lung cancer and lung development phenomena.

    PubMed

    Aghanoori, Mohamad-Reza; Mirzaei, Behnaz; Tavallaei, Mahmood

    2014-01-01

    MiRNAs are endogenous, single stranded ~22-nucleotide non-coding RNAs (ncRNAs) which are transcribed by RNA polymerase II and mediate negative post-transcriptional gene regulation through binding to 3'untranslated regions (UTR), possibly open reading frames (ORFs) or 5'UTRs of target mRNAs. MiRNAs are involved in the normal physiology of eukaryotic cells, so dysregulation may be associated with diseases like cancer, and neurodegenerative, heart and other disorders. Among all cancers, lung cancer, with high incidence and mortality worldwide, is classified into two main groups: non-small cell lung cancer and small cell lung cancer. Recent promising studies suggest that gene expression profiles and miRNA signatures could be a useful step in a noninvasive, low-cost and repeatable screening process of lung cancer. Similarly, every stage of lung development during fetal life is associated with specific miRNAs. Since lung development and lung cancer phenomena share the same physiological, biological and molecular processes like cell proliferation, development and shared mRNA or expression regulation pathways, and according to data adopted from various studies, they may have partially shared miRNA signature. Thus, focusing on lung cancer in relation to lung development in miRNA studies might provide clues for lung cancer diagnosis and prognosis.

  11. Activity and safety of brigatinib in ALK-rearranged non-small-cell lung cancer and other malignancies: a single-arm, open-label, phase 1/2 trial.

    PubMed

    Gettinger, Scott N; Bazhenova, Lyudmila A; Langer, Corey J; Salgia, Ravi; Gold, Kathryn A; Rosell, Rafael; Shaw, Alice T; Weiss, Glen J; Tugnait, Meera; Narasimhan, Narayana I; Dorer, David J; Kerstein, David; Rivera, Victor M; Clackson, Timothy; Haluska, Frank G; Camidge, David Ross

    2016-12-01

    Anaplastic lymphoma kinase (ALK) gene rearrangements are oncogenic drivers of non-small-cell lung cancer (NSCLC). Brigatinib (AP26113) is an investigational ALK inhibitor with potent preclinical activity against ALK mutants resistant to crizotinib and other ALK inhibitors. We aimed to assess brigatinib in patients with advanced malignancies, particularly ALK-rearranged NSCLC. In this ongoing, single-arm, open-label, phase 1/2 trial, we recruited patients from nine academic hospitals or cancer centres in the USA and Spain. Eligible patients were at least 18 years of age and had advanced malignancies, including ALK-rearranged NSCLC, and disease that was refractory to available therapies or for which no curative treatments existed. In the initial dose-escalation phase 1 stage of the trial, patients received oral brigatinib at total daily doses of 30-300 mg (according to a standard 3 + 3 design). The phase 1 primary endpoint was establishment of the recommended phase 2 dose. In the phase 2 expansion stage, we assessed three oral once-daily regimens: 90 mg, 180 mg, and 180 mg with a 7 day lead-in at 90 mg; one patient received 90 mg twice daily. We enrolled patients in phase 2 into five cohorts: ALK inhibitor-naive ALK-rearranged NSCLC (cohort 1), crizotinib-treated ALK-rearranged NSCLC (cohort 2), EGFR(T790M)-positive NSCLC and resistance to one previous EGFR tyrosine kinase inhibitor (cohort 3), other cancers with abnormalities in brigatinib targets (cohort 4), and crizotinib-naive or crizotinib-treated ALK-rearranged NSCLC with active, measurable, intracranial CNS metastases (cohort 5). The phase 2 primary endpoint was the proportion of patients with an objective response. Safety and activity of brigatinib were analysed in all patients in both phases of the trial who had received at least one dose of treatment. This trial is registered with ClinicalTrials.gov, number NCT01449461. Between Sept 20, 2011, and July 8, 2014, we enrolled 137 patients (79 [58%] with ALK

  12. Nivolumab plus ipilimumab as first-line treatment for advanced non-small-cell lung cancer (CheckMate 012): results of an open-label, phase 1, multicohort study.

    PubMed

    Hellmann, Matthew D; Rizvi, Naiyer A; Goldman, Jonathan W; Gettinger, Scott N; Borghaei, Hossein; Brahmer, Julie R; Ready, Neal E; Gerber, David E; Chow, Laura Q; Juergens, Rosalyn A; Shepherd, Frances A; Laurie, Scott A; Geese, William J; Agrawal, Shruti; Young, Tina C; Li, Xuemei; Antonia, Scott J

    2017-01-01

    Nivolumab has shown improved survival in the treatment of advanced non-small-cell lung cancer (NSCLC) previously treated with chemotherapy. We assessed the safety and activity of combination nivolumab plus ipilimumab as first-line therapy for NSCLC. The open-label, phase 1, multicohort study (CheckMate 012) cohorts reported here were enrolled at eight US academic centres. Eligible patients were aged 18 years or older with histologically or cytologically confirmed recurrent stage IIIb or stage IV, chemotherapy-naive NSCLC. Patients were randomly assigned (1:1:1) by an interactive voice response system to receive nivolumab 1 mg/kg every 2 weeks plus ipilimumab 1 mg/kg every 6 weeks, nivolumab 3 mg/kg every 2 weeks plus ipilimumab 1 mg/kg every 12 weeks, or nivolumab 3 mg/kg every 2 weeks plus ipilimumab 1 mg/kg every 6 weeks until disease progression, unacceptable toxicities, or withdrawal of consent. Data from the latter two cohorts, which were considered potentially suitable for further clinical development, are presented in this report; data from the other cohort (as well as several earlier cohorts) are described in the appendix. The primary outcome was safety and tolerability, assessed in all treated patients. This ongoing study is registered with ClinicalTrials.gov, number NCT01454102. Between May 15, 2014, and March 25, 2015, 78 patients were randomly assigned to receive nivolumab every 2 weeks plus ipilimumab every 12 weeks (n=38) or nivolumab every 2 weeks plus ipilimumab every 6 weeks (n=40). One patient in the ipilimumab every-6-weeks cohort was excluded before treatment; therefore 77 patients actually received treatment (38 in the ipilimumab every-12-weeks cohort; 39 in the ipilimumab every-6-weeks cohort). At data cut-off on Jan 7, 2016, 29 (76%) patients in the ipilimumab every-12-weeks cohort and 32 (82%) in the ipilimumab every-6-weeks cohort had discontinued treatment. Grade 3-4 treatment-related adverse events occurred in 14 (37%) patients in the

  13. Asthma and lung structure on computed tomography: the Multi-Ethnic Study of Atherosclerosis Lung Study.

    PubMed

    Donohue, Kathleen M; Hoffman, Eric A; Baumhauer, Heather; Guo, Junfeng; Ahmed, Firas S; Lovasi, Gina S; Jacobs, David R; Enright, Paul; Barr, R Graham

    2013-02-01

    The potential consequences of asthma in childhood and young adulthood on lung structure in older adults have not been studied in a large, population-based cohort. The authors hypothesized that a history of asthma onset in childhood (age 18 years or before) or young adulthood (age 19-45 years) was associated with altered lung structure on computed tomography in later life. The Multi-Ethnic Study of Atherosclerosis Lung Study recruited 3965 participants and assessed asthma history by using standardized questionnaires, guideline-based spirometry, and segmental airway dimensions and percentage of low attenuation area (%LAA) on computed tomographic scans. Asthma with onset in childhood and young adulthood was associated with large decrements in FEV(1) among participants with a mean age of 66 years (-365 mL and -343 mL, respectively; P < .001). Asthma with onset in childhood and young adulthood was associated with increased mean airway wall thickness standardized to an internal perimeter of 10 mm (0.1 mm, P < .001 for both), predominantly from narrower segmental airway lumens (-0.39 mm and -0.34 mm, respectively; P < .001). Asthma with onset in childhood and young adulthood also was associated with a greater %LAA (1.69% and 4.30%, respectively; P < .001). Findings were similar among never smokers, except that differential %LAA in childhood-onset asthma were not seen in them. Asthma with onset in childhood or young adulthood was associated with reduced lung function, narrower airways, and among asthmatic patients who smoked, greater %LAA in later life. Copyright © 2013 American Academy of Allergy, Asthma & Immunology. Published by Mosby, Inc. All rights reserved.

  14. Crackles and instabilities during lung inflation

    NASA Astrophysics Data System (ADS)

    Alencar, Adriano M.; Majumdar, Arnab; Hantos, Zoltan; Buldyrev, Sergey V.; Eugene Stanley, H.; Suki, Béla

    2005-11-01

    In a variety of physico-chemical reactions, the actual process takes place in a reactive zone, called the “active surface”. We define the active surface of the lung as the set of airway segments that are closed but connected to the trachea through an open pathway, which is the interface between closed and open regions in a collapsed lung. To study the active surface and the time interval between consecutive openings, we measured the sound pressure of crackles, associated with the opening of collapsed airway segments in isolated dog lungs, inflating from the collapsed state in 120 s. We analyzed the sequence of crackle amplitudes, inter-crackle intervals, and low frequency energy from acoustic data. The series of spike amplitudes spans two orders of magnitude and the inter-crackle intervals spans over five orders of magnitude. The distribution of spike amplitudes follows a power law for nearly two decades, while the distribution of time intervals between consecutive crackles shows two regimes of power law behavior, where the first region represents crackles coming from avalanches of openings whereas the second region is due to the time intervals between separate avalanches. Using the time interval between measured crackles, we estimated the time evolution of the active surface during lung inflation. In addition, we show that recruitment and instabilities along the pressure-volume curve are associated with airway opening and recruitment. We find a good agreement between the theory of the dynamics of lung inflation and the experimental data which combined with numerical results may prove useful in the clinical diagnosis of lung diseases.

  15. An open question.

    PubMed

    Ayling, John

    2004-01-01

    The lungs are surrounded by the pleural membranes. The visceral pleura directly covers the lung and is separated from the parietal pleura by a layer of surfactant, which reduces friction during respiratory movement. A potential space exists between these two layers, and they may become separated by fluid or air. A lung can collapse to the size of a fist under pressure from either. Standard treatment in the field for an open chest wound is an occlusive dressing. The first thing that can be used to occlude the wound is a gloved hand. After placing the dressing, evaluate the breath sounds and determine if they have improved. The dressing should be taped down on three sides, leaving one side open to relieve the pressure during exhalation (one-way valve). "Burping" the dressing involves lifting one side to make sure any pressure buildup is relieved, as occasionally the dressing can become adhered to the skin, which may lead to a tension pneumothorax. If, after ensuring the occlusive dressing is properly in place, the respiratory rate increases, distress level worsens, oxygen saturations fall and breath sounds decrease, then needle decompression is required. A neurovascular bundle is located underneath each rib, and it is important to avoid damage to that bundle by performing a decompression over the top of a rib. If the patient is intubated before the development of a tension pneumothorax, carefully evaluate the breath sounds (especially if the left-side sounds are diminished) to determine if the ET tube needs to be withdrawn a centimeter. The rescuer performing ventilation will usually recognize a tension pneumothorax by the difficulty in bagging the patient. Remember, when you perform a needle thoracentesis, you are creating an open chest wound. Early signs and symptoms of a tension pneumothorax include diminished or absent breath sounds, severe dyspnea, narrowing pulse pressure, tachycardia and restlessness. Neck veins may be distended, but this can be a normal

  16. Radiation Therapy for Lung Cancer

    MedlinePlus

    ... are available to help. HELPFUL WEB SITES ON LUNG CANCER American Lung Association www.lung.org Lungcancer.org www.lungcancer.org Lung Cancer Alliance www.lungcanceralliance.org Lung Cancer Online www. ...

  17. Risks of Lung Cancer Screening

    MedlinePlus

    ... Treatment Lung Cancer Prevention Lung Cancer Screening Research Lung Cancer Screening (PDQ®)–Patient Version What is screening? ... These are called diagnostic tests . General Information About Lung Cancer Key Points Lung cancer is a disease ...

  18. A multicenter, open-label, randomized phase II controlled study of rh-endostatin (Endostar) in combination with chemotherapy in previously untreated extensive-stage small-cell lung cancer.

    PubMed

    Lu, Shun; Li, Lu; Luo, Yi; Zhang, Li; Wu, Gang; Chen, Zhiwei; Huang, Cheng; Guo, Shuliang; Zhang, Yiping; Song, Xiangqun; Yu, Yongfeng; Zhou, Caicun; Li, Wei; Liao, Meilin; Li, Baolan; Xu, Liyan; Chen, Ping; Hu, Chunhong; Hu, Chengping

    2015-01-01

    Based on promising efficacy in a single-arm study, a randomized phase II trial was designed to compare the efficacy and safety of adding rh-endostatin (Endostar) to first-line standard etoposide and carboplatin (EC) chemotherapy for treatment of extensive-stage small-cell lung cancer. One hundred forty Chinese patients with pathologically confirmed, extensive-stage small-cell lung cancer were randomly assigned to EC alone or rh-endostatin + EC for 4-6 cycles, followed by single-agent rh-endostatin until progression or unacceptable toxicity. The primary endpoint was progression-free survival (PFS). The secondary endpoints included overall survival, Objective response rate (ORR), and quality of life. Median PFS was 6.4 months with rh-endostatin + EC (n = 69) and 5.9 months with EC (n = 69) (hazard ratio 0.8 [95% confidence interval 0.6-1.1]). PFS was significantly higher with rh-endostatin + EC than with EC (hazard ratio 0.4 [0.2-0.9; p = 0.020]) in female. Median overall survival was similar in both groups (12.1 versus 12.4 months, respectively [p = 0.82]). ORR was higher in the rh-endostatin + EC group (75.4%) than in the EC group (66.7%) (p = 0.348). The efficacy of rh-endostatin + EC relative to that of EC was reflected by greater improvements in patient-assessed quality of life scores after 4 and 6 weeks of treatment. There was no difference between each regimen in the incidence of nonhematological or Grade III-IV hematological toxicities. Addition of rh-endostatin to EC for the treatment of extensive-stage small-cell lung cancer had an acceptable toxicity profile, but did not improve overall survival, PFS, and ORR.

  19. Spanish genetic admixture is associated with larger V(O2) max decrement from sea level to 4338 m in Peruvian Quechua.

    PubMed

    Brutsaert, Tom D; Parra, Esteban J; Shriver, Mark D; Gamboa, Alfredo; Palacios, Jose-Antonio; Rivera, Maria; Rodriguez, Ivette; León-Velarde, Fabiola

    2003-08-01

    Quechua in the Andes may be genetically adapted to altitude and able to resist decrements in maximal O2 consumption in hypoxia (DeltaVo2 max). This hypothesis was tested via repeated measures of Vo2 max (sea level vs. 4338 m) in 30 men of mixed Spanish and Quechua origins. Individual genetic admixture level (%Spanish ancestry) was estimated by using ancestry-informative DNA markers. Genetic admixture explained a significant proportion of the variability in DeltaVo2 max after control for covariate effects, including sea level Vo2 max and the decrement in arterial O2 saturation measured at Vo2 max (DeltaSpO2 max) (R2 for admixture and covariate effects approximately 0.80). The genetic effect reflected a main effect of admixture on DeltaVo2 max (P = 0.041) and an interaction between admixture and DeltaSpO2 max (P = 0.018). Admixture predicted DeltaVo2 max only in subjects with a large DeltaSpO2 max (P = 0.031). In such subjects, DeltaVo2 max was 12-18% larger in a subgroup of subjects with high vs. low Spanish ancestry, with least squares mean values (+/-SE) of 739 +/- 71 vs. 606 +/- 68 ml/min, respectively. A trend for interaction (P = 0.095) was also noted between admixture and the decrease in ventilatory threshold at 4338 m. As previously, admixture predicted DeltaVo2 max only in subjects with a large decrease in ventilatory threshold. These findings suggest that the genetic effect on DeltaVo2 max depends on a subject's aerobic fitness. Genetic effects may be more important (or easier to detect) in athletic subjects who are more likely to show gas-exchange impairment during exercise. The results of this study are consistent with the evolutionary hypothesis and point to a better gas-exchange system in Quechua.

  20. Study parameters influencing NOAEL and LOAEL in toxicity feeding studies for pesticides: exposure duration versus dose decrement, dose spacing, group size and chemical class.

    PubMed

    Zarn, Jürg A; Engeli, Barbara E; Schlatter, Josef R

    2011-11-01

    The effect of exposure duration on no observed adverse effect levels (NOAEL) and lowest observed adverse effect levels (LOAEL) in rodent pesticide feeding studies was evaluated. Ratios of NOAEL (and LOAEL), expressed as pesticide concentrations in feed, were calculated from subacute to subchronic, subchronic to chronic and subacute to chronic studies. There was no statistical significant effect of exposure duration on ratio distributions. Whereas geometric means of ratios were in a narrow range of 1.1-2.5, the geometric standard deviations and 95th percentiles increased with dose spacing of the involved studies. With the exception of carbamates, the chemical class of pesticides had no influence on the ratio distributions. However, the number of animals in the shorter-term study of ratio couples being ≤ 1 was statistically significantly higher than in ratio couples being >1. Ratios ≤ 1 may be partly explained by the dose decrement over time observed in feeding studies applying the test substances in constant concentrations. The dose decrement possibly converts initially toxic doses to less toxic doses beyond the subacute phase. Ratios >1 seem to be caused predominantly by differences in study design parameters. In dietary risk assessment, the acceptable daily intake (ADI) is compared to pesticide intake estimates based on mean food consumption (i.e. the so called theoretical maximum daily intake, TMDI) being orders of magnitude lower than actual food consumption on eating occasions for certain food commodities. As subacute, subchronic and chronic NOAEL (and LOAEL), expressed as pesticide concentration in feed did not differ statistically significantly, the TMDI as benchmark for the ADI may underestimate the significance of the toxicity of subacute exposure.

  1. Intraoperative Motor-Evoked Potential Disappearance versus Amplitude-Decrement Alarm Criteria During Cervical Spinal Surgery: A Long-Term Prognosis

    PubMed Central

    Kim, Dong-Gun; Choi, Young-Doo; Jin, Seung-Hyun; Kim, Chi Heon; Lee, Kwang-Woo; Park, Kyung Seok

    2017-01-01

    Background and Purpose We studied the clinical significance of amplitude-reduction and disappearance alarm criteria for transcranial electric muscle motor-evoked potentials (MEPs) during cervical spinal surgery according to different lesion locations [intramedullary (IM) vs. nonintramedullary (NIM)] by evaluating the long-term postoperative motor status. Methods In total, 723 patients were retrospectively dichotomized into the IM and NIM groups. Each limb was analyzed respectively. One hundred and sixteen limbs from 30 patients with IM tumors and 2,761 limbs from 693 patients without IM tumors were enrolled. Postoperative motor deficits were assessed up to 6 months after surgery. Results At the end of surgery, 61 limbs (2.2%) in the NIM group and 14 limbs (12.1%) in the IM group showed MEP amplitudes that had decreased to below 50% of baseline, with 13 of the NIM limbs (21.3%) and 2 of the IM limbs (14.3%) showing MEP disappearance. Thirteen NIM limbs (0.5%) and 5 IM limbs (4.3%) showed postoperative motor deficits. The criterion for disappearance showed a lower sensitivity for the immediate motor deficit than did the criterion for amplitude decrement in both the IM and NIM groups. However, the disappearance criterion showed the same sensitivity as the 70%-decrement criterion in IM (100%) and NIM (83%) surgeries for the motor deficit at 6 months after surgery. Moreover, it has the highest specificity for the motor deficits among diverse alarm criteria, from 24 hours to 6 months after surgery, in both the IM and NIM groups. Conclusions The MEP disappearance alarm criterion had a high specificity in predicting the long-term prognosis after cervical spinal surgery. However, because it can have a low sensitivity in predicting an immediate postoperative deficit, combining different MEP alarm criteria according to the aim of specific instances of cervical spinal surgery is likely to be useful in practical intraoperative monitoring. PMID:27730765

  2. Symptom and Quality of Life Improvement in LUX-Lung 8, an Open-Label Phase III Study of Second-Line Afatinib Versus Erlotinib in Patients With Advanced Squamous Cell Carcinoma of the Lung After First-Line Platinum-Based Chemotherapy.

    PubMed

    Felip, Enriqueta; Hirsh, Vera; Popat, Sanjay; Cobo, Manuel; Fülöp, Andrea; Dayen, Charles; Trigo, José M; Gregg, Richard; Waller, Cornelius F; Soria, Jean-Charles; Goss, Glenwood D; Gordon, James; Wang, Bushi; Palmer, Michael; Ehrnrooth, Eva; Gadgeel, Shirish M

    2017-06-23

    In the phase III LUX-Lung 8 trial, afatinib significantly improved progression-free survival (PFS) and overall survival (OS) versus erlotinib in patients with squamous cell carcinoma (SCC) of the lung progressing during or after platinum-based chemotherapy. Patient-reported outcomes (PROs) and health-related quality of life (QoL) in these patients are presented. Patients (n = 795) were randomized 1:1 to oral afatinib (40 mg/d) or erlotinib (150 mg/d). PROs were collected (baseline, every 28 days until progression, 28 days after discontinuation) using the European Organization for Research and Treatment of Cancer QoL questionnaire and lung cancer-specific module. The percentage of patients improved during therapy, time to deterioration (TTD), and changes over time were analyzed for prespecified lung cancer-related symptoms and global health status (GHS)/QoL. Questionnaire compliance was 77.3% to 99.0% and 68.7% to 99.0% with afatinib and erlotinib, respectively. Significantly more patients who received afatinib versus erlotinib experienced improved scores for GHS/QoL (36% vs. 28%; P = .041) and cough (43% vs. 35%; P = .029). Afatinib significantly delayed TTD in dyspnea (P = .008) versus erlotinib, but not cough (P = .256) or pain (P = .869). Changes in mean scores favored afatinib for cough (P = .0022), dyspnea (P = .0007), pain (P = .0224), GHS/QoL (P = .0320), and all functional scales. Differences in adverse events between afatinib and erlotinib, specifically diarrhea, did not affect GHS/QoL. In patients with SCC of the lung, second-line afatinib was associated with improved prespecified disease-related symptoms and GHS/QoL versus erlotinib, complementing PFS and OS benefits with afatinib. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  3. Lung Ultrasound in the Critically Ill Neonate.

    PubMed

    Lichtenstein, Daniel A; Mauriat, Philippe

    2012-08-01

    Critical ultrasound is a new tool for first-line physicians, including neonate intensivists. The consideration of the lung as one major target allows to redefine the priorities. Simple machines work better than up-to-date ones. We use a microconvex probe. Ten standardized signs allow a majority of uses: the bat sign (pleural line), lung sliding and the A-line (normal lung surface), the quad sign and sinusoid sign indicating pleural effusion regardless its echogenicity, the tissue-like sign and fractal sign indicating lung consolidation, the B-line artifact and lung rockets (indicating interstitial syndrome), abolished lung sliding with the stratosphere sign, suggesting pneumothorax, and the lung point, indicating pneumothorax. Other signs are used for more sophisticated applications (distinguishing atelectasis from pneumonia for instance...). All these disorders were assessed in the adult using CT as gold standard with sensitivity and specificity ranging from 90 to 100%, allowing to consider ultrasound as a reasonable bedside gold standard in the critically ill. The same signs are found, with no difference in the critically ill neonate. Fast protocols such as the BLUE-protocol are available, allowing immediate diagnosis of acute respiratory failure using seven standardized profiles. Pulmonary edema e.g. yields anterior lung rockets associated with lung sliding, making the B-profile. The FALLS-protocol, inserted in a Limited Investigation including a simple model of heart and vessels, assesses acute circulatory failure using lung artifacts. Interventional ultrasound (mainly, thoracocenthesis) provides maximal safety. Referrals to CT can be postponed. CEURF proposes personnalized bedside trainings since 1990. Lung ultrasound opens physicians to a visual medicine.

  4. Lung Ultrasound in the Critically Ill Neonate

    PubMed Central

    Lichtenstein, Daniel A; Mauriat, Philippe

    2012-01-01

    Critical ultrasound is a new tool for first-line physicians, including neonate intensivists. The consideration of the lung as one major target allows to redefine the priorities. Simple machines work better than up-to-date ones. We use a microconvex probe. Ten standardized signs allow a majority of uses: the bat sign (pleural line), lung sliding and the A-line (normal lung surface), the quad sign and sinusoid sign indicating pleural effusion regardless its echogenicity, the tissue-like sign and fractal sign indicating lung consolidation, the B-line artifact and lung rockets (indicating interstitial syndrome), abolished lung sliding with the stratosphere sign, suggesting pneumothorax, and the lung point, indicating pneumothorax. Other signs are used for more sophisticated applications (distinguishing atelectasis from pneumonia for instance...). All these disorders were assessed in the adult using CT as gold standard with sensitivity and specificity ranging from 90 to 100%, allowing to consider ultrasound as a reasonable bedside gold standard in the critically ill. The same signs are found, with no difference in the critically ill neonate. Fast protocols such as the BLUE-protocol are available, allowing immediate diagnosis of acute respiratory failure using seven standardized profiles. Pulmonary edema e.g. yields anterior lung rockets associated with lung sliding, making the B-profile. The FALLS-protocol, inserted in a Limited Investigation including a simple model of heart and vessels, assesses acute circulatory failure using lung artifacts. Interventional ultrasound (mainly, thoracocenthesis) provides maximal safety. Referrals to CT can be postponed. CEURF proposes personnalized bedside trainings since 1990. Lung ultrasound opens physicians to a visual medicine. PMID:23255876

  5. Lung surfactant.

    PubMed Central

    Rooney, S A

    1984-01-01

    Aspects of pulmonary surfactant are reviewed from a biochemical perspective. The major emphasis is on the lipid components of surfactant. Topics reviewed include surfactant composition, cellular and subcellular sites as well as pathways of biosynthesis of phosphatidylcholine, disaturated phosphatidylcholine and phosphatidylglycerol. The surfactant system in the developing fetus and neonate is considered in terms of phospholipid content and composition, rates of precursor incorporation, activities of individual enzymes of phospholipid synthesis and glycogen content and metabolism. The influence of the following hormones and other factors on lung maturation and surfactant production is discussed: glucocorticoids, thyroid hormone, estrogen, prolactin, cyclic AMP, beta-adrenergic and cholinergic agonists, prostaglandins and growth factors. The influence of maternal diabetes, fetal sex, stress and labor are also considered. Nonphysiologic and toxic agents which influence surfactant in the fetus, newborn and adult are reviewed. PMID:6145585

  6. Treatment, rationale, and study design of TALISMAN study: a randomized phase II open-label study of second-line erlotinib versus intermittent erlotinib dosing with docetaxel in the treatment of former-smoker men affected by recurrent squamous non-small-cell lung cancer.

    PubMed

    Gridelli, Cesare; Rossi, Antonio; Venturino, Paola; de Marinis, Filippo

    2011-01-01

    We present the treatment rationale and study design of the TALISMAN (TArceva and docetaxeL In former-Smokers MAle patients with recurrent Non-small-cell lung cancer) study, an open-label, randomized phase II trial of erlotinib (arm A) or intermittent erlotinib and docetaxel (arm B) in male former smokers affected by recurrent squamous non-small-cell lung cancer (NSCLC). In arm A, treatment consists of erlotinib 150 mg daily orally until progression or inacceptable toxicity; in arm B, treatment consists of docetaxel 75 mg/m² on day 1 and erlotinib 150 mg orally on days 2-16, recycled every 3 weeks up to 4 cycles followed, in patients not progressed, by erlotinib 150 mg daily orally until disease progression or inacceptable toxicity. The primary endpoint of this study is the rate of patients without progression at 6 months, and secondary objectives include median progression-free survival, median overall survival, activity, and toxicity. In addition, translational research evaluating EGFR and KRAS mutational status will be investigated for both arms.

  7. Interstitial Lung Diseases

    MedlinePlus

    Interstitial lung disease is the name for a large group of diseases that inflame or scar the lungs. The inflammation and scarring make it hard to ... air is responsible for some types of interstitial lung diseases. Specific types include Black lung disease among ...

  8. Toll-like receptor 4 signaling is coupled to src family kinase activation, tyrosine phosphorylation of zonula adherens proteins, and opening of the paracellular pathway in human lung microvascular endothelia

    USDA-ARS?s Scientific Manuscript database

    Bacterial lipopolysaccharide (LPS) is a key mediator in the vascular leak syndromes associated with Gram-negative bacterial infections. LPS opens the paracellular pathway in pulmonary vascular endothelia through protein tyrosine phosphorylation. We now have identified the protein tyrosine kinase (PT...

  9. Ex vivo lung perfusion.

    PubMed

    Reeb, Jeremie; Cypel, Marcelo

    2016-03-01

    Lung transplantation is an established life-saving therapy for patients with end-stage lung disease. Unfortunately, greater success in lung transplantation is hindered by a shortage of lung donors and the relatively poor early-, mid-, and long-term outcomes associated with severe primary graft dysfunction. Ex vivo lung perfusion has emerged as a modern preservation technique that allows for a more accurate lung assessment and improvement in lung quality. This review outlines the: (i) rationale behind the method; (ii) techniques and protocols; (iii) Toronto ex vivo lung perfusion method; (iv) devices available; and (v) clinical experience worldwide. We also highlight the potential of ex vivo lung perfusion in leading a new era of lung preservation.

  10. The effects of electronic cigarette aerosol exposure on inflammation and lung function in mice.

    PubMed

    Larcombe, Alexander N; Janka, Maxine A; Mullins, Benjamin J; Berry, Luke J; Bredin, Arne; Franklin, Peter J

    2017-07-01

    Electronic cigarette usage is increasing worldwide, yet there is a paucity of information on the respiratory health effects of electronic cigarette aerosol exposure. This study aimed to assess whether exposure to electronic cigarette (e-cigarette) aerosol would alter lung function and pulmonary inflammation in mice and to compare the severity of any alterations with mice exposed to mainstream tobacco smoke. Female BALB/c mice were exposed for 8 wk to tobacco smoke, medical air (control), or one of four different types of e-cigarette aerosol. E-cigarette aerosols varied depending on nicotine content (0 or 12 mg/ml) and the main excipient (propylene glycol or glycerin). Twenty-four hours after the final exposure, we measured pulmonary inflammation, lung volume, lung mechanics, and responsiveness to methacholine. Mice exposed to tobacco cigarette smoke had increased pulmonary inflammation and responsiveness to methacholine compared with air controls. Mice exposed to e-cigarette aerosol did not have increased inflammation but did display decrements in parenchymal lung function at both functional residual capacity and high transrespiratory pressures. Mice exposed to glycerin-based e-cigarette aerosols were also hyperresponsive to methacholine regardless of the presence or absence of nicotine. This study shows, for the first time, that exposure to e-cigarette aerosol during adolescence and early adulthood is not harmless to the lungs and can result in significant impairments in lung function. Copyright © 2017 the American Physiological Society.

  11. Clinical Outcome of Patients Transplanted with Marginal Donor Lungs via Ex Vivo Lung Perfusion Compared to Standard Lung Transplantation.

    PubMed

    Fildes, James E; Archer, Louise D; Blaikley, John; Ball, Alexandra L; Stone, John P; Sjöberg, Trygve; Steen, Stig; Yonan, Nizar

    2015-05-01

    Lung transplantation is limited by a scarcity of suitable donors resulting in high waiting list mortality. Ex vivo lung perfusion (EVLP) allows the evaluation and reconditioning of marginal donor lungs for use in transplantation. This study aimed to compare clinical outcome of patients transplanted with marginal organs by means of EVLP with a standard lung transplant cohort through a multicenter open trial. Group 1 (n = 9) included patients transplanted using EVLP reconditioned marginal lungs. Group 2 (n = 46) consisted of date-matched patients transplanted using standard transplantation of acceptable lungs. The primary composite endpoint included acute rejection and infection at 12 months after transplantation. There was no significant difference in the overall incidence of acute rejection (P = 0.754) and the number of treated infection episodes (proven/probable pneumonia; P = 0.857/0.368 and proven/probable tracheobronchitis; P = 0.226/0.529) up to 12 months after transplantation, between group 1 and group 2. Additionally, there was no significant difference in early clinical outcome, including intensive care unit stay, hospital stay, and 1 year mortality between the two groups (P = 0.338, P = 0.112 and P = 0.372, respectively). This multicenter study demonstrates that EVLP is associated with no adverse effect on clinical outcome, including the incidence of acute rejection and infection after lung transplantation.

  12. Open Education and the Open Science Economy

    ERIC Educational Resources Information Center

    Peters, Michael A.

    2009-01-01

    Openness as a complex code word for a variety of digital trends and movements has emerged as an alternative mode of "social production" based on the growing and overlapping complexities of open source, open access, open archiving, open publishing, and open science. This paper argues that the openness movement with its reinforcing structure of…

  13. Open Education and the Open Science Economy

    ERIC Educational Resources Information Center

    Peters, Michael A.

    2009-01-01

    Openness as a complex code word for a variety of digital trends and movements has emerged as an alternative mode of "social production" based on the growing and overlapping complexities of open source, open access, open archiving, open publishing, and open science. This paper argues that the openness movement with its reinforcing structure of…

  14. Open Adoption

    ERIC Educational Resources Information Center

    Baran, Annette; And Others

    1976-01-01

    Adult adoptees are increasingly challenging the practice of sealing their birth records. The authors examine the historical roots of adoptive practices in this country and suggest that the time has come for open adoption to gain acceptance as an alternative. (Author)

  15. Opening remarks

    SciTech Connect

    Hildebrand, S.G.

    1994-09-01

    Included in this paper are the opening remarks of S.G. Hildebrand, from Environmental Science Division, ORNL, to a conference on water resources and water resource issues. Wetlands are the focus of this talk, with an emphasis on conservation and land use to conserve wetland functions and values.

  16. Opening Remarks

    NASA Technical Reports Server (NTRS)

    Goldin, Daniel S.

    2005-01-01

    In these opening remarks to a symposium reflecting on forty years of U.S. Human Spaceflight, NASA Administrator Daniel Goldin, reviews the impact that Alan Shepard had on him personally, to NASA, and to the whole idea of manned spaceflight. Mr Goldin cites Shepard as an example of the past and future of manned spaceflight.

  17. Opening Address

    Treesearch

    John T. Shannon

    2001-01-01

    I am glad to be here today to help open the symposium on Arkansas' forests. It is gratifying to see so many forestry leaders in attendance. I am particulary pleased to welcome my brother, State Forester from Oklahoma, Roger Davis; and representatives of the State Foresters from Tennessee and Louisiana.

  18. Interstitial lung disease in children.

    PubMed

    Cazzato, Salvatore; di Palmo, Emanuela; Ragazzo, Vincenzo; Ghione, Silvia

    2013-10-01

    Children's interstitial lung disease (ILD) includes a wide range of rare respiratory disorders associated with high morbidity and mortality. Genetic factors, systemic disease processes, nonspecific inflammatory or fibrotic patterns of repair seen in a number of clinical settings are involved in the ILD pathogenesis. Specific disorders more prevalent in young children include diffuse developmental disorders, alveolar growth abnormalities, genetic surfactant disorders, pulmonary interstitial glycogenosis and neuroendocrine cell hyperplasia of infancy. It may be difficult to recognize these entities and this can lead to delayed treatment. The diagnostic approach is based on a combination of history/physical examinations, imaging studies, pulmonary function testing, genetic testing, bronchoalveolar lavage (BAL) and in most cases an open lung biopsy. Although some disease types overlap with those seen in adults, in this review emphasis is placed on entities unique to the pediatric population focusing on clinical characteristics, histologic definitions, radiologic-pathologic correlation and therapeutic strategies. © 2013.

  19. Epidemiology of Lung Cancer

    PubMed Central

    Brock, Malcolm V.; Ford, Jean G.; Samet, Jonathan M.; Spivack, Simon D.

    2013-01-01

    Background: Ever since a lung cancer epidemic emerged in the mid-1900s, the epidemiology of lung cancer has been intensively investigated to characterize its causes and patterns of occurrence. This report summarizes the key findings of this research. Methods: A detailed literature search provided the basis for a narrative review, identifying and summarizing key reports on population patterns and factors that affect lung cancer risk. Results: Established environmental risk factors for lung cancer include smoking cigarettes and other tobacco products and exposure to secondhand tobacco smoke, occupational lung carcinogens, radiation, and indoor and outdoor air pollution. Cigarette smoking is the predominant cause of lung cancer and the leading worldwide cause of cancer death. Smoking prevalence in developing nations has increased, starting new lung cancer epidemics in these nations. A positive family history and acquired lung disease are examples of host factors that are clinically useful risk indicators. Risk prediction models based on lung cancer risk factors have been developed, but further refinement is needed to provide clinically useful risk stratification. Promising biomarkers of lung cancer risk and early detection have been identified, but none are ready for broad clinical application. Conclusions: Almost all lung cancer deaths are caused by cigarette smoking, underscoring the need for ongoing efforts at tobacco control throughout the world. Further research is needed into the reasons underlying lung cancer disparities, the causes of lung cancer in never smokers, the potential role of HIV in lung carcinogenesis, and the development of biomarkers. PMID:23649439

  20. Functional vascularized lung grafts for lung bioengineering

    PubMed Central

    Dorrello, N. Valerio; Guenthart, Brandon A.; O’Neill, John D.; Kim, Jinho; Cunningham, Katherine; Chen, Ya-Wen; Biscotti, Mauer; Swayne, Theresa; Wobma, Holly M.; Huang, Sarah X. L.; Snoeck, Hans-Willem; Bacchetta, Matthew; Vunjak-Novakovic, Gordana

    2017-01-01

    End-stage lung disease is the third leading cause of death worldwide, accounting for 400,000 deaths per year in the United States alone. To reduce the morbidity and mortality associated with lung disease, new therapeutic strategies aimed at promoting lung repair and increasing the number of donor lungs available for transplantation are being explored. Because of the extreme complexity of this organ, previous attempts at bioengineering functional lungs from fully decellularized or synthetic scaffolds lacking functional vasculature have been largely unsuccessful. An intact vascular network is critical not only for maintaining the blood-gas barrier and allowing for proper graft function but also for supporting the regenerative cells. We therefore developed an airway-specific approach to removing the pulmonary epithelium, while maintaining the viability and function of the vascular endothelium, using a rat model. The resulting vascularized lung grafts supported the attachment and growth of human adult pulmonary cells and stem cell–derived lung-specified epithelial cells. We propose that de-epithelialization of the lung with preservation of intact vasculature could facilitate cell therapy of pulmonary epithelium and enable bioengineering of functional lungs for transplantation. PMID:28875163

  1. Opening education.

    PubMed

    Smith, Marshall S

    2009-01-02

    Spurred by the publication of Massachusetts Institute of Technology OpenCourseWare in 2002, the open educational resources (OER) movement, which has rapidly expanded and captured the imagination and energy of millions of creators and users throughout the world, now faces many opportunities and substantial challenges as it moves to become an integral part of the world's educational environment. The confluence of the Web and a spirit of sharing intellectual property have fueled a worldwide movement to make knowledge and education materials open to all for use. OER are content (courses, books, lesson plans, articles, etc.), tools (virtual laboratories, simulations, and games), and software that support learning and educational practice. OER are free on the Web, and most have licenses that allow copyright holders to retain ownership while providing specified rights for use in original and modified forms. At the least, OER have helped to level the distribution of knowledge across the world. A second promise of OER is to help transform educational practices. This article explores the history of and promises and challenges for OER.

  2. A Comparison of Oxycodone and Alfentanil in Intravenous Patient-Controlled Analgesia with a Time-Scheduled Decremental Infusion after Laparoscopic Cholecystectomy.

    PubMed

    Kwon, Young Suk; Jang, Ji Su; Lee, Na Rea; Kim, Seong Su; Kim, Young Ki; Hwang, Byeong Mun; Kang, Seong Sik; Son, Hee Jeong; Lim, So Young

    2016-01-01

    Background. Oxycodone, a semisynthetic opioid, has been widely used for acute and chronic pain. Objectives. The aim of this study was to compare the analgesic and adverse effects of oxycodone and alfentanil on postoperative pain after laparoscopic cholecystectomy. Methods. This was a prospective, randomized, double-blind study. A total of 82 patients undergoing laparoscopic cholecystectomy were randomly assigned to receive either oxycodone or alfentanil using intravenous patient-controlled analgesia (PCA). PCA was administered as a time-scheduled decremental continuous infusion based on lean body mass for 48 hours postoperatively. Patients were assessed for pain with a visual analogue scale (VAS), the cumulative PCA dose, adverse effects, sedation level at 1, 4, 8, 16, 24, and 48 hours postoperatively, and satisfaction during the postoperative 48 hours. Results. There were no significant differences (p < 0.05) between the two groups in VAS score, cumulative PCA dose, adverse effects, sedation level at 1, 4, 8, 16, 24, and 48 hours postoperatively, and satisfaction during the postoperative 48 hours. Conclusions. Our data showed that the analgesic and adverse effects of oxycodone and alfentanil were similar. Therefore, oxycodone may be a good alternative to alfentanil for pain management using intravenous PCA after laparoscopic cholecystectomy when used at a conversion ratio of 10 : 1. This trial is registered with KCT0001962.

  3. A Comparison of Oxycodone and Alfentanil in Intravenous Patient-Controlled Analgesia with a Time-Scheduled Decremental Infusion after Laparoscopic Cholecystectomy

    PubMed Central

    Jang, Ji Su; Kim, Seong Su; Kim, Young Ki; Hwang, Byeong Mun; Kang, Seong Sik; Son, Hee Jeong

    2016-01-01

    Background. Oxycodone, a semisynthetic opioid, has been widely used for acute and chronic pain. Objectives. The aim of this study was to compare the analgesic and adverse effects of oxycodone and alfentanil on postoperative pain after laparoscopic cholecystectomy. Methods. This was a prospective, randomized, double-blind study. A total of 82 patients undergoing laparoscopic cholecystectomy were randomly assigned to receive either oxycodone or alfentanil using intravenous patient-controlled analgesia (PCA). PCA was administered as a time-scheduled decremental continuous infusion based on lean body mass for 48 hours postoperatively. Patients were assessed for pain with a visual analogue scale (VAS), the cumulative PCA dose, adverse effects, sedation level at 1, 4, 8, 16, 24, and 48 hours postoperatively, and satisfaction during the postoperative 48 hours. Results. There were no significant differences (p < 0.05) between the two groups in VAS score, cumulative PCA dose, adverse effects, sedation level at 1, 4, 8, 16, 24, and 48 hours postoperatively, and satisfaction during the postoperative 48 hours. Conclusions. Our data showed that the analgesic and adverse effects of oxycodone and alfentanil were similar. Therefore, oxycodone may be a good alternative to alfentanil for pain management using intravenous PCA after laparoscopic cholecystectomy when used at a conversion ratio of 10 : 1. This trial is registered with KCT0001962. PMID:27725791

  4. Feel the Fatigue and Be Active Anyway: Physical Activity on High-Fatigue Days Protects Adults With Arthritis From Decrements in Same-Day Positive Mood.

    PubMed

    Hegarty, Rosisin S M; Conner, Tamlin S; Stebbings, Simon; Treharne, Gareth J

    2015-09-01

    The present study examined whether daily physical activity moderated the within-person relationship between daily fatigue and positive or negative mood in patients with rheumatoid arthritis (RA) or osteoarthritis (OA). Participants were 142 patients, 70 with RA and 72 with OA (67.6% women). Participants completed daily diaries during 4 fixed time windows per day for 7 days. Each diary assessed fatigue, pain, and positive and negative mood. Participants wore pedometers throughout each day and recorded pedometer readings at the end of each day. Physical activity buffered the same-day relationship between daily fatigue and positive mood for both RA and OA participants. On high-fatigue days, large decrements in mood were noted, but this was mitigated on days when participants were more physically active. Being more physically active on high-fatigue days buffered the negative effect of fatigue on positive mood among adults with both OA and RA. These findings have implications for understanding the daily variations in fatigue and inform potential clinical interventions. © 2015, American College of Rheumatology.

  5. Bereavement is associated with time-dependent decrements in cellular immune function in asymptomatic human immunodeficiency virus type 1-seropositive homosexual men.

    PubMed Central

    Goodkin, K; Feaster, D J; Tuttle, R; Blaney, N T; Kumar, M; Baum, M K; Shapshak, P; Fletcher, M A

    1996-01-01

    Seventy-nine human immunodeficiency virus type 1 (HIV-1)-seropositive homosexual men participating in a longitudinal study of HIV-1 infection were assessed twice, 6 months apart, to investigate associations between bereavement and cellular immune function. Subjects were assessed by using a theory-driven model comprising life stressors, social support and coping style, and control variables. Natural killer cell cytotoxicity was decreased among the bereaved at both times. Lymphocyte proliferative response to phytohemagglutinin was decreased among the bereaved at the second time point but not at the first. These functional immune decrements are associated with increased neuroendocrine responses of the sympathetic adrenomeduallary system as well as the limbic-hypothalamic-pituitary-adrenal axis. Implications for differential neuroendocrine responses over time are discussed. Active coping style was independently and positively related to both immune measures. The results imply that a bereavement support group intervention merits investigation for an effect on immunological measures and clinical progression of HIV-1 infection as well as grief resolution. PMID:8770514

  6. Fundamental Vibration Frequency and Damping Estimation: A Comparison Using the Random Decrement Method, the Empirical Mode Decomposition, and the HV Spectral Ratio Method for Local Site Characterization

    NASA Astrophysics Data System (ADS)

    Huerta-Lopez, C. I.; Upegui Botero, F. M.; Pulliam, J.; Willemann, R. J.; Pasyanos, M.; Schmitz, M.; Rojas Mercedes, N.; Louie, J. N.; Moschetti, M. P.; Martinez-Cruzado, J. A.; Suárez, L.; Huerfano Moreno, V.; Polanco, E.

    2013-12-01

    Site characterization in civil engineering demands to know at least two of the dynamic properties of soil systems, which are: (i) dominant vibration frequency, and (ii) damping. As part of an effort to develop understanding of the principles of earthquake hazard analysis, particularly site characterization techniques using non invasive/non destructive seismic methods, a workshop (Pan-American Advanced Studies Institute: New Frontiers in Geophysical Research: Bringing New Tools and Techniques to Bear on Earthquake Hazard Analysis and Mitigation) was conducted during july 15-25, 2013 in Santo Domingo, Dominican Republic by the alliance of Pan-American Advanced Studies Institute (PASI) and Incorporated Research Institutions for Seismology (IRIS), jointly supported by Department of Energy (DOE) and National Science Foundation (NSF). Preliminary results of the site characterization in terms of fundamental vibration frequency and damping are here presented from data collected during the workshop. Three different methods were used in such estimations and later compared in order to identify the stability of estimations as well as the advantage or disadvantage among these methodologies. The used methods were the: (i) Random Decrement Method (RDM), to estimate fundamental vibration frequency and damping simultaneously; (ii) Empirical Mode Decomposition (EMD), to estimate the vibration modes, and (iii) Horizontal to Vertical Spectra ratio (HVSR), to estimate the fundamental vibration frequency. In all cases ambient vibration and induced vibration were used.

  7. Warning Signs of Lung Disease

    MedlinePlus

    ... Warning Signs of Lung Disease Warning Signs of Lung Disease A nagging cough or slight wheeze may ... prepare for you next office visit. Questions about Lung Health? Call our Lung HelpLine. Get free counseling ...

  8. Lung needle biopsy

    MedlinePlus

    ... if you have certain lung diseases such as emphysema. Usually, a collapsed lung after a biopsy does ... any type Bullae (enlarged alveoli that occur with emphysema) Cor pulmonale (condition that causes the right side ...

  9. Lungs and Respiratory System

    MedlinePlus

    ... Your 1- to 2-Year-Old Lungs and Respiratory System KidsHealth > For Parents > Lungs and Respiratory System A ... ll have taken at least 600 million breaths. Respiratory System Basics All of this breathing couldn't happen ...

  10. Ex vivo lung perfusion

    PubMed Central

    Machuca, Tiago N.

    2014-01-01

    Lung transplantation (LTx) is an established treatment option for eligible patients with end-stage lung disease. Nevertheless, the imbalance between suitable donor lungs available and the increasing number of patients considered for LTx reflects in considerable waitlist mortality. Among potential alternatives to address this issue, ex vivo lung perfusion (EVLP) has emerged as a modern preservation technique that allows for more accurate lung assessment and also improvement of lung function. Its application in high-risk donor lungs has been successful and resulted in safe expansion of the donor pool. This article will: (I) review the technical details of EVLP; (II) the rationale behind the method; (III) report the worldwide clinical experience with the EVLP, including the Toronto technique and others; (IV) finally, discuss the growing literature on EVLP application for donation after cardiac death (DCD) lungs. PMID:25132972

  11. Lung cancer screening update

    PubMed Central

    Dhillon, Samjot Singh; Loewen, Gregory; Jayaprakash, Vijayvel; Reid, Mary E.

    2013-01-01

    Lung cancer is the leading cause of cancer-related mortality globally and the American cancer society estimates approximately 226,160 new cases and 160,340 deaths from lung cancer in the USA in the year 2012. The majority of lung cancers are diagnosed in the later stages which impacts the overall survival. The 5-year survival rate for pathological st age IA lung cancer is 73% but drops to only 13% for stage IV. Thus, early detection through screening and prevention are the keys to reduce the global burden of lung cancer. This article discusses the current state of lung cancer screening, including the results of the National Lung Cancer Screening Trial, the consideration of implementing computed tomography screening, and a brief overview of the role of bronchoscopy in early detection and potential biomarkers that may aid in the early diagnosis of lung cancer. PMID:23599684

  12. Interstitial Lung Disease

    MedlinePlus

    ... Critical Care & Sleep Medicine Interstitial Lung Disease Program Sarcoidosis Program Autoimmune Lung Center Rebecca C. Keith, MD, ... Syndromes Hypersensitivity Pneumonitis LAM Lupus Rheumatoid Arthritis (RA) Sarcoidosis Overview Scleroderma (SSC) Systemic Vasculitis Reasons to Visit ...

  13. Lung gallium scan

    MedlinePlus

    ... the lungs. This is most often due to sarcoidosis or a certain type of pneumonia. Normal Results ... it may mean any of the following problems: Sarcoidosis (disease in which inflammation occurs in the lungs ...

  14. Opening the Dutch Open Telescope

    NASA Astrophysics Data System (ADS)

    Rutten, R. J.; de Wijn, A. G.; Sütterlin, P.; Bettonvil, F. C. M.; Hammerschlag, R. H.

    2002-10-01

    We hope to "open the DOT" to the international solar physics community as a facility for high-resolution tomography of the solar atmosphere. Our aim is to do so combining peer-review time allocation with service-mode operation in a "hands-on-telescope" education program bringing students to La Palma to assist in the observing and processing. The largest step needed is considerable speedup of the DOT speckle processing.

  15. The therapeutic effects of tuberostemonine against cigarette smoke-induced acute lung inflammation in mice.

    PubMed

    Jung, Kyung-Hwa; Beak, Hyunjung; Park, Soojin; Shin, Dasom; Jung, Jaehoon; Park, Sangwon; Kim, Jinju; Bae, Hyunsu

    2016-03-05

    Chronic obstructive pulmonary disease (COPD) is mainly caused by cigarette smoking and is characterized by the destruction of lung parenchyma, structural alterations of the small airways, and systemic inflammation. Tuberostemonine (TS) is an alkaloid-type phytochemical from Stemona tuberosa. In the present study, we evaluated the anti-inflammatory effect of TS in a cigarette smoke (CS)-induced mouse model of acute lung inflammation. The mice were whole-body exposed to CS or fresh air for 7 days. TS was administered by an intraperitoneal (i.p.) injection 1h before exposure to CS. To test the effects of TS, the numbers of total cells, neutrophils, macrophages and lymphocytes in the bronchoalveolar lavage (BAL) fluid were counted. Furthermore, we measured the levels of several chemokines, such as GCP-2, MIP-3α, MCP-1 and KC, in the lung tissue. The cellular profiles and histopathological analysis demonstrated that the infiltration of peribronchial and perivascular inflammatory cells significantly decreased in the TS-treated groups compared with the CS-exposure group. The TS treatment significantly ameliorated the airway epithelial thickness induced by CS exposure and caused a significant decrement in the production of chemokines in the lung. These results suggest that TS has anti-inflammatory effects against CS-induced acute lung inflammation.

  16. Rapid decline in lung function in coal miners: evidence of disease in small airways.

    PubMed

    Stansbury, Robert C; Beeckman-Wagner, Lu-Ann F; Wang, Mei-Lin; Hogg, Jeffery P; Petsonk, Edward L

    2013-09-01

    Coal mine dust exposure can cause both pneumoconiosis and chronic airflow limitation. The contributions of various pathophysiologic mechanisms to dust-related lung function decrements remain unclear. Clinical and physiological findings were assessed for 15 underground coal miners who had demonstrated accelerated FEV1 losses (decliners) over 6-18 years. Decliners' findings were evaluated in comparison to a group of 11 miners who had shown relatively stable lung function (referents) during the same period. At follow-up examination, the decliners showed significantly greater mean airway resistance (10.47 vs. 6.78 cmH2 O/L/s; P = 0.05) and more air trapping (RV/TLC = 37.5 vs. 29.1%; P < 0.01) compared to the referents. Decliners also demonstrated more evidence of small airways dysfunction and tended to have more bronchospasm than the referent group. Total lung capacity, lung compliance, diffusing capacity, and chest radiography did not differ significantly between the two groups. After cessation of mine dust exposures, the decliners' mean rate of FEV1 loss normalized. In a series of working coal miners, accelerated lung function declines were associated with air trapping and evidence of small airways dysfunction. A preventive benefit from controlling dust exposures was suggested. Copyright © 2013 Wiley Periodicals, Inc.

  17. Open University

    ScienceCinema

    None

    2016-07-12

    Michel Pentz est née en Afrique du Sud et venu au Cern en 1957 comme physicien et président de l'associaion du personnel. Il est également fondateur du mouvement Antiapartheid de Genève et a participé à la fondation de l'Open University en Grande-Bretagne. Il nous parle des contextes pédagogiques, culturels et nationaux dans lesquels la méthode peut s'appliquer.

  18. Lung cancer prevention.

    PubMed

    Slatore, Christopher; Sockrider, Marianna

    2014-11-15

    Lung cancer is a common form of cancer.There are things you can do to lower your risk of lung cancer. Stop smoking tobacco. Ask your health care provider for help in quitting, including use of medicines to help with nicotine dependence. discuss with your healthcare provider,what you are taking or doing to decrease your risk for lung cancer

  19. Lungs and Respiratory System

    MedlinePlus

    ... A Week of Healthy Breakfasts Shyness Lungs and Respiratory System KidsHealth > For Teens > Lungs and Respiratory System A ... didn't breathe, you couldn't live. Lungs & Respiratory System Basics Each day we breathe about 20,000 ...

  20. Results of the safety run-in part of the METAL (METformin in Advanced Lung cancer) study: a multicentre, open-label phase I-II study of metformin with erlotinib in second-line therapy of patients with stage IV non-small-cell lung cancer.

    PubMed

    Morgillo, Floriana; Fasano, Morena; Della Corte, Carminia Maria; Sasso, Ferdinando Carlo; Papaccio, Federica; Viscardi, Giuseppe; Esposito, Giovanna; Di Liello, Raimondo; Normanno, Nicola; Capuano, Annalisa; Berrino, Liberato; Vicidomini, Giovanni; Fiorelli, Alfonso; Santini, Mario; Ciardiello, Fortunato

    2017-01-01

    Our previous works demonstrated the ability of metformin to revert resistance to gefitinib, a selective epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor, in non-small-cell lung cancer (NSCLC) EGFR/LKB1 wild-type (WT) cell lines. However, the optimal dose of metformin to be used in non-diabetic patients still remains to be defined. The phase I-II trial METformin in Advanced Lung cancer (METAL) was designed to identify the maximum tolerated dose and to evaluate safety and activity of metformin combined with erlotinib in second-line treatment of patients with stage IV NSCLC, whose tumours harbour the WT EGFR gene. We report results from the safety run-in part designed to detect acute toxicities, to study pharmacokinetics and to identify the recommended phase II dose (RPD) to be used for the following phase of the study. In the run-in phase, metformin treatment was administered according to a dose escalation scheme and, subsequently, combined with erlotinib. Twelve patients were enrolled. Common adverse events were diarrhoea, decreased appetite, abdominal pain, vomiting and skin toxicity, mostly reversible with symptomatic medical treatment. Dose-limiting toxicities were vomiting and diarrhoea registered in the initial cohort receiving metformin 2000 mg plus erlotinib at 150 mg die, which was declared the maximum administered dose. Only one of nine patients treated at the next lower dose of 1500 mg of metformin plus erlotinib at 150 mg experienced G3 gastrointestinal toxicity. Metformin plasma-concentration profile confirmed the trend already observed in non-diabetic population. Glycemic profiles showed stability of the blood glucose level within the physiological range for non-diabetic subjects. At a follow-up of 30 weeks, six (50%) patients experienced a disease control (5 SD and 1 partial response). The RP2D of metformin dose was defined at 1500 mg/day to be combined with erlotinib 150 mg. EudraCT number: 2014-000349-59.

  1. Effects of flow rate and airleak at the nares and mouth opening on positive distending pressure delivery using commercially available high-flow nasal cannula systems: a lung model study.

    PubMed

    Hasan, Rashed A; Habib, Robert H

    2011-01-01

    Use of high-flow humidified nasal cannulas to deliver continuous positive airway pressure in children is increasing. Data on the relationship between the flow values and the corresponding pressures are limited. The purpose of this experiment was to evaluate the relationship between the device, intraprong, and proximal airway pressures and the flow values in a neonatal/pediatric test lung model, using the Vapotherm 2000i and Fisher-Paykel humidified nasal cannulas devices. Using a pediatric size cannula (2-mm inner diameter), we measured the device, intraprong, and proximal airway pressures at random flow values between 0 L/min and 12 L/min with an FIO2 of 0.21 at a temperature of 37°C and 100% humidity. Measurements were repeated for both devices under simulated minimal and moderate nares-prong leak (leak). Effects of varying mouth leak were also studied. All three pressures generally increased with increasing flows with both devices, irrespective of leak. In case of minimal leak, the Fisher-Paykel device generated larger pressures than the Vapotherm device for flows of < 8 L/min, whereas this trend was reversed at higher flows due principally to the pressure release feature of the Fisher-Paykel system. Under minimal leak, the intraprong pressure values varied between 22% and 27% and 20% and 32% of the corresponding device pressure value for Fisher-Paykel and Vapotherm, respectively. The proximal airway pressure was further reduced by about 20% to 30% relative to the intrapong pressure values with the two devices. The device pressure was essentially unaffected by nares-prong leaks or mouth leak. The intraprong pressure and particularly the proximal airway pressure were reduced substantially, as either nares or mouth leak increased. High flow humidified nasal cannulas systems may deliver uncontrolled continuous positive airway pressure to infants. This, along with the potentially large nares and mouth leak effects on any form of continuous positive airway pressure

  2. Positive End-Expiratory Pressure and Variable Ventilation in Lung-Healthy Rats under General Anesthesia

    PubMed Central

    Camilo, Luciana M.; Ávila, Mariana B.; Cruz, Luis Felipe S.; Ribeiro, Gabriel C. M.; Spieth, Peter M.; Reske, Andreas A.; Amato, Marcelo; Giannella-Neto, Antonio; Zin, Walter A.; Carvalho, Alysson R.

    2014-01-01

    Objectives Variable ventilation (VV) seems to improve respiratory function in acute lung injury and may be combined with positive end-expiratory pressure (PEEP) in order to protect the lungs even in healthy subjects. We hypothesized that VV in combination with moderate levels of PEEP reduce the deterioration of pulmonary function related to general anesthesia. Hence, we aimed at evaluating the alveolar stability and lung protection of the combination of VV at different PEEP levels. Design Randomized experimental study. Setting Animal research facility. Subjects Forty-nine male Wistar rats (200–270 g). Interventions Animals were ventilated during 2 hours with protective low tidal volume (VT) in volume control ventilation (VCV) or VV and PEEP adjusted at the level of minimum respiratory system elastance (Ers), obtained during a decremental PEEP trial subsequent to a recruitment maneuver, and 2 cmH2O above or below of this level. Measurements and Main Results Ers, gas exchange and hemodynamic variables were measured. Cytokines were determined in lung homogenate and plasma samples and left lung was used for histologic analysis and diffuse alveolar damage scoring. A progressive time-dependent increase in Ers was observed independent on ventilatory mode or PEEP level. Despite of that, the rate of increase of Ers and lung tissue IL-1 beta concentration were significantly lower in VV than in VCV at the level of the PEEP of minimum Ers. A significant increase in lung tissue cytokines (IL-6, IL-1 beta, CINC-1 and TNF-alpha) as well as a ventral to dorsal and cranial to caudal reduction in aeration was observed in all ventilated rats with no significant differences among groups. Conclusions VV combined with PEEP adjusted at the level of the PEEP of minimal Ers seemed to better prevent anesthesia-induced atelectasis and might improve lung protection throughout general anesthesia. PMID:25383882

  3. Causation of Binet IQ Decrements

    ERIC Educational Resources Information Center

    Thorndike, Robert L.

    1977-01-01

    The 1972 re-norming of the Stanford-Binet Intelligence Scale for children from three to six years of age produced unusually high scores. When these children were retested three years later, some drop in scores was noted. Reasons for the initial scores and the score decline are discussed. (Author/JKS)

  4. Trephine biopsy of the lung and pleura

    PubMed Central

    Steel, S. J.; Winstanley, D. P.

    1969-01-01

    During the last five years 140 biopsies of the lung or pleura have been performed with a high-speed air-drill. A specially designed trephine, 2·1 mm. in bore, proved effective in obtaining adequate specimens from patients with diffuse lung lesions. With this method 111 out of 119 (93%) consecutive lung biopsies were successful in producing specimens of lung tissue for histological examination and 101 (85%) of these biopsies were diagnostically significant. Conditions such as sarcoidosis, berylliosis, alveolar proteinosis, polyarteritis nodosa, asbestosis, and diffuse interstitial pulmonary fibrosis were conclusively diagnosed. Complications were not serious and the commonest, pneumothorax, which occurred in 26% of the lung biopsies, was usually asymptomatic. The procedure is rapid and painless and breath-holding is unnecessary. It is performed under local anaesthesia and can be repeated, if required, thus having many advantages over biopsy by open thoracotomy. However, full thoracic surgical cover should be available. Indications include diffuse and localized lesions of the lung or pleura where a definitive diagnosis is required for the purpose of treatment, prognosis, or a claim for industrial compensation. Images PMID:5348325

  5. The lung in space

    NASA Technical Reports Server (NTRS)

    Prisk, G. Kim

    2005-01-01

    The lung is exquisitely sensitive to gravity, which induces gradients in ventilation, blood flow, and gas exchange. Studies of lungs in microgravity provide a means of elucidating the effects of gravity. They suggest a mechanism by which gravity serves to match ventilation to perfusion, making for a more efficient lung than anticipated. Despite predictions, lungs do not become edematous, and there is no disruption to, gas exchange in microgravity. Sleep disturbances in microgravity are not a result of respiratory-related events; obstructive sleep apnea is caused principally by the gravitational effects on the upper airways. In microgravity, lungs may be at greater risk to the effects of inhaled aerosols.

  6. The lung in space

    NASA Technical Reports Server (NTRS)

    Prisk, G. Kim

    2005-01-01

    The lung is exquisitely sensitive to gravity, which induces gradients in ventilation, blood flow, and gas exchange. Studies of lungs in microgravity provide a means of elucidating the effects of gravity. They suggest a mechanism by which gravity serves to match ventilation to perfusion, making for a more efficient lung than anticipated. Despite predictions, lungs do not become edematous, and there is no disruption to, gas exchange in microgravity. Sleep disturbances in microgravity are not a result of respiratory-related events; obstructive sleep apnea is caused principally by the gravitational effects on the upper airways. In microgravity, lungs may be at greater risk to the effects of inhaled aerosols.

  7. Site Characterization in the Urban Area of Tijuana, B. C., Mexico by Means of: H/V Spectral Ratios, Spectral Analysis of Surface Waves, and Random Decrement Method

    NASA Astrophysics Data System (ADS)

    Tapia-Herrera, R.; Huerta-Lopez, C. I.; Martinez-Cruzado, J. A.

    2009-05-01

    Results of site characterization for an experimental site in the metropolitan area of Tijuana, B. C., Mexico are presented as part of the on-going research in which time series of earthquakes, ambient noise, and induced vibrations were processed with three different methods: H/V spectral ratios, Spectral Analysis of Surface Waves (SASW), and the Random Decrement Method, (RDM). Forward modeling using the wave propagation stiffness matrix method (Roësset and Kausel, 1981) was used to compute the theoretical SH/P, SV/P spectral ratios, and the experimental H/V spectral ratios were computed following the conventional concepts of Fourier analysis. The modeling/comparison between the theoretical and experimental H/V spectral ratios was carried out. For the SASW method the theoretical dispersion curves were also computed and compared with the experimental one, and finally the theoretical free vibration decay curve was compared with the experimental one obtained with the RDM. All three methods were tested with ambient noise, induced vibrations, and earthquake signals. Both experimental spectral ratios obtained with ambient noise as well as earthquake signals agree quite well with the theoretical spectral ratios, particularly at the fundamental vibration frequency of the recording site. Differences between the fundamental vibration frequencies are evident for sites located at alluvial fill (~0.6 Hz) and at sites located at conglomerate/sandstones fill (0.75 Hz). Shear wave velocities for the soft soil layers of the 4-layer discrete soil model ranges as low as 100 m/s and up to 280 m/s. The results with the SASW provided information that allows to identify low velocity layers, not seen before with the traditional seismic methods. The damping estimations obtained with the RDM are within the expected values, and the dominant frequency of the system also obtained with the RDM correlates within the range of plus-minus 20 % with the one obtained by means of the H/V spectral

  8. Half-squat or jump squat training under optimum power load conditions to counteract power and speed decrements in Brazilian elite soccer players during the preseason.

    PubMed

    Loturco, Irineu; Pereira, Lucas A; Kobal, Ronaldo; Zanetti, Vinicius; Gil, Saulo; Kitamura, Katia; Abad, Cesar Cavinato Cal; Nakamura, Fabio Y

    2015-01-01

    The purpose of this study was to test which specific type of exercise (i.e., jump squat (JS) or half-squat (HS)) is more effective at maintaining speed and power abilities throughout a preseason in soccer players. Twenty-three male soccer players were randomly allocated into two groups: JS and HS. The mean propulsive power, vertical jumping ability, and sprinting performance were evaluated before and after 4 weeks of a preseason period. The optimum power loads for the JS and HS exercises were assessed and were used as load-references. The soccer players performed 10 power oriented training sessions in total. Both JS and HS maintained power in JS and speed abilities (P > 0.05, for main effects and interaction effect) as indicated by ANCOVA. Both groups demonstrated reduced power during HS (ES = -0.76 vs. -0.78, for JS and HS, respectively); both groups improved acceleration (ACC) from 5 to 10 m (ES = 0.52). JS was more effective at reducing the ACC decrements over 0-5 m (ES = -0.38 vs. -0.58, for JS and HS, respectively). The HS group increased squat jump height (ES = 0.76 vs. 0.11, for HS and JS, respectively). In summary, JS is more effective in reducing the ACC capacity over very short sprints while HS is more effective in improving squat jump performance. Both strategies improve ACC over longer distances. New training strategies should be implemented/developed to avoid concurrent training effects between power and endurance adaptations during professional soccer preseasons.

  9. A Multiple Decrement Life Table Reveals That Host Plant Resistance and Parasitism Are Major Causes of Mortality for the Wheat Stem Sawfly.

    PubMed

    Buteler, Micaela; Peterson, Robert K D; Hofland, Megan L; Weaver, David K

    2015-12-01

    This study investigated the dynamics of parasitism, host plant resistance, pathogens, and predation on the demography of wheat stem sawfly, Cephus cinctus Norton (Hymenoptera: Cephidae), developing in susceptible (hollow stem) and resistant (solid stem) wheat hosts. This study is also the first to investigate the prevalence and impact of cannibalism on wheat stem sawfly mortality. Wheat stem sawflies were sampled in two commercial wheat fields over 4 yr from the egg stage through adult emergence, and multiple decrement life tables were constructed and analyzed. Cannibalism, host plant resistance, or unknown factors were the most prevalent factors causing egg mortality. Summer mortality of prediapause larvae ranged from 28 to 84%, mainly due to parasitism by Bracon cephi (Gahan) and Bracon lissogaster Muesebeck, cannibalism, and host plant resistance. Winter mortality ranged from 6 to 54% of the overwintering larvae, mainly due to unknown factors or pathogens. Cannibalism is a major cause of irreplaceable mortality because it is absolute, with only a single survivor in every multiple infested stem. Subsequent to obligate cannibalism, mortality of feeding larvae due to host plant resistance was lower in hollow stem wheat than in solid stem wheat. Mortality from host plant resistance was largely irreplaceable. Irreplaceable mortality due to parasitoids was greater in hollow stem wheat than in solid stem wheat. Host plant resistance due to stem solidness and parasitism in hollow stems cause substantial mortality in populations of actively feeding larvae responsible for all crop losses. Therefore, enhancing these mortality factors is vital to effective integrated pest management of wheat stem sawfly. © The Authors 2015. Published by Oxford University Press on behalf of Entomological Society of America. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  10. Probiotic Streptococcus thermophilus FP4 and Bifidobacterium breve BR03 Supplementation Attenuates Performance and Range-of-Motion Decrements Following Muscle Damaging Exercise

    PubMed Central

    Jäger, Ralf; Purpura, Martin; Stone, Jason D.; Turner, Stephanie M.; Anzalone, Anthony J.; Eimerbrink, Micah J.; Pane, Marco; Amoruso, Angela; Rowlands, David S.; Oliver, Jonathan M.

    2016-01-01

    Probiotics have immunomodulatory effects. However, little is known about the potential benefit of probiotics on the inflammation subsequent to strenuous exercise. In a double-blind, randomized, placebo controlled, crossover design separated by a 21-day washout, 15 healthy resistance-trained men ingested an encapsulated probiotic Streptococcus (S.) thermophilus FP4 and Bifidobacterium (B.) breve BR03 at 5 bn live cells (AFU) concentration each, or a placebo, daily for 3 weeks prior to muscle-damaging exercise (ClinicalTrials.gov NCT02520583). Isometric strength, muscle soreness, range of motion and girth, and blood interleukin-6 (IL-6) and creatine kinase (CK) concentrations were measured from pre- to 72 h post-exercise. Statistical analysis was via mixed models and magnitude-based inference to the standardized difference. Probiotic supplementation resulted in an overall decrease in circulating IL-6, which was sustained to 48 h post-exercise. In addition, probiotic supplementation likely enhanced isometric average peak torque production at 24 to 72 h into the recovery period following exercise (probiotic–placebo point effect ±90% CI: 24 h, 11% ± 7%; 48 h, 12% ± 18%; 72 h, 8% ± 8%). Probiotics also likely moderately increased resting arm angle at 24 h (2.4% ± 2.0%) and 48 h (1.9% ± 1.9%) following exercise, but effects on soreness and flexed arm angle and CK were unclear. These data suggest that dietary supplementation with probiotic strains S. thermophilus FP4 and B. breve BR03 attenuates performance decrements and muscle tension in the days following muscle-damaging exercise. PMID:27754427

  11. [Lung cancer screening].

    PubMed

    Sánchez González, M

    2014-01-01

    Lung cancer is a very important disease, curable in early stages. There have been trials trying to show the utility of chest x-ray or computed tomography in Lung Cancer Screening for decades. In 2011, National Lung Screening Trial results were published, showing a 20% reduction in lung cancer mortality in patients with low dose computed tomography screened for three years. These results are very promising and several scientific societies have included lung cancer screening in their guidelines. Nevertheless we have to be aware of lung cancer screening risks, such as: overdiagnosis, radiation and false positive results. Moreover, there are many issues to be solved, including choosing the appropriate group to be screened, the duration of the screening program, intervals between screening and its cost-effectiveness. Ongoing trials will probably answer some of these questions. This article reviews the current evidence on lung cancer screening.

  12. Perioperative Lung Protection Provided by High-Dose Ambroxol in Patients with Lung Cancer.

    PubMed

    Wang, Xin; Wang, Lei; Wang, Huayong; Zhang, Hao

    2015-11-01

    The purpose is to observe the clinical effect of large doses of ambroxol hydrochloride in lung protection during the perioperative period of lung cancer operation. Fifty-six lung cancer patients who have undergone open-thoracic pulmonary lobectomy were divided randomly into two groups, and were given normal and large doses of ambroxol hydrochloride, respectively, during their perioperative period. Statistics based on post-operation clinical observations were analyzed in terms of ease of expectoration and expectoration properties, duration of antibiotics dependence, occurrence of lung complications, and adverse reactions related to ambroxol hydrochloride. On the third and the seventh day, the experimental group showed signs of improvement in terms of ease of expectoration and expectoration properties, compared with the controlled group. In terms of occurrence of post-operation lung complications and duration of antibiotics dependence, the experimental group also performed better. Using large doses of ambroxol hydrochloride would result in better clinical effects than using normal doses in preventing post-operation complications, and its clinical value in lung protection during lung cancer perioperative period calls for further research and promotion.

  13. Mechanism of action of ozone on the human lung

    SciTech Connect

    Hazucha, M.J.; Bates, D.V.; Bromberg, P.A. )

    1989-10-01

    Fourteen healthy normal volunteers were randomly exposed to air and 0.5 ppm of ozone (O3) in a controlled exposure chamber for a 2-h period during which 15 min of treadmill exercise sufficient to produce a ventilation of approximately 40 l/min was alternated with 15-min rest periods. Before testing an esophageal balloon was inserted, and lung volumes, flow rates, maximal inspiratory (at residual volume and functional residual capacity) and expiratory (at total lung capacity and functional residual capacity) mouth pressures, and pulmonary mechanics (static and dynamic compliance and airway resistance) were measured before and immediately after the exposure period. After the postexposure measurements had been completed, the subjects inhaled an aerosol of 20% lidocaine until response to citric acid aerosol inhalation was abolished. All of the measurements were immediately repeated. We found that the O3 exposure (1) induced a significant mean decrement of 17.8% in vital capacity (this change was the result of a marked fall in inspiratory capacity without significant increase in residual volume), (2) significantly increased mean airway resistance and specific airway resistance but did not change dynamic or static pulmonary compliance or viscous or elastic work, (3) significantly reduced maximal transpulmonary pressure (by 19%) but produced no changes in inspiratory or expiratory maximal mouth pressures, and (4) significantly increased respiratory rate (in 5 subjects by more than 6 breaths/min) and decreased tidal volume.

  14. OpenER, a Dutch Initiative in Open Educational Resources

    ERIC Educational Resources Information Center

    Schuwer, Robert; Mulder, Fred

    2009-01-01

    Over the period 2006-2008, the Dutch Open Universiteit Nederland conducted an experiment in which Open Educational Resources (OER) were offered in an effort to bridge the gap between informal and formal learning and to establish a new style of entry portal to higher education with no barriers at all. OpenER received considerable attention both in…

  15. Openness initiative

    SciTech Connect

    Duncan, S.S.

    1995-12-31

    Although antinuclear campaigns seem to be effective, public communication and education efforts on low-level radioactive waste have mixed results. Attempts at public information programs on low-level radioactive waste still focus on influencing public opinion. A question then is: {open_quotes}Is it preferable to have a program focus on public education that will empower individuals to make informed decisions rather than trying to influence them in their decisions?{close_quotes} To address this question, a case study with both quantitative and qualitative data will be used. The Ohio Low-Level Radioactive Waste Education Program has a goal to provide people with information they want/need to make their own decisions. The program initiated its efforts by conducting a statewide survey to determine information needed by people and where they turned for that information. This presentation reports data from the survey and then explores the program development process in which programs were designed and presented using the information. Pre and post data from the programs reveal attitude and knowledge shifts.

  16. SU-E-J-249: Correlation of Mean Lung Ventilation Value with Ratio of Total Lung Volumes

    SciTech Connect

    Yu, N; Qu, H; Xia, P

    2014-06-01

    Purpose: Lung ventilation function measured from 4D-CT and from breathing correlated CT images is a novel concept to incorporate the lung physiologic function into treatment planning of radiotherapy. The calculated ventilation functions may vary from different breathing patterns, affecting evaluation of the treatment plans. The purpose of this study is to correlate the mean lung ventilation value with the ratio of the total lung volumes obtained from the relevant CTs. Methods: A ventilation map was calculated from the variations of voxel-to-voxel CT densities from two breathing phases from either 4D-CT or breathing correlated CTs. An open source image registration tool of Plastimatch was used to deform the inhale phase images to the exhale phase images. To calculate the ventilation map inside lung, the whole lung was delineated and the tissue outside the lung was masked out. With a software tool developed in house, the 3D ventilation map was then converted in the DICOM format associated with the planning CT images. The ventilation map was analyzed on a clinical workstation. To correlate ventilation map thus calculated with lung volume change, the total lung volume change was compared the mean ventilation from our method. Results: Twenty two patients who underwent stereotactic body irradiation for lung cancer was selected for this retrospective study. For this group of patients, the ratio of lung volumes for the inhale (Vin ) and exhale phase (Vex ) was shown to be linearly related to the mean of the local ventilation (Vent), Vin/Vex=1.+0.49*Vent (R2=0.93, p<0.01). Conclusion: The total lung volume change is highly correlated with the mean of local ventilation. The mean of local ventilation may be useful to assess the patient's lung capacity.

  17. Timolol-induced interstitial lung disease

    PubMed Central

    Patel, Hetain; Wilches, Lina Vanessa; Guerrero, Jorge

    2015-01-01

    Timolol maleate is a non-selective beta-adrenergic receptor blocking agent with demonstrated efficacy in the treatment of open-angle glaucoma. A 76 year old female who presented with productive cough, progressive dyspnea and hypoxia after starting timolol maleate opthalamic drops following glaucoma surgery. The patient was diagnosed with interstitial lung disease secondary to timolol treatment and after cessation of the offending agent along with corticosteroid treatment, symptoms improved drastically. Elimination of other possible causes of disease along with evolution of radiological and functional signs left us with a diagnosis of timolol-induced interstitial lung disease. To our knowledge, this is the second reported case of timolol-induced interstitial lung disease. PMID:26236595

  18. Opening Address

    NASA Astrophysics Data System (ADS)

    Crovini, L.

    1994-01-01

    Ladies and Gentlemen To quote Mr Jean Terrien: "Physics must be one step ahead of metrology". A long-serving Director of the BIPM, he said these words when visiting the IMGC in 1970 as a member of the scientific board of our Institute. At that time it was still an open question whether the IMGC should start research work on the absolute measurement of silicon lattice spacing. Mr Terrien underlined the revolutionary character of x-ray interferometry and, eventually, he caused the balance needle to lean towards the ... right direction. Mr Terrien correctly foresaw that, like Michelson's interferometer of 1880, x-ray interferometry could have a prominent place in today's science and technology. And while, in the first case, after more than a century we can see instruments based on electromagnetic wave interaction within every one's reach in laboratories and, sometimes, in workshops, in the second case, twenty-five years since the first development of an x-ray interferometer we can witness its role in nanometrology. Today and tomorrow we meet to discuss how to go beyond the sixth decimal place in the value of the Avogadro constant. We are aware that the quest for this achievement requires the cooperation of scientists with complementary capabilities. I am sure that the present workshop is a very good opportunity to present and discuss results and to improve and extend existing cooperation. The new adjustment of fundamental constants envisaged by the CODATA Task Group is redoubling scientists' efforts to produce competitive values of NA. The results of the measurements of the silicon lattice spacing in terms of an optical wavelength, which were available for the 1986 adjustment, combined with the determination of silicon molar volume, demonstrate how such an NA determination produces a consistent set of other constants and opens the way to a possible redefinition of the kilogram. We shall see in these two days how far we have progressed along this road. For us at the

  19. Ozone inhalation effects in females varying widely in lung size: Comparison with males

    SciTech Connect

    Messineo, T.D.; Adams, W.C. )

    1990-07-01

    It has been suggested that lung size accounts for observed gender differences in responsiveness to the same total inhaled dose of O3. To test the hypothesis that lung size is a determinant of magnitude of response within a gender, two groups of 14 healthy young adult females differing significantly in forced vital capacity (FVC; i.e., small-lung group mean = 3.74 liters (range 3.2-4.0) and large-lung group mean = 5.11 liters (range 4.5-6.2)) were exposed for 1 h to filtered air (FA) and to 0.18 and 0.30 ppm O3. On each occasion, subjects exercised continuously on a cycle ergometer at a work rate that elicited a mean minute ventilation of approximately 47 l/min. For the small-lung group (mean total lung capacity (TLC) = 4.52 liters) exercise O2 uptake was 67% of maximal O2 uptake (VO2max), and that for the large-lung group (TLC 6.37 liters) was 61% of VO2max. Statistical analysis revealed significant decrements for both groups in FVC, forced expiratory volume in 1 s (FEV1.0), and forced expiratory flow rate in the middle half of FVC on exposure to 0.18 and 0.30 ppm O3. Exercise respiratory frequency increased, and tidal volume decreased significantly in both groups in response to 0.18 and 0.30 ppm O3 exposure. On exposure to 0.30 ppm O3, the number of individual subjective symptoms reported and their severity were significantly greater for both groups than those reported for the FA and 0.18 ppm O3 exposures. Both groups evidenced similar percent changes in pulmonary function and exercise ventilation response, and in subjective symptom response.

  20. Lung cancer in women

    PubMed Central

    Barrera-Rodriguez, Raúl; Morales-Fuentes, Jorge

    2012-01-01

    Recent biological advances in tumor research provide clear evidence that lung cancer in females is different from that in males. These differences appear to have a direct impact on the clinical presentation, histology, and outcomes of lung cancer. Women are more likely to present with lung adenocarcinoma, tend to receive a diagnosis at an earlier age, and are more likely to be diagnosed with localized disease. Women may also be more predisposed to molecular aberrations resulting from the carcinogenic effects of tobacco, but do not appear to be more susceptible than men to developing lung cancer. The gender differences found in female lung cancer make it mandatory that gender stratification is used in clinical trials in order to improve the survival rates of patients with lung cancer. PMID:28210127

  1. Pediatric Lung Transplantation.

    PubMed

    Sweet, Stuart C

    2017-06-01

    Pediatric lung transplant is a viable option for treatment of end-stage lung disease in children, with > 100 pediatric lung transplants reported to the Registry of the International Society of Heart and Lung Transplantation each year. Long-term success is limited by availability of donor organs, debilitation as a result of chronic disease, impaired mucus clearance resulting from both surgical and pharmacologic interventions, increased risk for infection resulting from immunosuppression, and most importantly late complications, such as chronic lung allograft dysfunction. Opportunities for investigation and innovation remain in all of these domains: (1) Ex vivo lung perfusion is a promising technology with the potential for increasing the lung donor pool, (2) evolving extracorporeal support strategies coupled with effective rehabilitation will effectively bridge critically ill patients to transplant, and most importantly, (3) research efforts intended to increase our understanding of the underlying mechanisms of chronic lung allograft dysfunction will ultimately lead to the development of effective therapies to prevent or treat the variety of chronic lung allograft dysfunction presentations. Copyright © 2017 by Daedalus Enterprises.

  2. [Microstructure of the lung: diffusion measurement of hyperpolarized 3Helium].

    PubMed

    Morbach, Andreas E; Gast, Klaus K; Schmiedeskamp, Jörg; Herweling, Annette; Windirsch, Michael; Dahmen, Anja; Ley, Sebastian; Heussel, Claus-Peter; Heil, Werner; Kauczor, Hans-Ulrich; Schreiber, Wolfgang G

    2006-01-01

    Imaging methods to study the lung are traditionally based on x-ray or on radioactive contrast agents. Conventional magnetic resonance imaging (MRI) has only limited applications for lung imaging because of the low tissue density of protons concentration of hydrogen atoms, which are usually the basis for the imaging. The introduction of hyperpolarized noble gases as a contrast agent in MRI has opened new possibilities for lung diagnosis. The present paper describes this new technique. Diffusion-weighted MRI for assessment of the lung microstructure is presented here as an example of the new possibilities of functional imaging. Studies to determine the sensitivity of the diffusion measurement and regarding the correlation with traditionally established methods are also presented, along with results of the measurement of the reproducibility determined in a clinical pilot study on healthy volunteers and patients. Furthermore, a pilot measurement of the 3He diffusion tensor in the lung is presented.

  3. Lung function reductions associated with motor vehicle density in chronic obstructive pulmonary disease: a cross-sectional study.

    PubMed

    Nitschke, Monika; Appleton, Sarah L; Li, Qiaoyu; Tucker, Graeme R; Shah, Pushan; Bi, Peng; Pisaniello, Dino L; Adams, Robert J

    2016-10-24

    Motor vehicle-related air pollution can potentially impair lung function. The effect of pollution in people with compromised pulmonary function such as in COPD has not been previously investigated. To examine the association of lung function with motor vehicle density in people with spirometrically determined COPD in a cross-sectional study. In 2004-06, The North West Adelaide Health Study (NWAHS), a biomedical cohort of adults assessed pre and post-bronchodilator spirometry (n = 3,103). Traffic density, obtained from the motor vehicle inventory maintained by the South Australian Environment Protection Authority, was expressed as the daily numbers of vehicles travelling within a 200 m diameter zone around participants' geocoded residences. In subjects with COPD (FEV1/FVC <0.7, n = 221, 7.1 %), increasing daily vehicle density was associated with statistically significant decreases in lung function parameters after adjustment for smoking and socio-economic variables. Mean (95 % CI) post-bronchodilator % predicted FEV1 was 81 % (76-87) in the low (≤7179/day) compared with 71 % (67-75) in the high (≥15,270/day) vehicle exposure group (p < 0.05). Linear regression analysis in all subjects with COPD showed significant decrements in post-bronchodilator FEV1/FVC ratio and % predicted FEV1 of 0.03 and 0.05 % respectively per daily increase in 1000 vehicles. In men with COPD (n = 150), the corresponding reductions were 0.03 and 0.06 %. Smaller, non-significant decrements were seen in females. No difference was seen in those without COPD. Vehicle traffic density was associated with significant reductions in lung function in people with COPD. Urban planning should consider the health impacts for those with pre-existing respiratory conditions.

  4. Open Education Revisited.

    ERIC Educational Resources Information Center

    Bough, Max, Ed.

    1979-01-01

    This journal provides 12 brief articles focused on open education. Topics explored include (1) open education and reading, (2) mainstreaming, (3) characteristics of an open teacher, (4) administration of an open concept school, (5) an existential methodology in the language arts, (6) social studies in open education, (7) open education in early…

  5. Open Standards, Open Source, and Open Innovation: Harnessing the Benefits of Openness

    ERIC Educational Resources Information Center

    Committee for Economic Development, 2006

    2006-01-01

    Digitization of information and the Internet have profoundly expanded the capacity for openness. This report details the benefits of openness in three areas--open standards, open-source software, and open innovation--and examines the major issues in the debate over whether openness should be encouraged or not. The report explains each of these…

  6. Your Lungs and Respiratory System

    MedlinePlus

    ... Lifesaver Kids Talk About: Coaches Your Lungs & Respiratory System KidsHealth > For Kids > Your Lungs & Respiratory System Print ... its regular size. You've just felt the power of your lungs! continue A Look Inside the ...

  7. 6 Common Cancers - Lung Cancer

    MedlinePlus

    ... Home Current Issue Past Issues 6 Common Cancers - Lung Cancer Past Issues / Spring 2007 Table of Contents ... for Desperate Housewives. (Photo ©2005 Kathy Hutchins / Hutchins) Lung Cancer Lung cancer causes more deaths than the ...

  8. Interstitial lung disease - adults - discharge

    MedlinePlus

    ... lung disease Pulmonary alveolar proteinosis Rheumatoid lung disease Sarcoidosis Patient Instructions Eating extra calories when sick - adults ... team. Related MedlinePlus Health Topics Interstitial Lung Diseases Sarcoidosis Browse the Encyclopedia A.D.A.M., Inc. ...

  9. Opening Address

    NASA Astrophysics Data System (ADS)

    Yamada, T.

    2014-12-01

    Ladies and Gentlemen, it is my great honor and pleasure to present an opening address of the 3rd International Workshop on "State of the Art in Nuclear Cluster Physics"(SOTANCP3). On the behalf of the organizing committee, I certainly welcome all your visits to KGU Kannai Media Center belonging to Kanto Gakuin University, and stay in Yokohama. In particular, to whom come from abroad more than 17 countries, I would appreciate your participations after long long trips from your homeland to Yokohama. The first international workshop on "State of the Art in Nuclear Cluster Physics", called SOTANCP, was held in Strasbourg, France, in 2008, and the second one was held in Brussels, Belgium, in 2010. Then the third workshop is now held in Yokohama. In this period, we had the traditional 10th cluster conference in Debrecen, Hungary, in 2012. Thus we have the traditional cluster conference and SOTANCP, one after another, every two years. This obviously shows our field of nuclear cluster physics is very active and flourishing. It is for the first time in about 10 years to hold the international workshop on nuclear cluster physics in Japan, because the last cluster conference held in Japan was in Nara in 2003, about 10 years ago. The president in Nara conference was Prof. K. Ikeda, and the chairpersons were Prof. H. Horiuchi and Prof. I. Tanihata. I think, quite a lot of persons in this room had participated at the Nara conference. Since then, about ten years passed. So, this workshop has profound significance for our Japanese colleagues. The subjects of this workshop are to discuss "the state of the art in nuclear cluster physics" and also discuss the prospect of this field. In a couple of years, we saw significant progresses of this field both in theory and in experiment, which have brought better and new understandings on the clustering aspects in stable and unstable nuclei. I think, the concept of clustering has been more important than ever. This is true also in the

  10. Lung protective strategies in anaesthesia.

    PubMed

    Kilpatrick, B; Slinger, P

    2010-12-01

    Patients are at risk for several types of lung injury in the perioperative period including atelectasis, pneumonia, pneumothorax, acute lung injury, and acute respiratory distress syndrome. Anaesthetic management can cause, exacerbate, or ameliorate these injuries. This review examines the effects of perioperative mechanical ventilation and its role in ventilator-induced lung injury. Lung protective ventilatory strategies to specific clinical situations such as cardiopulmonary bypass and one-lung ventilation along with newer novel lung protective strategies are discussed.

  11. Lung alveolar epithelium and interstitial lung disease.

    PubMed

    Corvol, Harriet; Flamein, Florence; Epaud, Ralph; Clement, Annick; Guillot, Loic

    2009-01-01

    Interstitial lung diseases (ILDs) comprise a group of lung disorders characterized by various levels of inflammation and fibrosis. The current understanding of the mechanisms underlying the development and progression of ILD strongly suggests a central role of the alveolar epithelium. Following injury, alveolar epithelial cells (AECs) may actively participate in the restoration of a normal alveolar architecture through a coordinated process of re-epithelialization, or in the development of fibrosis through a process known as epithelial-mesenchymal transition (EMT). Complex networks orchestrate EMT leading to changes in cell architecture and behaviour, loss of epithelial characteristics and gain of mesenchymal properties. In the lung, AECs themselves may serve as a source of fibroblasts and myofibroblasts by acquiring a mesenchymal phenotype. This review covers recent knowledge on the role of alveolar epithelium in the pathogenesis of ILD. The mechanisms underlying disease progression are discussed, with a main focus on the apoptotic pathway, the endoplasmic reticulum stress response and the developmental pathway.

  12. The role of surfactant in the static lung mechanics of the lizard Ctenophorus nuchalis.

    PubMed

    Daniels, C B; Eskandari-Marandi, B D; Nicholas, T E

    1993-10-01

    We previously showed that the lung of the central Australian lizard, Ctenophorus nuchalis, contains a large amount of surfactant, the composition of which varies with body temperature. We now show that the specific compliance of the lungs of these lizards remains constant regardless of whether they were maintained at 10, 18, 27, 37 or 43 degrees C for 4 hours. In contrast, the opening pressure was constant up to 27 degrees C, but decreased at 37 and 43 degrees C. When we lavaged the lungs in situ to remove the majority of surfactant, specific compliance decreased while opening pressure increased. The lungs of C. nuchalis are essentially two bubbles, with the left one larger at low and intermediate volumes. After collapsing both lungs, the larger left lung always inflated first. However, following lavage the smaller right lung inflated first. As the larger lung, when collapsed, would have a much greater area of epithelial contact, this result is consistent with surfactant acting as an 'antiglue'. During deflation the smaller lung collapsed first, consistent with the law of Laplace. Compliance did not change in the saline-filled lung suggesting that the gas-liquid interface does not play a major role. We conclude that in the lungs of these lizards, surfactant is acting as an antiglue. This might be important during periods of apnea at low body temperatures, when residual volume is small and epithelial surfaces may come into contact.

  13. An alternative method to achieve one-lung ventilation by surgical pneumothorax in difficult lung isolation patient: a case report.

    PubMed

    Yeh, Pin-Hung; Hsu, Po-Kai

    2016-04-01

    It is challenging to establish one-lung ventilation in difficult airway patients. Surgical pneumothorax under spontaneous breathing to obtain well-collapsed lung is a feasible method for thoracic surgery. A 76-year-old man with right empyema was scheduled for decortication. The patient had limited mouth opening due to facial cellulitis extending from the left cheek to neck. Generally, lung isolation is achieved by double-lumen endotracheal tube or bronchial blocker. Double-lumen tube insertion is difficult for patients with limited mouth opening and right-side placement of bronchial blocker usually causes insufficient deflation. We introduce an alternative lung isolation technique by surgical pneumothorax under spontaneous breathing simply with an endotracheal tube placement. This technique has never been applied into the management of difficult one-lung ventilation. By this method, we provide an ideal surgical condition with safer, less time-consuming, and less skill-demanding anesthesia. It would be an alternative choice for management of one-lung ventilation in the difficult lung isolation patient.

  14. Lung diffusion testing

    MedlinePlus

    ... the blood from the lungs, and to allow carbon dioxide to "diffuse" from the blood into the lungs. How the Test is Performed You breathe in (inhale) air containing a very small amount of carbon monoxide and a tracer gas, such as methane ...

  15. Lung Cancer Indicators Recurrence

    Cancer.gov

    This study describes prognostic factors for lung cancer spread and recurrence, as well as subsequent risk of death from the disease. The investigators observed that regardless of cancer stage, grade, or type of lung cancer, patients in the study were more

  16. Artificial lung: current perspectives.

    PubMed

    Go, T; Macchiarini, P

    2008-10-01

    While the number of the patients suffering from end-stage pulmonary disease has been increasing, the most common treatment for this entity remains mechanical ventilation that entails the risks of lung damage by itself. Although the lung protective strategy for the prevention of further damage to the lung tissue has been elucidated and performed, mechanical ventilation alone as the management tactic coping with the patients of acute respiratory distress syndrome, chronic respiratory failure and lung transplantations has been a frustrated scenario. Extracorporeal membrane oxygenation or extracorporeal lung assist have been applied to these patients with occasional success, but it always accompanies difficulties such as multiple blood transfusion, labor intensity, technically complexity and tendency to infection. In contrast to advances in the development of cardiac or renal support systems for adults, the development of extra-, para- and intracorporeal mechanical systems for acute or chronic lung respiratory failure has logged far behind. It has been mostly due to the lack of the capable technologies. Entering 21st century with advent of new technology especially invention of the low resistance oxygenator, the developments of artificial lungs have entered the new stage. In this report current status of the artificial lungs will be reviewed.

  17. Lung Diseases and Conditions

    MedlinePlus

    ... Explore How the Lungs Work What Are... The Respiratory System What Happens When You Breathe What Controls Your Breathing Lung Diseases & Conditions Clinical Trials Links Related Topics Asthma Bronchitis COPD How the Heart Works Respiratory Failure Send a link to NHLBI to someone ...

  18. Lycopene and Lung Cancer

    USDA-ARS?s Scientific Manuscript database

    Although epidemiological studies have shown dietary intake of lycopene is associated with decreased risk of lung cancer, the effect of lycopene on lung carcinogenesis has not been well studied. A better understanding of lycopene metabolism and the mechanistic basis of lycopene chemoprevention must ...

  19. Indium lung disease.

    PubMed

    Cummings, Kristin J; Nakano, Makiko; Omae, Kazuyuki; Takeuchi, Koichiro; Chonan, Tatsuya; Xiao, Yong-Long; Harley, Russell A; Roggli, Victor L; Hebisawa, Akira; Tallaksen, Robert J; Trapnell, Bruce C; Day, Gregory A; Saito, Rena; Stanton, Marcia L; Suarthana, Eva; Kreiss, Kathleen

    2012-06-01

    Reports of pulmonary fibrosis, emphysema, and, more recently, pulmonary alveolar proteinosis (PAP) in indium workers suggested that workplace exposure to indium compounds caused several different lung diseases. To better understand the pathogenesis and natural history of indium lung disease, a detailed, systematic, multidisciplinary analysis of clinical, histopathologic, radiologic, and epidemiologic data for all reported cases and workplaces was undertaken. Ten men (median age, 35 years) who produced, used, or reclaimed indium compounds were diagnosed with interstitial lung disease 4-13 years after first exposure (n = 7) or PAP 1-2 years after first exposure (n = 3). Common pulmonary histopathologic features in these patients included intraalveolar exudate typical of alveolar proteinosis (n = 9), cholesterol clefts and granulomas (n = 10), and fibrosis (n = 9). Two patients with interstitial lung disease had pneumothoraces. Lung disease progressed following cessation of exposure in most patients and was fatal in two. Radiographic data revealed that two patients with PAP subsequently developed fibrosis and one also developed emphysematous changes. Epidemiologic investigations demonstrated the potential for exposure to respirable particles and an excess of lung abnormalities among coworkers. Occupational exposure to indium compounds was associated with PAP, cholesterol ester crystals and granulomas, pulmonary fibrosis, emphysema, and pneumothoraces. The available evidence suggests exposure to indium compounds causes a novel lung disease that may begin with PAP and progress to include fibrosis and emphysema, and, in some cases, premature death. Prospective studies are needed to better define the natural history and prognosis of this emerging lung disease and identify effective prevention strategies.

  20. Lung transplant infection.

    PubMed

    Burguete, Sergio R; Maselli, Diego J; Fernandez, Juan F; Levine, Stephanie M

    2013-01-01

    Lung transplantation has become an accepted therapeutic procedure for the treatment of end-stage pulmonary parenchymal and vascular disease. Despite improved survival rates over the decades, lung transplant recipients have lower survival rates than other solid organ transplant recipients. The morbidity and mortality following lung transplantation is largely due to infection- and rejection-related complications. This article will review the common infections that develop in the lung transplant recipient, including the general risk factors for infection in this population, and the most frequent bacterial, viral, fungal and other less frequent opportunistic infections. The epidemiology, diagnosis, prophylaxis, treatment and outcomes for the different microbial pathogens will be reviewed. The effects of infection on lung transplant rejection will also be discussed.

  1. Immunotherapy in Lung Cancer.

    PubMed

    Castellanos, Emily H; Horn, Leora

    2016-01-01

    Lung cancer has not traditionally been viewed as an immune-responsive tumor. However, it is becoming evident that tumor-induced immune suppression is vital to malignant progression. Immunotherapies act by enhancing the patient's innate immune response and hold promise for inducing long-term responses in select patients with non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC). Immune checkpoint inhibitors, in particular, inhibitors to cytotoxic T-lymphocyte-associated antigen 4 (CTLA-4) and programmed death 1 (PD-1) and programmed death receptor ligand 1 (PD-L1) have shown promise in early studies and are currently in clinical trials in both small cell lung cancer and non-small cell lung cancer patients. Two large randomized phase III trials recently demonstrated superior overall survival (OS) in patients treated with anti-PD-1 therapy compared to chemotherapy in the second-line setting.

  2. Lung cancer screening.

    PubMed

    Tanoue, Lynn T; Tanner, Nichole T; Gould, Michael K; Silvestri, Gerard A

    2015-01-01

    The United States Preventive Services Task Force recommends lung cancer screening with low-dose computed tomography (LDCT) in adults of age 55 to 80 years who have a 30 pack-year smoking history and are currently smoking or have quit within the past 15 years. This recommendation is largely based on the findings of the National Lung Screening Trial. Both policy-level and clinical decision-making about LDCT screening must consider the potential benefits of screening (reduced mortality from lung cancer) and possible harms. Effective screening requires an appreciation that screening should be limited to individuals at high risk of death from lung cancer, and that the risk of harm related to false positive findings, overdiagnosis, and unnecessary invasive testing is real. A comprehensive understanding of these aspects of screening will inform appropriate implementation, with the objective that an evidence-based and systematic approach to screening will help to reduce the enormous mortality burden of lung cancer.

  3. Erlotinib, cabozantinib, or erlotinib plus cabozantinib as second-line or third-line treatment of patients with EGFR wild-type advanced non-small-cell lung cancer (ECOG-ACRIN 1512): a randomised, controlled, open-label, multicentre, phase 2 trial.

    PubMed

    Neal, Joel W; Dahlberg, Suzanne E; Wakelee, Heather A; Aisner, Seena C; Bowden, Michaela; Huang, Ying; Carbone, David P; Gerstner, Gregory J; Lerner, Rachel E; Rubin, Jerome L; Owonikoko, Taofeek K; Stella, Philip J; Steen, Preston D; Khalid, Ahmed Ali; Ramalingam, Suresh S

    2016-12-01

    Erlotinib is approved for the treatment of all patients with advanced non-small-cell lung cancer (NSCLC), but is most active in the treatment of EGFR mutant NSCLC. Cabozantinib, a small molecule tyrosine kinase inhibitor, targets MET, VEGFR, RET, ROS1, and AXL, which are implicated in lung cancer tumorigenesis. We compared the efficacy of cabozantinib alone or in combination with erlotinib versus erlotinib alone in patients with EGFR wild-type NSCLC. This three group, randomised, controlled, open-label, multicentre, phase 2 trial was done in 37 academic and community oncology practices in the USA. Patients were eligible if they had received one or two previous treatments for advanced non-squamous, EGFR wild-type, NSCLC. Patients were stratified by performance status and line of therapy, and randomly assigned using permuted blocks within strata to receive open-label oral daily dosing of erlotinib (150 mg), cabozantinib (60 mg), or erlotinib (150 mg) and cabozantinib (40 mg). Imaging was done every 8 weeks. At the time of radiographic progression, there was optional crossover for patients in either single-drug group to receive combination treatment. The primary endpoint was to compare progression-free survival in patients given erlotinib alone versus cabozantinib alone, and in patients given erlotinib alone versus the combination of erlotinib plus cabozantinib. We assessed the primary endpoint in the per-protocol population, which was defined as all patients who were eligible, randomly assigned, and received at least one dose of treatment. The safety analysis population included all patients who received study treatment irrespective of eligibility. This trial is registered with ClinicalTrials.gov, number NCT01708954. Between Feb 7, 2013, and July 1, 2014, we enrolled and randomly assigned 42 patients to erlotinib treatment, 40 patients to cabozantinib treatment, and 43 patients to erlotinib plus cabozantinib treatment, of whom 111 (89%) in total were included in the

  4. Primary non-Hodgkin's lymphoma of the lung presenting as bronchiolitis obliterans organizing pneumonia.

    PubMed

    Safadi, R; Berkman, N; Haviv, Y S; Ben-Yehuda, A; Amir, G; Naparstek, Y

    1997-12-01

    A 44-year-old man presented with fever, dyspnea, and bilateral cavitary lung lesions. Following percutaneous transthoracic CT guided needle biopsy of the lung, a diagnosis of bronchiolitis obliterans organizing pneumonia (BOOP) was made and the patient was treated with corticosteroids. Despite a good initial response he developed new lung lesions within six months, associated with a lack of response to corticosteroids. Due to further deterioration and the development of Guillian-Barre' syndrome an open lung biopsy was performed and revealed T-cell rich, B-cell non Hodgkin's lymphoma with BOOP. We suggest that BOOP may be the presenting manifestation of primary lung lymphoma. We recommend that when BOOP has an atypical course or does not respond to corticosteroids open lung biopsy should be performed in order to exclude pulmonary lymphoma.

  5. Lung cancer - non-small cell

    MedlinePlus

    Cancer - lung - non-small cell; Non-small cell lung cancer; NSCLC; Adenocarcinoma - lung; Squamous cell carcinoma - lung ... Smoking causes most cases (around 90%) of lung cancer. The risk depends on the number of cigarettes ...

  6. Occupational lung cancer

    SciTech Connect

    Coultas, D.B.; Samet, J.M. )

    1992-06-01

    The overall importance of occupational agents as a cause of lung cancer has been a controversial subject since the 1970s. A federal report, released in the late 1970s, projected a surprisingly high burden of occupational lung cancer; for asbestos and four other agents, from 61,000 to 98,000 cases annually were attributed to these agents alone. Many estimates followed, some much more conservative. For example, Doll and Peto estimated that 15% of lung cancer in men and 5% in women could be attributed to occupational exposures. A number of population-based case-control studies also provide relevant estimates. In a recent literature review, Vineis and Simonato cited attributable risk estimates for occupation and lung cancer that ranged from 4% to 40%; for asbestos alone, the estimates ranged from 1% to 5%. These estimates would be expected to vary across locations and over time. Nevertheless, these recent estimates indicate that occupation remains an important cause of lung cancer. Approaches to Prevention. Prevention of lung cancer mortality among workers exposed to agents or industrial processes that cause lung cancer may involve several strategies, including eliminating or reducing exposures, smoking cessation, screening, and chemo-prevention. For example, changes in industrial processes that have eliminated or reduced exposures to chloromethyl ethers and nickel compounds have provided evidence of reduced risk of lung cancer following these changes. Although occupational exposures are important causes of lung cancer, cigarette smoking is the most important preventable cause of lung cancer. For adults, the work site offers an important location to target smoking cessation efforts. In fact, the work site may be the only place to reach many smokers.

  7. Estimation of Lung Ventilation

    NASA Astrophysics Data System (ADS)

    Ding, Kai; Cao, Kunlin; Du, Kaifang; Amelon, Ryan; Christensen, Gary E.; Raghavan, Madhavan; Reinhardt, Joseph M.

    Since the primary function of the lung is gas exchange, ventilation can be interpreted as an index of lung function in addition to perfusion. Injury and disease processes can alter lung function on a global and/or a local level. MDCT can be used to acquire multiple static breath-hold CT images of the lung taken at different lung volumes, or with proper respiratory control, 4DCT images of the lung reconstructed at different respiratory phases. Image registration can be applied to this data to estimate a deformation field that transforms the lung from one volume configuration to the other. This deformation field can be analyzed to estimate local lung tissue expansion, calculate voxel-by-voxel intensity change, and make biomechanical measurements. The physiologic significance of the registration-based measures of respiratory function can be established by comparing to more conventional measurements, such as nuclear medicine or contrast wash-in/wash-out studies with CT or MR. An important emerging application of these methods is the detection of pulmonary function change in subjects undergoing radiation therapy (RT) for lung cancer. During RT, treatment is commonly limited to sub-therapeutic doses due to unintended toxicity to normal lung tissue. Measurement of pulmonary function may be useful as a planning tool during RT planning, may be useful for tracking the progression of toxicity to nearby normal tissue during RT, and can be used to evaluate the effectiveness of a treatment post-therapy. This chapter reviews the basic measures to estimate regional ventilation from image registration of CT images, the comparison of them to the existing golden standard and the application in radiation therapy.

  8. Ultrasensitive characterization of site-specific glycosylation of affinity-purified haptoglobin from lung cancer patient plasma using 10 μm i.d. porous layer open tubular liquid chromatography-linear ion trap collision-induced dissociation/electron transfer dissociation mass spectrometry.

    PubMed

    Wang, Dongdong; Hincapie, Marina; Rejtar, Tomas; Karger, Barry L

    2011-03-15

    Site-specific analysis of protein glycosylation is important for biochemical and clinical research efforts. Glycopeptide analysis using liquid chromatography-collision-induced dissociation/electron transfer dissociation mass spectrometry (LC-CID/ETD-MS) allows simultaneous characterization of the glycan structure and attached peptide site. However, due to the low ionization efficiency of glycopeptides during electrospray ionization, 200-500 fmol of sample per injection is needed for a single LC-MS run, which makes it challenging for the analysis of limited amounts of glycoprotein purified from biological matrixes. To improve the sensitivity of LC-MS analysis for glycopeptides, an ultranarrow porous layer open tubular (PLOT) LC column (2.5 m × 10 μm i.d.) was coupled to a linear ion trap (LTQ) collision-induced dissociation/electron transfer dissociation mass spectrometer to provide sensitive analysis of N-linked protein glycosylation heterogeneity. The potential of the developed method is demonstrated by the characterization of site-specific glycosylation using haptoglobin (Hpt) as a model protein. To limit the amount of haptoglobin to low picomole amounts of protein, we affinity purified it from 1 μL of pooled lung cancer patient plasma. A total of 26 glycoforms/glycan compositions on three Hpt tryptic glycopeptides were identified and quantified from 10 LC-MS runs with a consumption of 100 fmol of Hpt digest (13 ng of protein, 10 fmol per injection). Included in this analysis was the determination of the glycan occupancy level. At this sample consumption level, the high sensitivity of the PLOT LC-LTQ-CID/ETD-MS system allowed glycopeptide identification and structure determination, along with relative quantitation of glycans presented on the same peptide backbone, even for low abundant glycopeptides at the ∼100 amol level. The PLOT LC-MS system is shown to have sufficient sensitivity to allow characterization of site-specific protein glycosylation from trace

  9. Atelectasis causes alveolar injury in nonatelectatic lung regions.

    PubMed

    Tsuchida, Shinya; Engelberts, Doreen; Peltekova, Vanya; Hopkins, Natalie; Frndova, Helena; Babyn, Paul; McKerlie, Colin; Post, Martin; McLoughlin, Paul; Kavanagh, Brian P

    2006-08-01

    Many authors have suggested that the mechanism by which atelectasis contributes to injury is through the repetitive opening and closing of distal airways in lung regions that are atelectatic. However, neither the topographic nor mechanistic relationships between atelectasis and distribution of lung injury are known. To investigate how atelectasis contributes to ventilator-induced lung injury. Surfactant depletion was performed in anesthetized rats that were then allocated to noninjurious or injurious ventilation for 90 min. Lung injury was quantified by gas exchange, compliance, histology, wet-to-dry weight, and cytokine expression, and its distribution by histology, stereology, cytokine mRNA expression, in situ hybridization, and immunohistochemistry. Functional residual capacity, percent atelectasis, and injury-induced lung water accumulation were measured using gravimetric and volumetric techniques. Atelectasis occurred in the dependent lung regions. Injurious ventilation was associated with alveolar and distal airway injury, while noninjurious ventilation was not. With injurious ventilation, alveolar injury (i.e., histology, myeloperoxidase protein expression, quantification, and localization of cytokine mRNA expression) was maximal in nondependent regions, whereas distal airway injury was equivalent in atelectatic and nonatelectatic regions. These data support the notion that lung injury associated with atelectasis involves trauma to the distal airways. We provide topographic and biochemical evidence that such distal airway injury is not localized solely to atelectatic areas, but is instead generalized in both atelectatic and nonatelectatic lung regions. In contrast, alveolar injury associated with atelectasis does not occur in those areas that are atelectatic but occurs instead in remote nonatelectatic alveoli.

  10. Real-time images of tidal recruitment using lung ultrasound.

    PubMed

    Tusman, Gerardo; Acosta, Cecilia M; Nicola, Marco; Esperatti, Mariano; Bohm, Stephan H; Suarez-Sipmann, Fernando

    2015-12-01

    Ventilator-induced lung injury is a form of mechanical damage leading to a pulmonary inflammatory response related to the use of mechanical ventilation enhanced by the presence of atelectasis. One proposed mechanism of this injury is the repetitive opening and closing of collapsed alveoli and small airways within these atelectatic areas-a phenomenon called tidal recruitment. The presence of tidal recruitment is difficult to detect, even with high-resolution images of the lungs like CT scan. The purpose of this article is to give evidence of tidal recruitment by lung ultrasound. A standard lung ultrasound inspection detected lung zones of atelectasis in mechanically ventilated patients. With a linear probe placed in the intercostal oblique position. We observed tidal recruitment within atelectasis as an improvement in aeration at the end of inspiration followed by the re-collapse at the end of expiration. This mechanism disappeared after the performance of a lung recruitment maneuver. Lung ultrasound was helpful in detecting the presence of atelectasis and tidal recruitment and in confirming their resolution after a lung recruitment maneuver.

  11. Micro-imaging of the Mouse Lung via MRI

    NASA Astrophysics Data System (ADS)

    Wang, Wei

    Quantitative measurement of lung microstructure is of great significance in assessment of pulmonary disease, particularly in the earliest stages. Conventional stereological assessment of ex-vivo fixed tissue specimens under the microscope has a long and successful tradition and is regarded as a gold standard, but the invasive nature limits its applications and the practicality of use in longitudinal studies. The technique for diffusion MRI-based 3He lung morphometry was previously developed and validated for human lungs, and was recently extended to ex-vivo mouse lungs. The technique yields accurate, quantitative information about the microstructure and geometry of acinar airways. In this dissertation, the 3He lung morphometry technique is for the first time successfully implemented for in-vivo studies of mice. It can generate spatially-resolved maps of parameters that reveal the microstructure of mouse lung. Results in healthy mice indicate excellent agreement between in-vivo morphometry via 3He MRI and microscopic morphometry after sacrifice. The implementation and validation of 3He morphometry in healthy mice open up new avenues for application of the technique as a precise, noninvasive, in-vivo biomarker of changes in lung microstructure, within various mouse models of lung disease. We have applied 3He morphometry to the Sendai mouse model of lung disease. Specifically, the Sendai-virus model of chronic obstructive lung disease has demonstrated an innate immune response in mouse airways that exhibits similarities to the chronic airway inflammation in human COPD and asthma, but the effect on distal lung parenchyma had not been investigated. We imaged the time course and regional distribution of mouse lung microstructural changes in vivo after Sendai virus (SeV) infection with 1H and 3He diffusion MRI. 1H MR images detected the SeV-induced pulmonary inflammation in vivo and 3He lung morphometry showed modest increase in alveolar duct radius distal to airway

  12. Open Source, Openness, and Higher Education

    ERIC Educational Resources Information Center

    Wiley, David

    2006-01-01

    In this article David Wiley provides an overview of how the general expansion of open source software has affected the world of education in particular. In doing so, Wiley not only addresses the development of open source software applications for teachers and administrators, he also discusses how the fundamental philosophy of the open source…

  13. Open Source, Openness, and Higher Education

    ERIC Educational Resources Information Center

    Wiley, David

    2006-01-01

    In this article David Wiley provides an overview of how the general expansion of open source software has affected the world of education in particular. In doing so, Wiley not only addresses the development of open source software applications for teachers and administrators, he also discusses how the fundamental philosophy of the open source…

  14. Sandia OpenSHMEM

    SciTech Connect

    Barrett, Brian W.; Smith, Stan; Dinan, James; Seager, Kayla; Grant, Ryan E.

    2016-03-15

    Sandia OpenSHMEM is an implementation of the OpenSHMEM Standard over the Portals 4 Networking API and the OpenFabrics Interface (OFI). Sandia OpenSHMEM is designed to be a low-overhead implementation of the OpenSHMEM standard which takes advantage of the many features of the Portals 4 specification.

  15. Open access, open education resources and open data in Uganda.

    PubMed

    Salvo, Ivana Di; Mwoka, Meggie; Kwaga, Teddy; Rukundo, Priscilla Aceng; Ernest, Dennis Ssesanga; Osaheni, Louis Aikoriogie; John, Kasibante; Shafik, Kasirye; de Sousa, Agostinho Moreira

    2015-01-01

    As a follow up to OpenCon 2014, International Federation of Medical Students' Associations (IFMSA) students organized a 3 day workshop Open Access, Open Education Resources and Open Data in Kampala from 15-18 December 2014. One of the aims of the workshop was to engage the Open Access movement in Uganda which encompasses the scientific community, librarians, academia, researchers and students. The IFMSA students held the workshop with the support of: Consortium for Uganda University Libraries (CUUL), The Right to Research Coalition, Electronic Information for Libraries (EIFL), Makerere University, International Health Sciences University (IHSU), Pan African Medical Journal (PAMJ) and the Centre for Health Human Rights and Development (CEHURD). All these organizations are based or have offices in Kampala. The event culminated in a meeting with the Science and Technology Committee of Parliament of Uganda in order to receive the support of the Ugandan Members of Parliament and to make a concrete change for Open Access in the country.

  16. Lung Cancer Screening Update.

    PubMed

    Ruchalski, Kathleen L; Brown, Kathleen

    2016-07-01

    Since the release of the US Preventive Services Task Force and Centers for Medicare and Medicaid Services recommendations for lung cancer screening, low-dose chest computed tomography screening has moved from the research arena to clinical practice. Lung cancer screening programs must reach beyond image acquisition and interpretation and engage in a multidisciplinary effort of clinical shared decision-making, standardization of imaging and nodule management, smoking cessation, and patient follow-up. Standardization of radiologic reports and nodule management will systematize patient care, provide quality assurance, further reduce harm, and contain health care costs. Although the National Lung Screening Trial results and eligibility criteria of a heavy smoking history are the foundation for the standard guidelines for low-dose chest computed tomography screening in the United States, currently only 27% of patients diagnosed with lung cancer would meet US lung cancer screening recommendations. Current and future efforts must be directed to better delineate those patients who would most benefit from screening and to ensure that the benefits of screening reach all socioeconomic strata and racial and ethnic minorities. Further optimization of lung cancer screening program design and patient eligibility will assure that lung cancer screening benefits will outweigh the potential risks to our patients.

  17. Lung Transplantation for Scleroderma-related Lung Disease

    PubMed Central

    Richardson, Claire B.; Singer, Jonathan P

    2014-01-01

    Lung transplantation for scleroderma-related lung disease is controversial due to extra-pulmonary organ involvement that may threaten allograft and patient survival after transplant surgery. Despite concerns, several lung transplant programs do offer lung transplantation to patients with scleroderma-related lung disease. In this review, we evaluate the scleroderma-related extra-pulmonary organ involvement that may result in poorer outcomes after lung transplantation as well as the existing evidence on survival, freedom from bronchiolitis obliterans syndrome (BOS), and other important clinical outcomes after lung transplantation. Among the nine studies reviewed, comprising 226 subjects, survival and freedom from BOS appears to be similar for subjects undergoing lung transplantation for scleroderma compared to non-scleroderma lung diseases. Although scleroderma is a systemic disease with several unique potential threats to allograft and patient survival, lung transplantation appears to be a reasonable intervention for this patient population. PMID:27833787

  18. Bioengineering Lungs for Transplantation.

    PubMed

    Gilpin, Sarah E; Charest, Jonathan M; Ren, Xi; Ott, Harald C

    2016-05-01

    Whole lung extracellular matrix scaffolds can be created by perfusion of cadaveric organs with decellularizing detergents, providing a platform for organ regeneration. Lung epithelial engineering must address both the proximal airway cells that function to metabolize toxins and aid mucociliary clearance and the distal pneumocytes that facilitate gas exchange. Engineered pulmonary vasculature must support in vivo blood perfusion with low resistance and intact barrier function and be antithrombotic. Repopulating the native lung matrix with sufficient cell numbers in appropriate anatomic locations is required to enable organ function.

  19. Microgravity and the lung

    NASA Technical Reports Server (NTRS)

    West, John B.

    1991-01-01

    Results are presented from studies of the effect of microgravity on the lungs of rats flown on the Cosmos 2044 mission, and from relevant laboratory experiments. The effects of microgravity fall into five categories: topographical structure and function, the lung volumes and mechanics, the intrathoracic blood pressures and volumes, the pulmonary deposition of aerosol, and denitrogenaton during EVA. The ultrastructure of the left lungs of rats flown for 14 days on the Cosmos 2044 spacecraft and that of some tail-suspended rats disclosed presence of red blood cells in the alveolar spaces, indicating that pulmonary hemorrhage and pulmonary edema occurred in these rats. Possible causes for this phenomenon are discussed.

  20. Lung Cancer Screening.

    PubMed

    Hoffman, Richard M; Sanchez, Rolando

    2017-07-01

    Lung cancer is the leading cause of cancer death in the United States. More than 80% of these deaths are attributed to tobacco use, and primary prevention can effectively reduce the cancer burden. The National Lung Screening Trial showed that low-dose computed tomography (LDCT) screening could reduce lung cancer mortality in high-risk patients by 20% compared with chest radiography. The US Preventive Services Task Force recommends annual LDCT screening for persons aged 55 to 80 years with a 30-pack-year smoking history, either currently smoking or having quit within 15 years. Published by Elsevier Inc.

  1. The lung communication network.

    PubMed

    Losa, Davide; Chanson, Marc

    2015-08-01

    The different types of cells in the lung, from the conducting airway epithelium to the alveolar epithelium and the pulmonary vasculature, are interconnected by gap junctions. The specific profile of gap junction proteins, the connexins, expressed in these different cell types forms compartments of intercellular communication that can be further shaped by the release of extracellular nucleotides via pannexin1 channels. In this review, we focus on the physiology of connexins and pannexins and describe how this lung communication network modulates lung function and host defenses in conductive and respiratory airways.

  2. Cyclophosphamide in diffuse lung damage.

    PubMed

    Musiatowicz, B; Sulkowska, M; Sulik, M; Famulski, W; Dziecioł, J; Sobaniec-Lotowska, M; Baltaziak, M; Arciuch, L; Rółkowski, R; Jabłońska, E

    1997-01-01

    Some cyclophosphamide toxic effects on lung tissue are presented. Cyclophosphamide metabolism, pathogenesis of lung damage and morphological lung tissue changes caused by that agent were characterized. Attention was focused on BAL evaluation as a useful method in the monitoring of lung tissue damage degree.

  3. Familial risk for lung cancer

    PubMed Central

    Kanwal, Madiha; Ding, Xiao-Ji; Cao, Yi

    2017-01-01

    Lung cancer, which has a low survival rate, is a leading cause of cancer-associated mortality worldwide. Smoking and air pollution are the major causes of lung cancer; however, numerous studies have demonstrated that genetic factors also contribute to the development of lung cancer. A family history of lung cancer increases the risk for the disease in both smokers and never-smokers. This review focuses on familial lung cancer, in particular on the familial aggregation of lung cancer. The development of familial lung cancer involves shared environmental and genetic factors among family members. Familial lung cancer represents a good model for investigating the association between environmental and genetic factors, as well as for identifying susceptibility genes for lung cancer. In addition, studies on familial lung cancer may help to elucidate the etiology and mechanism of lung cancer, and may identify novel biomarkers for early detection and diagnosis, targeted therapy and improved prevention strategies. This review presents the aetiology and molecular biology of lung cancer and then systematically introduces and discusses several aspects of familial lung cancer, including the characteristics of familial lung cancer, population-based studies on familial lung cancer and the genetics of familial lung cancer. PMID:28356926

  4. What Are the Lungs?

    MedlinePlus

    ... oxygen from the air. They also help remove carbon dioxide (a waste gas that can be toxic) from ... The lungs' intake of oxygen and removal of carbon dioxide is called gas exchange. Gas exchange is part ...

  5. Women and Lung Cancer

    MedlinePlus

    ... Horrigan Conners Center for Women’s Health and Gender Biology, Brigham and Women’s Hospital, Harvard Medical School, April, ... Lung Cancer in Women: The Differences in Epidemiology, Biology and Treatment Outcomes, Maria Patricia Rivera MD Expert ...

  6. Lung Carcinoid Tumor: Surgery

    MedlinePlus

    ... the sleeve above and below the stain and sewing the cuff back onto the shortened sleeve. A ... because it requires a great deal of technical skill. Possible risks and side effects of lung surgery ...

  7. Justice and lung cancer.

    PubMed

    Wilson, Aaron

    2013-04-01

    Lung cancer is the leading cause of cancer deaths, yet research funding is by far the lowest for lung cancer than for any other cancer compared with respective death rates. Although this discrepancy should appear alarming, one could argue that lung cancer deserves less attention because it is more attributable to poor life choices than other common cancers. Accordingly, the general question that I ask in this article is whether victims of more avoidable diseases, such as lung cancer, deserve to have their needs taken into less consideration than those of less avoidable diseases, on the grounds of either retributive or distributive justice. Such unequal treatment may be the "penalty" one incurs for negligent or reckless behavior. However, I hope to show that such unequal treatment cannot be supported by any coherent accounts of retributive or distributive justice.

  8. Protecting Your Lungs

    MedlinePlus

    ... That Can Damage Your Lungs Secondhand smoke, outdoor air pollution , chemicals in the home and workplace, and radon ... nothing else matters ® . Help us fight to reduce pollution in the air we breathe. Donate

  9. Interstitial lung disease

    MedlinePlus

    ... screened for lung disease. These jobs include coal mining, sand blasting, and working on a ship. Treatment ... Traveling with breathing problems Using oxygen at home Images Clubbing Coal workers pneumoconiosis - stage II Coal workers ...

  10. Abscess in the Lungs

    MedlinePlus

    ... a sample of sputum and try to grow (culture) the organism causing the abscess, but this test ... obtain samples of lung secretions or tissue for culture if, for example, Antibiotics seem ineffective Obstruction of ...

  11. Lung disease - resources

    MedlinePlus

    ... gov/health/dci/Diseases/Asthma/Asthma_WhatIs.html Emphysema/COPD (Chronic Obstructive Pulmonary Disease): COPD Foundation -- www.copdfoundation.org National Emphysema Foundation -- www.emphysemafoundation.org National Heart, Lung, and ...

  12. Biomarkers of Lung Injury

    EPA Science Inventory

    Unlike the hepatic, cardiovascular, nervous, or excretory organ systems, where there .ls a strong contribution of host factors or extracellular biochemical milieu in causing organ damage, the causes of lung injuries and subsequent diseases are primarily from direct environmental ...

  13. Immunotherapy for lung cancer.

    PubMed

    Steven, Antonius; Fisher, Scott A; Robinson, Bruce W

    2016-07-01

    Treatment of lung cancer remains a challenge, and lung cancer is still the leading cause of cancer-related mortality. Immunotherapy has previously failed in lung cancer but has recently emerged as a very effective new therapy, and there is now growing worldwide enthusiasm in cancer immunotherapy. We summarize why immune checkpoint blockade therapies have generated efficacious and durable responses in clinical trials and why this has reignited interest in this field. Cancer vaccines have also been explored in the past with marginal success. Identification of optimal candidate neoantigens may improve cancer vaccine efficacy and may pave the way to personalized immunotherapy, alone or in combination with other immunotherapy such as immune checkpoint blockade. Understanding the steps in immune recognition and eradication of cancer cells is vital to understanding why previous immunotherapies failed and how current therapies can be used optimally. We hold an optimistic view for the future prospect in lung cancer immunotherapy.

  14. Biomarkers of Lung Injury

    EPA Science Inventory

    Unlike the hepatic, cardiovascular, nervous, or excretory organ systems, where there .ls a strong contribution of host factors or extracellular biochemical milieu in causing organ damage, the causes of lung injuries and subsequent diseases are primarily from direct environmental ...

  15. Lung Cancer Biomarkers.

    PubMed

    I, Hoseok; Cho, Je-Yoel

    2015-01-01

    Lung cancer is the most frequently occurring cancer in the world and continually leads in mortality among cancers. The overall 5-year survival rate for lung cancer has risen only 4% (from 12% to 16%) over the past 4 decades, and late diagnosis is a major obstacle in improving lung cancer prognosis. Survival of patients undergoing lung resection is greater than 80%, suggesting that early detection and diagnosis of cancers before they become inoperable and lethal will greatly improve mortality. Lung cancer biomarkers can be used for screening, detection, diagnosis, prognosis, prediction, stratification, therapy response monitoring, and so on. This review focuses on noninvasive diagnostic and prognostic biomarkers. For that purpose, our discussion in this review will focus on biological fluid-based biomarkers. The body fluids include blood (serum or plasma), sputum, saliva, BAL, pleural effusion, and VOC. Since it is rich in different cellular and molecular elements and is one of the most convenient and routine clinical procedures, serum or plasma is the main source for the development and validation of many noninvasive biomarkers. In terms of molecular aspects, the most widely validated ones are proteins, some of which are used in the clinical sector, though in limited accessory purposes. We will also discuss the lung cancer (protein) biomarkers in clinical trials and currently in the validation phase with hundreds of samples. After proteins, we will discuss microRNAs, methylated DNA, and circulating tumor cells, which are being vigorously developed and validated as potential lung cancer biomarkers. The main aim of this review is to provide researchers and clinicians with an understanding of the potential noninvasive lung cancer biomarkers in biological fluids that have recently been discovered.

  16. Lung epinephrine synthesis

    SciTech Connect

    Kennedy, B.; Elayan, H.; Ziegler, M.G. )

    1990-04-01

    We studied in vitro and in vivo epinephrine (E) synthesis by rat lung. Nine days after removal of the adrenal medullas, circulating E was reduced to 7% of levels found in sham-operated rats but 30% of lung E remained. Treatment of demedullated rats with 6 hydroxydopamine plus reserpine did not further reduce lung E. In the presence of S-(3H)adenosylmethionine lung homogenates readily N-methylated norepinephrine (NE) to form (3H)E. The rate of E synthesis by lung homogenates was progressively more rapid with increasing NE up to a concentration of 3 mM, above which it declined. The rate of E formation was optimal at an incubation pH of 8 and at temperatures of approximately 55 degrees C. We compared the E-forming enzyme(s) of lung homogenates with those of adrenal and cardiac ventricle. The adrenal contains mainly phenylethanolamine N-methyltransferase (PNMT), which is readily inhibited by SKF 29661 and methylates dopamine (DA) very poorly. Cardiac ventricles contain mainly nonspecific N-methyltransferase (NMT), which is poorly inhibited by SKF 29661 and readily methylates both DA and NE. Lung homogenates were inhibited by SKF 29661 about half as well as adrenal but more than ventricle. We used the rate of E formation from NE as an index of PNMT-like activity and deoxyepinephrine synthesis from DA as an index of NMT-like activity. PNMT and NMT activity in rat lung homogenates were not correlated with each other, displayed different responses to change in temperature, and were affected differently by glucocorticoids.

  17. Indium Lung Disease

    PubMed Central

    Nakano, Makiko; Omae, Kazuyuki; Takeuchi, Koichiro; Chonan, Tatsuya; Xiao, Yong-long; Harley, Russell A.; Roggli, Victor L.; Hebisawa, Akira; Tallaksen, Robert J.; Trapnell, Bruce C.; Day, Gregory A.; Saito, Rena; Stanton, Marcia L.; Suarthana, Eva; Kreiss, Kathleen

    2012-01-01

    Background: Reports of pulmonary fibrosis, emphysema, and, more recently, pulmonary alveolar proteinosis (PAP) in indium workers suggested that workplace exposure to indium compounds caused several different lung diseases. Methods: To better understand the pathogenesis and natural history of indium lung disease, a detailed, systematic, multidisciplinary analysis of clinical, histopathologic, radiologic, and epidemiologic data for all reported cases and workplaces was undertaken. Results: Ten men (median age, 35 years) who produced, used, or reclaimed indium compounds were diagnosed with interstitial lung disease 4-13 years after first exposure (n = 7) or PAP 1-2 years after first exposure (n = 3). Common pulmonary histopathologic features in these patients included intraalveolar exudate typical of alveolar proteinosis (n = 9), cholesterol clefts and granulomas (n = 10), and fibrosis (n = 9). Two patients with interstitial lung disease had pneumothoraces. Lung disease progressed following cessation of exposure in most patients and was fatal in two. Radiographic data revealed that two patients with PAP subsequently developed fibrosis and one also developed emphysematous changes. Epidemiologic investigations demonstrated the potential for exposure to respirable particles and an excess of lung abnormalities among coworkers. Conclusions: Occupational exposure to indium compounds was associated with PAP, cholesterol ester crystals and granulomas, pulmonary fibrosis, emphysema, and pneumothoraces. The available evidence suggests exposure to indium compounds causes a novel lung disease that may begin with PAP and progress to include fibrosis and emphysema, and, in some cases, premature death. Prospective studies are needed to better define the natural history and prognosis of this emerging lung disease and identify effective prevention strategies. PMID:22207675

  18. Lung Epithelial Progenitor Cells

    PubMed Central

    Rawlins, Emma L.

    2008-01-01

    The current enthusiasm for stem cell research stems from the hope that damaged or diseased tissues may one day be repaired through the manipulation of endogenous or exogenous stem cells. The postnatal human respiratory system is highly accessible and provides unique opportunities for the application of such techniques. Several putative adult lung epithelial stem cells have been identified in the mouse model system. However, their in vivo capabilities to contribute to different lineages, and their control mechanisms, remain unclear. If stem cell–based therapies are to be successful in the lung, it is vitally important that we understand the normal behavior of adult lung stem cells, and how this is regulated. Lung embryonic progenitor cells are much better defined and characterized than their adult counterparts. Moreover, experiments on a variety of developing tissues are beginning to uncover general mechanisms by which embryonic progenitors influence final organ size and structure. This provides a framework for the study of lung embryonic progenitor cells, facilitating experimental design and interpretation. A similar approach to investigating adult lung stem cells could produce rapid advances in the field. PMID:18684716

  19. Pediatric lobar lung transplantation.

    PubMed

    Watson, T J; Starnes, V A

    1996-07-01

    The disparity between available donors and potential recipients of lung transplants has demanded a certain degree of flexibility on the part of transplantation surgeons. Marginal donors are now being used more frequently, and downsizing lungs from larger donors to fit into small recipients is quite common. In some instances, particularly in the circumstances of children, a single lobe from a much larger donor may serve very well as an entire lung in the recipient. Although either the upper or lower lobes from either side may be used, the lower lobes, especially the left, are better suited for this purpose because of the anatomy of the arterial, venous, and bronchial systems. As an extension of this concept, living-donor lung transplantation is now an accepted practice in carefully selected patients. Most children are best treated with bilateral lobar transplantation, particularly when cystic fibrosis is the indication. For living-donor transplantation, this obviously involves engaging two willing donors able to pass a rigorous physical and psychological evaluation. Although the recipients are generally sicker than the average cadaveric lung transplant recipient, early results to date have been similar to those receiving cadaveric lungs. In this article, we will describe our experience with this procedure, including the evaluation process, the technical aspects of the donor and recipient operations, and the results in the donors and recipients.

  20. Optimizing a canine survival model of orthotopic lung transplantation.

    PubMed

    Farivar, A S; Yunusov, M Y; Chen, P; Leone, R J; Madtes, D K; Kuhr, C S; Spector, M R; Abrams, K; Hwang, B; Nash, R A; Mulligan, M S

    2006-06-01

    While acute models of orthotopic lung transplantation have been described in dogs, the technical considerations of developing a survival model in this species have not been elaborated. Herein, we describe optimization of a canine survival model of orthotopic lung transplantation. Protocols of orthotopic left lung transplantation and single lung ventilation were established in acute experiments (n=9). Four dogs, serving as controls, received autologous, orthotopic lung transplants. Allogeneic transplants were performed in 16 DLA-identical and 16 DLA-mismatched unrelated recipient dogs. Selective right lung ventilation was utilized in all animals. A Malecot tube was left in the pleural space connected to a Heimlich valve for up to 24 hours. To date, animals have been followed up to 24 months by chest radiography, pulmonary function tests, bronchoscopy with lavage, and open biopsies. Long-term survival was achieved in 34/36 animals. Two recipients died intraoperatively secondary to cardiac arrest. All animals were extubated on the operating table, and in all cases the chest tube was removed within 24 hours. Major complications included thrombosis of the pulmonary artery and subcritical stenosis of bronchial anastamosis. One recipient underwent successful treatment of a small bowel intussusception. We report our experience in developing a survival canine model of orthotopic single lung transplantation. While short-term survival following canine lung transplantation is achievable, we report particular considerations that facilitate animal comfort, early extubation, and lung reexpansion in the immediate postoperative period, further optimizing use of this species for experimental modeling of long-term complications after lung transplantation.

  1. Developing EZH2 Targeted Therapy for Lung Cancer

    PubMed Central

    Frankel, Arthur E.; Liu, Xin; Minna, John D.

    2016-01-01

    Summary Epigenetic targets are exciting new avenues for cancer drug discovery. Zhang and colleagues have designed the open-source EZH2 inhibitor JQEZ5 and shown anti-tumor efficacy in vitro and in vivo in preclinical studies in murine and human lung adenocarcinomas models expressing high levels of EZH2 (1). PMID:27587466

  2. Type I Interferons as Regulators of Lung Inflammation

    PubMed Central

    Makris, Spyridon; Paulsen, Michelle; Johansson, Cecilia

    2017-01-01

    Immune responses to lung infections must be tightly regulated in order to permit pathogen eradication while maintaining organ function. Exuberant or dysregulated inflammation can impair gas exchange and underlies many instances of lung disease. An important driver of inflammation in the lung is the interferon (IFN) response. Type I IFNs are antiviral cytokines that induce a large range of proteins that impair viral replication in infected cells. This cell-intrinsic action plays a crucial role in protecting the lungs from spread of respiratory viruses. However, type I IFNs have also recently been found to be central to the initiation of lung inflammatory responses, by inducing recruitment and activation of immune cells. This helps control virus burden but can cause detrimental immunopathology and contribute to disease severity. Furthermore, there is now increasing evidence that type I IFNs are not only induced after viral infections but also after infection with bacteria and fungi. The pro-inflammatory function of type I IFNs in the lung opens up the possibility of immune modulation directed against this antiviral cytokine family. In this review, the initiation and signaling of type I IFNs as well as their role in driving and maintaining lung inflammation will be discussed. PMID:28344581

  3. Indoor nitrous acid and respiratory symptoms and lung function in adults

    PubMed Central

    Jarvis, D; Leaderer, B; Chinn, S; Burney, P

    2005-01-01

    Background: Nitrogen dioxide (NO2) is an important pollutant of indoor and outdoor air, but epidemiological studies show inconsistent health effects. These inconsistencies may be due to failure to account for the health effects of nitrous acid (HONO) which is generated directly from gas combustion and indirectly from NO2. Methods: Two hundred and seventy six adults provided information on respiratory symptoms and lung function and had home levels of NO2 and HONO measured as well as outdoor levels of NO2. The association of indoor HONO levels with symptoms and lung function was examined. Results: The median indoor HONO level was 3.10 ppb (IQR 2.05–5.09), with higher levels in homes with gas hobs, gas ovens, and in those measured during the winter months. Non-significant increases in respiratory symptoms were observed in those living in homes with higher HONO levels. An increase of 1 ppb in indoor HONO was associated with a decrease in forced expiratory volume in 1 second (FEV1) percentage predicted (–0.96%; 95% CI –0.09 to –1.82) and a decrease in percentage FEV1/forced vital capacity (FVC) (–0.45%; 95% CI –0.06 to –0.83) after adjustment for relevant confounders. Measures of indoor NO2 were correlated with HONO (r = 0.77), but no significant association of indoor NO2 with symptoms or lung function was observed. After adjustment for NO2 measures, the association of HONO with low lung function persisted. Conclusion: Indoor HONO levels are associated with decrements in lung function and possibly with more respiratory symptoms. Inconsistencies between studies examining health effects of NO2 and use of gas appliances may be related to failure to account for this association. PMID:15923247

  4. Open for Business

    ERIC Educational Resources Information Center

    Voyles, Bennett

    2007-01-01

    People know about the Sakai Project (open source course management system); they may even know about Kuali (open source financials). So, what is the next wave in open source software? This article discusses business intelligence (BI) systems. Though open source BI may still be only a rumor in most campus IT departments, some brave early adopters…

  5. Open space and imagination

    Treesearch

    G. Scott Place; Bruce Hronek

    2001-01-01

    Open space is a necessary tool in our park system for fostering creativity and allowing for relaxation. In addition, open space areas allow people to exercise, find self-worth, and to use their imagination. This manuscript addresses the issue of what is happening in open space provided in several park settings. Do residents use open space as a place where they can play...

  6. Open for Business

    ERIC Educational Resources Information Center

    Voyles, Bennett

    2007-01-01

    People know about the Sakai Project (open source course management system); they may even know about Kuali (open source financials). So, what is the next wave in open source software? This article discusses business intelligence (BI) systems. Though open source BI may still be only a rumor in most campus IT departments, some brave early adopters…

  7. Live Imaging of the Lung

    PubMed Central

    Looney, Mark R.; Bhattacharya, Jahar

    2015-01-01

    Live lung imaging has spanned the discovery of capillaries in the frog lung by Malpighi to the current use of single and multiphoton imaging of intravital and isolated perfused lung preparations incorporating fluorescent molecular probes and transgenic reporter mice. Along the way, much has been learned about the unique microcirculation of the lung, including immune cell migration and the mechanisms by which cells at the alveolar-capillary interface communicate with each other. In this review, we highlight live lung imaging techniques as applied to the role of mitochondria in lung immunity, mechanisms of signal transduction in lung compartments, studies on the composition of alveolar wall liquid, and neutrophil and platelet trafficking in the lung under homeostatic and inflammatory conditions. New applications of live lung imaging and the limitations of current techniques are discussed. PMID:24245941

  8. Protective lung ventilation in operating room: a systematic review.

    PubMed

    Futier, E; Constantin, J M; Jaber, S

    2014-06-01

    Postoperative pulmonary and extrapulmonary complications adversely affect clinical outcomes and healthcare utilization, so that prevention has become a measure of the quality of perioperative care. Mechanical ventilation is an essential support therapy to maintain adequate gas exchange during general anesthesia for surgery. Mechanical ventilation using high tidal volume (VT) (between 10 and 15 mL/kg) has been historically encouraged to prevent hypoxemia and atelectasis formation in anesthetized patients undergoing abdominal and thoracic surgery. However, there is accumulating evidence from both experimental and clinical studies that mechanical ventilation, especially the use of high VT and plateau pressure, may potentially aggravate or even initiate lung injury. Ventilator-associated lung injury can result from cyclic alveolar overdistension of non-dependent lung tissue, and repetitive opening and closing of dependent lung tissue resulting in ultrastructural damage at the junction of closed and open alveoli. Lung-protective ventilation, which refers to the use of lower VT and limited plateau pressure to minimize overdistension, and positive end-expiratory pressure to prevent alveolar collapse at end-expiration, was shown to improve outcome in critically ill patients with acute respiratory distress syndrome (ARDS). It has been recently suggested that this approach might also be beneficial in a broader population, especially in critically ill patients without ARDS at the onset of mechanical ventilation. There is, however, little evidence regarding a potential beneficial effect of lung protective ventilation during surgery, especially in patients with healthy lungs. Although surgical patients are frequently exposed to much shorter periods of mechanical ventilation, this is an important gap in knowledge given the number of patients receiving mechanical ventilation in the operating room. This review developed the benefits of lung protective ventilation during surgery

  9. Screening for Lung Cancer

    PubMed Central

    Mazzone, Peter J.; Naidich, David P.; Bach, Peter B.

    2013-01-01

    Background: Lung cancer is by far the major cause of cancer deaths largely because in the majority of patients it is at an advanced stage at the time it is discovered, when curative treatment is no longer feasible. This article examines the data regarding the ability of screening to decrease the number of lung cancer deaths. Methods: A systematic review was conducted of controlled studies that address the effectiveness of methods of screening for lung cancer. Results: Several large randomized controlled trials (RCTs), including a recent one, have demonstrated that screening for lung cancer using a chest radiograph does not reduce the number of deaths from lung cancer. One large RCT involving low-dose CT (LDCT) screening demonstrated a significant reduction in lung cancer deaths, with few harms to individuals at elevated risk when done in the context of a structured program of selection, screening, evaluation, and management of the relatively high number of benign abnormalities. Whether other RCTs involving LDCT screening are consistent is unclear because data are limited or not yet mature. Conclusions: Screening is a complex interplay of selection (a population with sufficient risk and few serious comorbidities), the value of the screening test, the interval between screening tests, the availability of effective treatment, the risk of complications or harms as a result of screening, and the degree with which the screened individuals comply with screening and treatment recommendations. Screening with LDCT of appropriate individuals in the context of a structured process is associated with a significant reduction in the number of lung cancer deaths in the screened population. Given the complex interplay of factors inherent in screening, many questions remain on how to effectively implement screening on a broader scale. PMID:23649455

  10. Minimally Invasive Surgery for Early-Stage Lung Cancer: From Innovation to Standard of Care.

    PubMed

    White, Abby; Swanson, Scott J

    2016-11-15

    The era of minimally invasive surgery for lung cancer follows decades of research; the collection and interpretation of countless qualitative and quantitative data points; and tireless efforts by a few pioneering thoracic surgeons who believed they could deliver a safe and oncologically sound operation with less tissue trauma, an improved physiologic profile, and fewer complications than traditional open surgery. This review highlights those efforts and the role of minimally invasive surgery for early-stage lung cancer in light of evolving technology, the emerging understanding of the biology of early-stage lung cancer, and lung cancer screening.

  11. Lung dendritic cells imprint T cell lung homing and promote lung immunity through the chemokine receptor CCR4

    PubMed Central

    Strassner, James P.

    2013-01-01

    T cell trafficking into the lung is critical for lung immunity, but the mechanisms that mediate T cell lung homing are not well understood. Here, we show that lung dendritic cells (DCs) imprint T cell lung homing, as lung DC–activated T cells traffic more efficiently into the lung in response to inhaled antigen and at homeostasis compared with T cells activated by DCs from other tissues. Consequently, lung DC–imprinted T cells protect against influenza more effectively than do gut and skin DC–imprinted T cells. Lung DCs imprint the expression of CCR4 on T cells, and CCR4 contributes to T cell lung imprinting. Lung DC–activated, CCR4-deficient T cells fail to traffic into the lung as efficiently and to protect against influenza as effectively as lung DC–activated, CCR4-sufficient T cells. Thus, lung DCs imprint T cell lung homing and promote lung immunity in part through CCR4. PMID:23960189

  12. Open access, open education resources and open data in Uganda

    PubMed Central

    Salvo, Ivana Di; Mwoka, Meggie; Kwaga, Teddy; Rukundo, Priscilla Aceng; Ernest, Dennis Ssesanga; Osaheni, Louis Aikoriogie; John, Kasibante; Shafik, Kasirye; de Sousa, Agostinho Moreira

    2015-01-01

    As a follow up to OpenCon 2014, International Federation of Medical Students’ Associations (IFMSA) students organized a 3 day workshop Open Access, Open Education Resources and Open Data in Kampala from 15-18 December 2014. One of the aims of the workshop was to engage the Open Access movement in Uganda which encompasses the scientific community, librarians, academia, researchers and students. The IFMSA students held the workshop with the support of: Consortium for Uganda University Libraries (CUUL), The Right to Research Coalition, Electronic Information for Libraries (EIFL), Makerere University, International Health Sciences University (IHSU), Pan African Medical Journal (PAMJ) and the Centre for Health Human Rights and Development (CEHURD). All these organizations are based or have offices in Kampala. The event culminated in a meeting with the Science and Technology Committee of Parliament of Uganda in order to receive the support of the Ugandan Members of Parliament and to make a concrete change for Open Access in the country. PMID:26327966

  13. Adaptive lung ventilation.

    PubMed

    Linton, D M

    2001-09-01

    Adaptive lung ventilation (ALV) is a method of closed-loop mechanical ventilation analogous to modern closed-loop technology in aviation such as the autopilot and automatic landing system. The algorithm of the controller of ALV is designed to automatically provide pressure-controlled synchronized intermittent mandatory ventilation (P-SIMV) and weaning as individually required in any clinical situation. The synchronized pressure limited breaths constantly adapt to the patient requirements to encourage optimal alveolar ventilation with minimal adverse physiological disturbance and timely weaning. The ease of application, efficiency, and safety of the first ALV controllers have been demonstrated in lung models, in patients with normal lungs undergoing general anesthesia, in patients requiring unusual positioning, in transition to and from one-lung anesthesia, and in long-term ventilation of patients with various lung pathologies and in weaning patients who have restrictive or obstructive pulmonary disease. Prospective comparative studies of ALV versus other currently used manually selected modes of mechanical ventilation, such as the one reported in this article, should confirm the safety and identify the benefits of this form of advanced closed-loop mechanical ventilation technology.

  14. Mechanisms of lung aging.

    PubMed

    Brandenberger, Christina; Mühlfeld, Christian

    2017-03-01

    Lung aging is associated with structural remodeling, a decline of respiratory function and a higher susceptibility to acute and chronic lung diseases. Individual factors that modulate pulmonary aging include basic genetic configuration, environmental exposure, life-style and biography of systemic diseases. However, the actual aging of the lung takes place in pulmonary resident cells and is closely linked to aging of the immune system (immunosenescence). Therefore, this article reviews the current knowledge about the impact of aging on pulmonary cells and the immune system, without analyzing those factors that may accelerate the aging process in depth. Hallmarks of aging include alterations at molecular, cellular and cell-cell interaction levels. Because of the great variety of cell types in the lung, the consequences of aging display a broad spectrum of phenotypes. For example, aging is associated with more collagen and less elastin production by fibroblasts, thus increasing pulmonary stiffness and lowering compliance. Decreased sympathetic airway innervation may increase the constriction status of airway smooth muscle cells. Aging of resident and systemic immune cells leads to a pro-inflammatory milieu and reduced capacity of fighting infectious diseases. The current review provides an overview of cellular changes occurring with advancing age in general and in several cell types of the lung as well as of the immune system. Thereby, this survey not only aims at providing a better understanding of the mechanisms of pulmonary aging but also to identify gaps in knowledge that warrant further investigations.

  15. How Are Lung Carcinoid Tumors Staged?

    MedlinePlus

    ... Tumor Early Detection, Diagnosis, and Staging How Are Lung Carcinoid Tumors Staged? The stage of a cancer ... Your Doctor About Lung Carcinoid Tumors? More In Lung Carcinoid Tumors About Lung Carcinoid Tumors Causes, Risk ...

  16. How Are Lung Carcinoid Tumors Diagnosed?

    MedlinePlus

    ... Tumor Early Detection, Diagnosis, and Staging How Are Lung Carcinoid Tumors Diagnosed? Certain signs and symptoms might ... Your Doctor About Lung Carcinoid Tumors? More In Lung Carcinoid Tumors About Lung Carcinoid Tumors Causes, Risk ...

  17. How Is Childhood Interstitial Lung Disease Treated?

    MedlinePlus

    ... the NHLBI on Twitter. How Is Childhood Interstitial Lung Disease Treated? Childhood interstitial lung disease (chILD) is ... prevent acid reflux, which can lead to aspiration. Lung Transplant A lung transplant may be an option ...

  18. Lung pair phantom

    DOEpatents

    Olsen, Peter C.; Gordon, N. Ross; Simmons, Kevin L.

    1993-01-01

    The present invention is a material and method of making the material that exhibits improved radiation attenuation simulation of real lungs, i.e., an "authentic lung tissue" or ALT phantom. Specifically, the ALT phantom is a two-part polyurethane medium density foam mixed with calcium carbonate, potassium carbonate if needed for K-40 background, lanthanum nitrate, acetone, and a nitrate or chloride form of a radionuclide. This formulation is found to closely match chemical composition and linear attenuation of real lungs. The ALT phantom material is made according to established procedures but without adding foaming agents or preparing thixotropic concentrate and with a modification for ensuring uniformity of density of the ALT phantom that is necessary for accurate simulation. The modification is that the polyurethane chemicals are mixed at a low temperature prior to pouring the polyurethane mixture into the mold.

  19. Lung pair phantom

    DOEpatents

    Olsen, P.C.; Gordon, N.R.; Simmons, K.L.

    1993-11-30

    The present invention is a material and method of making the material that exhibits improved radiation attenuation simulation of real lungs, i.e., an ``authentic lung tissue`` or ALT phantom. Specifically, the ALT phantom is a two-part polyurethane medium density foam mixed with calcium carbonate, potassium carbonate if needed for K-40 background, lanthanum nitrate, acetone, and a nitrate or chloride form of a radionuclide. This formulation is found to closely match chemical composition and linear attenuation of real lungs. The ALT phantom material is made according to established procedures but without adding foaming agents or preparing thixotropic concentrate and with a modification for ensuring uniformity of density of the ALT phantom that is necessary for accurate simulation. The modification is that the polyurethane chemicals are mixed at a low temperature prior to pouring the polyurethane mixture into the mold.

  20. [Indium lung disease].

    PubMed

    Nakano, Makiko; Omae, Kazuyuki

    2014-02-01

    "Indium lung" is a new occupational lung disease. The global demand for indium, the major material used in manufacturing flat-screen display panels, has skyrocketed since the 1990s (Japan comprises 85% of the worldwide demand). The first case was reported in Japan in 2003, followed by seven cases (interstitial pneumonia and emphysema) in Japan. Two pulmonary alveolar proteinosis (PAP) cases in the USA followed in 2011. Indium lung has been described as interstitial pneumonia, pneumothorax, emphysema, and PAP. In 2013, The Japan Ministry of Health, Labor and Welfare issued an "Ordinance on the Prevention of Hazards Due to Specified Chemical Substances" requiring employers to provide regular health checks for employees and measurements of work environment concentrations of respirable indium dust.

  1. Lung mass, right upper lung - chest x-ray (image)

    MedlinePlus

    This picture is a chest x-ray of a person with a lung mass. This is a front view, where the lungs are the two dark areas and ... visible in the middle of the chest. The x-ray shows a mass in the right upper lung, ...

  2. Particles causing lung disease.

    PubMed Central

    Kilburn, K H

    1984-01-01

    The lung has a limited number of patterns of reaction to inhaled particles. The disease observed depends upon the location: conducting airways, terminal bronchioles and alveoli, and upon the nature of inflammation induced: acute, subacute or chronic. Many different agents cause narrowing of conducting airways (asthma) and some of these cause permanent distortion or obliteration of airways as well. Terminal bronchioles appear to be particularly susceptible to particles which cause goblet cell metaplasia, mucous plugging and ultimately peribronchiolar fibrosis. Cancer is the last outcome at the bronchial level and appears to depend upon continuous exposure to or retention of an agent in the airway and failure of the affected cells to be exfoliated which may be due to squamous metaplasia. Alveoli are populated by endothelial cells, Type I or pavement epithelial cells and metabolically active cuboidal Type II cells that produce the lungs specific surfactant, dipalmytol lecithin. Disturbances of surfactant lead to edema in distal lung while laryngeal edema due to anaphylaxis or fumes may produce asphyxia. Physical retention of indigestible particles or retention by immune memory responses may provoke hyaline membranes, stimulate alveolar lipoproteinosis and finally fibrosis. This later exuberant deposition of connective tissue has been best studied in the occupational pneumoconioses especially silicosis and asbestosis. In contrast emphysema a catabolic response, appears frequently to result from leakage or release of lysosomal proteases into the lung during processing of cigarette smoke particles. The insidious and probably most important human lung disease due to particles is bronchiolar obstruction and obliteration, producing progressive impairment of air flow. The responsible particle is the complex combination of poorly digestive lipids and complex carbohydrates with active chemicals which we call cigarette smoke. More research is needed to perfect, correct and

  3. Lung-MAP Clinical Trial

    Cancer.gov

    A collection of material about the Lung-MAP study, which will examine treatment outcomes for patients with squamous cell lung cancer assigned to different targeted drugs based on the results of genomic tumor profiling.

  4. Seniors' Lungs Can Tackle Exercise

    MedlinePlus

    ... news/fullstory_167082.html Seniors' Lungs Can Tackle Exercise Researchers find older adults' respiratory systems keep up ... News) If seniors want to start a vigorous exercise program, there's a good chance their lungs can ...

  5. Lung Cancer Rates by State

    MedlinePlus

    ... HPV-Associated Ovarian Prostate Skin Uterine Cancer Home Lung Cancer Rates by State Language: English Español (Spanish) ... incidence data are currently available. Rates of Getting Lung Cancer by State The number of people who ...

  6. National Lung Screening Trial (NLST)

    Cancer.gov

    The National Lung Screening Trial (NLST), a research study sponsored by the National Cancer Institute that used low-dose helical CT scans or chest X-ray to screen men and women at risk for lung cancer.

  7. The ALCHEMIST Lung Cancer Trial

    Cancer.gov

    A collection of material about the ALCHEMIST lung cancer trial that will examine tumor tissue from patients with early-stage, completely resected lung cancer for gene mutations in the EGFR and ALK genes, and a

  8. What Are Lung Function Tests?

    MedlinePlus

    ... COPD How the Lungs Work Idiopathic Pulmonary Fibrosis Sarcoidosis Send a link to NHLBI to someone by ... the Lungs Work Idiopathic Pulmonary Fibrosis Oxygen Therapy Sarcoidosis Stress Testing Rate This Content: Updated: December 9, ...

  9. Small Cell Lung Cancer

    PubMed Central

    Kalemkerian, Gregory P.; Akerley, Wallace; Bogner, Paul; Borghaei, Hossein; Chow, Laura QM; Downey, Robert J.; Gandhi, Leena; Ganti, Apar Kishor P.; Govindan, Ramaswamy; Grecula, John C.; Hayman, James; Heist, Rebecca Suk; Horn, Leora; Jahan, Thierry; Koczywas, Marianna; Loo, Billy W.; Merritt, Robert E.; Moran, Cesar A.; Niell, Harvey B.; O’Malley, Janis; Patel, Jyoti D.; Ready, Neal; Rudin, Charles M.; Williams, Charles C.; Gregory, Kristina; Hughes, Miranda

    2013-01-01

    Neuroendocrine tumors account for approximately 20% of lung cancers; most (≈15%) are small cell lung cancer (SCLC). These NCCN Clinical Practice Guidelines in Oncology for SCLC focus on extensive-stage SCLC because it occurs more frequently than limited-stage disease. SCLC is highly sensitive to initial therapy; however, most patients eventually die of recurrent disease. In patients with extensive-stage disease, chemotherapy alone can palliate symptoms and prolong survival in most patients; however, long-term survival is rare. Most cases of SCLC are attributable to cigarette smoking; therefore, smoking cessation should be strongly promoted. PMID:23307984

  10. Small cell lung cancer.

    PubMed

    Kalemkerian, Gregory P; Akerley, Wallace; Bogner, Paul; Borghaei, Hossein; Chow, Laura Qm; Downey, Robert J; Gandhi, Leena; Ganti, Apar Kishor P; Govindan, Ramaswamy; Grecula, John C; Hayman, James; Heist, Rebecca Suk; Horn, Leora; Jahan, Thierry; Koczywas, Marianna; Loo, Billy W; Merritt, Robert E; Moran, Cesar A; Niell, Harvey B; O'Malley, Janis; Patel, Jyoti D; Ready, Neal; Rudin, Charles M; Williams, Charles C; Gregory, Kristina; Hughes, Miranda

    2013-01-01

    Neuroendocrine tumors account for approximately 20% of lung cancers; most (≈15%) are small cell lung cancer (SCLC). These NCCN Clinical Practice Guidelines in Oncology for SCLC focus on extensive-stage SCLC because it occurs more frequently than limited-stage disease. SCLC is highly sensitive to initial therapy; however, most patients eventually die of recurrent disease. In patients with extensive-stage disease, chemotherapy alone can palliate symptoms and prolong survival in most patients; however, long-term survival is rare. Most cases of SCLC are attributable to cigarette smoking; therefore, smoking cessation should be strongly promoted.

  11. Radiotherapy for lung cancer

    SciTech Connect

    Bleehen, N.M.; Cox, J.D.

    1985-05-01

    The role of radiation therapy in the management of lung cancer was reviewed at a workshop held in Cambridge, England, in June 1984. It was concluded that there was a continuing role for radiation therapy in the primary management of small cell lung cancer, including the loco-regional treatment for patients with limited disease. Radical radiotherapy for patients with non-small cell carcinoma could be curative for a proportion of patients with limited disease. Careful planning and quality control was essential. Palliative radiotherapy provided useful treatment for many other patients. Other related aspects of treatment are also presented.

  12. Poverty and lung health.

    PubMed

    Rusen, I D; Squire, S Bertel; Billo, Nils E

    2010-04-01

    The International Union Against Tuberculosis and Lung Disease (The Union) held its 40th World Conference on Lung Health in Cancun, Mexico, between 3 and 7 December 2009. It was attended by over 2000 delegates from 104 countries around the world. The conference featured four stimulating plenary sessions and an extensive selection of scientific symposia. A total of 1125 abstracts were also presented from five broad categories: clinical trials and TB basic science, clinical research for treatment and care, epidemiology, education, advocacy and social issues, and policy and program implementation. In addition, the conference was preceded by a series of well-attended postgraduate courses and workshops.

  13. Lung Ablation: Whats New?

    PubMed

    Xiong, Lillian; Dupuy, Damian E

    2016-07-01

    Lung cancer had an estimated incidence of 221,200 in 2015, making up 13% of all cancer diagnoses. Tumor ablation is an important treatment option for nonsurgical lung cancer and pulmonary metastatic patients. Radiofrequency ablation has been used for over a decade with newer modalities, microwave ablation, cryoablation, and irreversible electroporation presenting as additional and possibly improved treatment options for patients. This minimally invasive therapy is best for small primary lesions or favorably located metastatic tumors. These technologies can offer palliation and sometimes cure of thoracic malignancies. This article discusses the current available technologies and techniques available for tumor ablation.

  14. Heliox attenuates lung inflammation and structural alterations in acute lung injury.

    PubMed

    Nawab, Ursula S; Touch, Suzanne M; Irwin-Sherman, Tami; Blackson, Thomas J; Greenspan, Jay S; Zhu, Guangfa; Shaffer, Thomas H; Wolfson, Marla R

    2005-12-01

    Low-density gas mixtures, such as heliox, were shown to reduce the work of breathing and facilitate the distribution of inspired gas. Since supplemental ventilatory and oxygen requirements may lead to pulmonary inflammation and structural alterations, we hypothesized that by reducing these requirements, heliox breathing may attenuate the acute inflammatory and structural changes associated with acute lung injury. Spontaneously breathing neonatal pigs were anesthetized, instrumented, supported with continuous positive airway pressure (CPAP), injured with oleic acid, and randomized to nitrox (n = 6) or heliox (n = 5).F(I)O(2) was titrated for pulse oximetry (SpO(2)) 95 +/- 2% for 4 hr. Gas exchange and pulmonary mechanics were measured. Lungs were analyzed for myeloperoxidase (MPO), interleukin-8 (IL-8), and histomorphometery. Relationships between physiologic indices and cumulative lung structure and inflammatory indices were evaluated. With heliox, compliance was significantly greater, while tidal volume, frequency, minute ventilation, F(I)O(2), arterial carbon dioxide tension (PaCO(2)), MPO, and IL-8 were significantly lower compared to nitrox. The expansion index and number of exchange units were significantly greater with heliox, while the exchange unit area (EUA) was smaller. MPO was significantly and positively correlated with F(I)O(2) (r = 0.76) and EUA (r = 0.63), and negatively correlated with number of open exchange units/field (r = -0.73). Compared to breathing nitrox, these data indicate that heliox improved the distribution of inspired gas, thereby recruiting more gas exchange units, improving gas exchange efficiency, reducing ventilatory and oxygen requirements, and attenuating lung inflammation. These data suggest that heliox breathing may have the combined therapeutic benefits of attenuating lung inflammation by reducing mechanical and oxidative stress in the clinical management of acute lung injury. (c) 2005 Wiley-Liss, Inc.

  15. Current and future molecular diagnostics in non-small-cell lung cancer.

    PubMed

    Li, Chun Man; Chu, Wing Ying; Wong, Di Lun; Tsang, Hin Fung; Tsui, Nancy Bo Yin; Chan, Charles Ming Lok; Xue, Vivian Wei Wen; Siu, Parco Ming Fai; Yung, Benjamin Yat Ming; Chan, Lawrence Wing Chi; Wong, Sze Chuen Cesar

    2015-01-01

    The molecular investigation of lung cancer has opened up an advanced area for the diagnosis and therapeutic management of lung cancer patients. Gene alterations in cancer initiation and progression provide not only information on molecular changes in lung cancer but also opportunities in advanced therapeutic regime by personalized targeted therapy. EGFR mutations and ALK rearrangement are important predictive biomarkers for the efficiency of tyrosine kinase inhibitor treatment in lung cancer patients. Moreover, epigenetic aberration and microRNA dysregulation are recent advances in the early detection and monitoring of lung cancer. Although a wide range of molecular tests are available, standardization and validation of assay protocols are essential for the quality of the test outcome. In this review, current and new advancements of molecular biomarkers for non-small-cell lung cancer will be discussed. Recommendations on future development of molecular diagnostic services will also be explored.

  16. Open Smart Energy Gateway (OpenSEG)

    SciTech Connect

    2014-09-01

    The Open Smart Energy Gateway (OpenSEG) aims to provide near-real time smart meter data to consumers without the delays or latencies associated with it being transported to the utility data center and then back to the consumer's application. To do this, the gateway queries the local Smart Meter to which it is bound to get energy consumption information at pre-defined intervals (minimum interval is 4 seconds). OpenSEG then stores the resulting data internally for retrieval by an external application.

  17. Lung Mechanics in Marine Mammals

    DTIC Science & Technology

    2012-09-30

    lung mechanics in vivo during spontaneous breathing (dynamic) and mechanical ventilation (static), and the static compliance of the excised lung after...to depth. Physiological Zoology, 1982. 55(1): p. 105-111. 6. Fahlman, A., et al., Estimating the effect of lung collapse and pulmonary shunt on gas...1 DISTRIBUTION STATEMENT A. Approved for public release; distribution is unlimited. Lung Mechanics in Marine Mammals Andreas Fahlman

  18. Quantitative assessment of lung microstructure in healthy mice using an MR-based 3He lung morphometry technique

    PubMed Central

    Osmanagic, E.; Sukstanskii, A. L.; Quirk, J. D.; Woods, J. C.; Pierce, R. A.; Conradi, M. S.; Weibel, E. R.

    2010-01-01

    The recently developed technique of lung morphometry using hyperpolarized 3He diffusion magnetic resonance (MR) (Yablonskiy DA, Sukstanskii AL, Woods JC, Gierada DS, Quirk JD, Hogg JC, Cooper JD, Conradi MS. J Appl Physiol 107: 1258–1265, 2009) permits in vivo study of lung microstructure at the alveolar level. Originally proposed for human lungs, it also has the potential to study small animals. The technique relies on theoretical developments in the area of gas diffusion in lungs linking the diffusion attenuated MR signal to the lung microstructure. To adapt this technique to small animals, certain modifications in MR protocol and data analysis are required, reflecting the smaller size of mouse alveoli and acinar airways. This is the subject of the present paper. Herein, we established empirical relationships relating diffusion measurements to geometrical parameters of lung acinar airways with dimensions typical for mice and rats by using simulations of diffusion in the airways. We have also adjusted the MR protocol to acquire data with much shorter diffusion times compared with humans to accommodate the substantially smaller acinar airway length. We apply this technique to study mouse lungs ex vivo. Our MR-based measurements yield mean values of lung surface-to-volume ratio of 670 cm−1, alveolar density of 3,200 per mm3, alveolar depth of 55 μm, and mean chord length of 62 μm, all consistent with published data obtained histologically in mice by unbiased methods. The proposed technique can be used for in vivo experiments, opening a door for longitudinal studies of lung morphometry in mice and other small animals. PMID:20798272

  19. Non-surgical intratracheal instillation of mice with analysis of lungs and lung draining lymph nodes by flow cytometry.

    PubMed

    Rayamajhi, Manira; Redente, Elizabeth F; Condon, Tracy V; Gonzalez-Juarrero, Mercedes; Riches, David W H; Lenz, Laurel L

    2011-05-02

    Phagocytic cells such as alveolar macrophages and lung dendritic cells (LDCs) continuously sample antigens from the alveolar spaces in the lungs. LDCs, in particular, are known to migrate to the lung draining lymph nodes (LDLNs) where they present inhaled antigens to T cells initiating an appropriate immune response to a variety of immunogens. To model interactions between the lungs and airborne antigens in mice, antigens can be administered intranasally, intratracheally or as aerosols. Delivery by each route involves distinct technical skills and limitations that need to be considered before designing an experiment. For example, intranasal and aerosolized exposure delivers antigens to both the lungs and the upper respiratory tract. Hence antigens can access the nasal associated lymphoid tissue (NALT), potentially complicating interpretation of the results. In addition, swallowing, sneezing and the breathing rate of the mouse may also lead to inconsistencies in the doses delivered. Although the involvement of the upper respiratory tract may be preferred for some studies, it can complicate experiments focusing on events specifically initiated in the lungs. In this setting, the intratracheal (i.t) route is preferable as it delivers test materials directly into the lungs and bypasses the NALT. Many i.t injection protocols involve either blind intubation of the trachea through the oral cavity or surgical exposure of the trachea to access the lungs. Herein, we describe a simple, consistent, non-surgical method for i.t instillation. The opening of the trachea is visualized using a laryngoscope and a bent gavage needle is then inserted directly into the trachea to deliver the innoculum. We also describe procedures for harvesting and processing of LDLNs and lungs for analysis of antigen trafficking by flow cytometry. Copyright © 2011 Journal of Visualized Experiments

  20. Functional disability and quality of life decrements in mental disorders: Results from the Mental Health Module of the German Health Interview and Examination Survey for Adults (DEGS1-MH).

    PubMed

    Mack, Simon; Jacobi, Frank; Beesdo-Baum, Katja; Gerschler, Anja; Strehle, Jens; Höfler, Michael; Busch, Markus A; Maske, Ulrike; Hapke, Ulfert; Gaebel, Wolfgang; Zielasek, Jürgen; Maier, Wolfgang; Wittchen, Hans-Ulrich

    2015-09-01

    This paper provides nationally representative data on how current and past mental disorders are related to functional disability and health-related quality of life (QoL). Results are based on a nationally representative sample (DEGS1-MH; n=4483 aged 18-79). Respondents were examined by clinical interviewers with the DSM-IV Composite International Diagnostic Interview (DIA-X/M-CIDI). Functional disability, i.e. number of disability days in the past 4weeks, and QoL, i.e. mental (MCS) and physical (PCS) component scale of the SF-36V2, were examined in subjects with 12-month mental disorders (=active cases [AC]) and compared to (a) subjects who never met diagnostic criteria (=unaffected individuals [UAI]), and (b) those with a history of mental disorders but not meeting the diagnostic criteria in the past 12months (=non-active cases [NAC]; partially or fully remitted). In comparison to UAI (mean: 1.9), AC reveals a 2-3 fold disability days/month (5.4, P<.001) and a substantially reduced MCS (UAI: 52.1; AC: 43.3, P<.001). NAC had a similar number of disability days as UAI, but significantly reduced MCS scores (49.9; P<.001). Disability days and QoL decrements were highest in internalizing disorders including somatoform disorders and most pronounced in comorbid cases. By and large, findings of a previous study were confirmed and extended for this nationally representative German sample. 12-month mental disorders, particularly internalizing, including somatoform disorders, are associated with high levels of disability and increased health-related QoL decrements. Partial or complete remission of the mental disorders is associated with a normalization of the numbers of disability days. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  1. Environmental radiation and the lung

    PubMed Central

    Hamrick, Philip E.; Walsh, Phillip J.

    1974-01-01

    Environmental sources of radioactive materials and their relation to lung doses and lung burdens are described. The approaches used and the problems encountered in estimating lung doses are illustrated. Exposure to radon daughter products is contrasted to exposure to plutonium as particular examples of the hazards associated with radioactive materials of different chemical and physical characteristics. PMID:4620334

  2. [Lung auscultation--an overview].

    PubMed

    Bürgi, Urs; Huber, Lars Christian

    2015-07-01

    The auscultation of the lungs is - among anamnesis - the most important part in the assessment of patients presenting with pulmonary symptoms. The lung auscultation is reproducible, cost efficient and very helpful to distinguish between differential diagnoses, in particular in emergency situations. Detection and description of lung sounds requires experience and should be performed by strict adherence to the internationally accepted terminology.

  3. Gallbladder removal - open

    MedlinePlus

    ... the surgeon needs to switch to an open surgery if laparoscopic surgery cannot be successfully continued. Other reasons for removing the gallbladder by open surgery: Unexpected bleeding during the laparoscopic operation Obesity Pancreatitis (inflammation in the pancreas) Pregnancy ( ...

  4. Respiratory compliance but not gas exchange correlates with changes in lung aeration after a recruitment maneuver: an experimental study in pigs with saline lavage lung injury

    PubMed Central

    Henzler, Dietrich; Pelosi, Paolo; Dembinski, Rolf; Ullmann, Annette; Mahnken, Andreas H; Rossaint, Rolf; Kuhlen, Ralf

    2005-01-01

    Introduction Atelectasis is a common finding in acute lung injury, leading to increased shunt and hypoxemia. Current treatment strategies aim to recruit alveoli for gas exchange. Improvement in oxygenation is commonly used to detect recruitment, although the assumption that gas exchange parameters adequately represent the mechanical process of alveolar opening has not been proven so far. The aim of this study was to investigate whether commonly used measures of lung mechanics better detect lung tissue collapse and changes in lung aeration after a recruitment maneuver as compared to measures of gas exchange Methods In eight anesthetized and mechanically ventilated pigs, acute lung injury was induced by saline lavage and a recruitment maneuver was performed by inflating the lungs three times with a pressure of 45 cmH2O for 40 s with a constant positive end-expiratory pressure of 10 cmH2O. The association of gas exchange and lung mechanics parameters with the amount and the changes in aerated and nonaerated lung volumes induced by this specific recruitment maneuver was investigated by multi slice CT scan analysis of the whole lung. Results Nonaerated lung correlated with shunt fraction (r = 0.68) and respiratory system compliance (r = 0.59). The arterial partial oxygen pressure (PaO2) and the respiratory system compliance correlated with poorly aerated lung volume (r = 0.57 and 0.72, respectively). The recruitment maneuver caused a decrease in nonaerated lung volume, an increase in normally and poorly aerated lung, but no change in the distribution of a tidal breath to differently aerated lung volumes. The fractional changes in PaO2, arterial partial carbon dioxide pressure (PaCO2) and venous admixture after the recruitment maneuver did not correlate with the changes in lung volumes. Alveolar recruitment correlated only with changes in the plateau pressure (r = 0.89), respiratory system compliance (r = 0.82) and parameters obtained from the pressure-volume curve

  5. Open Rotor Development

    NASA Technical Reports Server (NTRS)

    Van Zante, Dale E.; Rizzi, Stephen A.

    2016-01-01

    The ERA project executed a comprehensive test program for Open Rotor aerodynamic and acoustic performance. System studies used the data to estimate the fuel burn savings and acoustic margin for an aircraft system with open rotor propulsion. The acoustic measurements were used to produce an auralization that compares the legacy blades to the current generation of open rotor designs.

  6. Openness as infrastructure

    PubMed Central

    2011-01-01

    The advent of open access to peer reviewed scholarly literature in the biomedical sciences creates the opening to examine scholarship in general, and chemistry in particular, to see where and how novel forms of network technology can accelerate the scientific method. This paper examines broad trends in information access and openness with an eye towards their applications in chemistry. PMID:21999327

  7. In Brief: Open government

    NASA Astrophysics Data System (ADS)

    Showstack, Randy

    2010-03-01

    U.S. President Barack Obama's Memorandum on Transparency and Open Government requires federal agencies to take steps toward increased transparency, public participation, and collaboration. Agencies are accepting suggestions until 19 March 2010. For more information, visit http://www.whitehouse.gov/open and http://www.usa.gov/webcontent/open/tool_poc.shtml.

  8. Open Access Alternatives

    ERIC Educational Resources Information Center

    Tenopir, Carol

    2004-01-01

    Open access publishing is a hot topic today. But open access publishing can have many different definitions, and pros and cons vary with the definitions. Open access publishing is especially attractive to companies and small colleges or universities that are likely to have many more readers than authors. A downside is that a membership fee sounds…

  9. Asian Open Universities.

    ERIC Educational Resources Information Center

    Hill, John

    1983-01-01

    The appearance of open universities in Asia is of interest to Australian educators, particularly since the Asian institutions differ in some respects from the British model which combined open entry to all and extensively employed the electronic media. The Asian Open Universities have provided access to higher education for many. (SSH)

  10. Particles causing lung disease

    SciTech Connect

    Kilburn, K.H.

    1984-04-01

    The lung has a limited number of patterns of reaction to inhaled particles. The disease observed depends upon the location: conducting airways, terminal bronchioles and alveoli, and upon the nature of inflammation induced: acute, subacute or chronic. Many different agents cause narrowing of conducting airways (asthma) and some of these cause permanent distortion or obliteration of airways as well. Terminal bronchioles appear to be particularly susceptible to particles which cause goblet cell metaplasia, mucous plugging and ultimately peribronchiolar fibrosis. Cancer is the last outcome at the bronchial level and appears to depend upon continuous exposure to or retention of an agent in the airway and failure of the affected cells to be exfoliated which may be due to squamous metaplasia. Alveoli are populated by endothelial cells, Type I or pavement epithelial cells and metabolically active cuboidal Type II cells that produce the lungs specific surfactant, dipalmytol lecithin. Disturbances of surfactant lead to edema in distal lung while laryngeal edema due to anaphylaxis or fumes may produce asphyxia. Physical retention of indigestible particles or retention by immune memory responses may provoke hyaline membranes, stimulate alveolar lipoproteinosis and finally fibrosis. This later exuberant deposition of connective tissue has been best studied in the occupational pneumoconioses especially silicosis and asbestosis. In contrast emphysema a catabolic response appears frequently to result from leakage or release of lysosomal proteases into the lung during processing of cigarette smoke particles. 164 references, 1 figure, 2 tables.

  11. Lung Cancer Brain Metastases.

    PubMed

    Goldberg, Sarah B; Contessa, Joseph N; Omay, Sacit B; Chiang, Veronica

    2015-01-01

    Brain metastases are common among patients with lung cancer and have been associated with significant morbidity and limited survival. However, the treatment of brain metastases has evolved as the field has advanced in terms of central nervous system imaging, surgical technique, and radiotherapy technology. This has allowed patients to receive improved treatment with less toxicity and more durable benefit. In addition, there have been significant advances in systemic therapy for lung cancer in recent years, and several treatments including chemotherapy, targeted therapy, and immunotherapy exhibit activity in the central nervous system. Utilizing systemic therapy for treating brain metastases can avoid or delay local therapy and often allows patients to receive effective treatment for both intracranial and extracranial disease. Determining the appropriate treatment for patients with lung cancer brain metastases therefore requires a clear understanding of intracranial disease burden, tumor histology, molecular characteristics, and overall cancer prognosis. This review provides updates on the current state of surgery and radiotherapy for the treatment of brain metastases, as well as an overview of systemic therapy options that may be effective in select patients with intracranial metastases from lung cancer.

  12. Lung transplant - slideshow

    MedlinePlus

    ... anatomy URL of this page: //medlineplus.gov/ency/presentations/100120.htm Lung transplant - series—Normal anatomy To use the sharing features on this page, please enable JavaScript. Go to slide 1 out of 5 Go to slide 2 ...

  13. Stereology of the lung.

    PubMed

    Schneider, Jan Philipp; Ochs, Matthias

    2013-01-01

    Many scientific projects require a quantitative assessment of organ, tissue and cell (ultra)structure. Such quantitative (morphometric) data are essential to make statistically valid comparisons between experimental groups. The structures of interest are measured at different microscopic levels. However, measurements in microscopy pose two problems: 1) Only a small fraction of the whole biological system can be analyzed (sampling problem). 2) The analysis is performed on nearly two-dimensional (physical, optical or virtual) sections through the object although the aim is to obtain biologically meaningful three-dimensional data (3D vs 2D problem). These problems are solved by the application of unbiased sampling and measurement tools known as stereology. This chapter gives a brief introduction to the theory and practical application of stereology, using the lung as an example. Stereological tools needed to quantify volume, number and surface area are introduced and examples are given how to estimate total lung volume, volume of lung parenchyma, alveolar surface area and number of alveolar epithelial type II cells per lung.

  14. An amyloid lung

    PubMed Central

    Zundel, W. E.; Prior, A. P.

    1971-01-01

    A 55-year-old housewife died from an illness characterized by progressive respiratory incapacity. Changes were confined to the lungs and consisted of a diffuse infiltration by amyloid. No adequate cause was found for this amyloid, and we suggest that this is a case of primary alveolar septal amyloidosis. Images PMID:5559913

  15. Agenesis of the lung.

    PubMed

    Sbokos, C G; McMillan, I K

    1977-07-01

    Agenesis of the lung is rare. The cases of ten patients with this malformation are recorded and illustrated. Most had congenital malformation of other organs, especially the heart, as well. All had hypoplasia of the pulmonary artery or its branches. A pantaloon-like appearance of the trachea and the main bronchi on the bronchograms is described. Exercise tolerance was impaired in all patients.

  16. Chemoprevention of Lung Cancer

    PubMed Central

    Szabo, Eva; Mao, Jenny T.; Lam, Stephen; Reid, Mary E.

    2013-01-01

    Background: Lung cancer is the most common cause of cancer death in men and women in the United States. Cigarette smoking is the main risk factor. Former smokers are at a substantially increased risk of developing lung cancer compared with lifetime never smokers. Chemoprevention refers to the use of specific agents to reverse, suppress, or prevent the process of carcinogenesis. This article reviews the major agents that have been studied for chemoprevention. Methods: Articles of primary, secondary, and tertiary prevention trials were reviewed and summarized to obtain recommendations. Results: None of the phase 3 trials with the agents β-carotene, retinol, 13-cis-retinoic acid, α-tocopherol, N-acetylcysteine, acetylsalicylic acid, or selenium has demonstrated beneficial and reproducible results. To facilitate the evaluation of promising agents and to lessen the need for a large sample size, extensive time commitment, and expense, surrogate end point biomarker trials are being conducted to assist in identifying the most promising agents for later-stage chemoprevention trials. With the understanding of important cellular signaling pathways and the expansion of potentially important targets, agents (many of which target inflammation and the arachidonic acid pathway) are being developed and tested which may prevent or reverse lung carcinogenesis. Conclusions: By integrating biologic knowledge, additional early-phase trials can be performed in a reasonable time frame. The future of lung cancer chemoprevention should entail the evaluation of single agents or combinations that target various pathways while working toward identification and validation of intermediate end points. PMID:23649449

  17. Bridging to lung transplantation for severe pulmonary hypertension using dual central Novalung lung assist devices.

    PubMed

    Mayes, Jonathan; Niranjan, Gunaratnam; Dark, John; Clark, Stephen

    2016-05-01

    This case describes the technique of using dual Novalungs (a pumpless extracorporeal system) to bridge a patient with idiopathic pulmonary hypertension to bilateral lung transplantation. A 41-year old lady with idiopathic pulmonary hypertension (with a possible veno-occlusive element) presented with symptoms of end-stage heart and lung failure. This was refractory to medical management with iloprost, sildenafil and bosentan. The patient was placed on the urgent waiting list for lung transplantation and central pulmonary artery to left atrial Novalung insertion was performed. Local anaesthetic was given before performing peripheral cardiopulmonary bypass due to the high risk of cardiac arrest. Two days later, donor organs became available and the patient was taken for double-lung transplantation. The pulmonary artery cannula was removed leaving a large defect. This was then closed using a bovine pericardial patch. Due to the damaged right superior pulmonary vein from Novalung cannulation, cardioplegia was given to facilitate an open atrial anastomosis. After 13 days in the intensive therapy unit, she was transferred to the ward. There were no further complications and she has been discharged home.

  18. The influence of polycyclic aromatic hydrocarbons on lung function in a representative sample of the Canadian population.

    PubMed

    Cakmak, Sabit; Hebbern, Chris; Cakmak, Jasmine D; Dales, Robert E

    2017-09-01

    We investigated the associations between exposure to polycyclic aromatic hydrocarbons (PAHs) and selected respiratory physiologic measures in cycles 2 and 3 of the Canadian Health Measures Survey, a nationally representative population sample. Using generalized linear mixed models, we tested the association between selected PAH metabolites and 1-second forced expiratory volume (FEV1), forced vital capacity (FVC), and the ratio between the two (FEV1/FVC) in 3531 people from 6 to 79 years of age. An interquartile change in urinary PAH metabolite was associated with significant decrements in FEV1 and FVC for eight PAHs, 2-hydroxynapthalene, 1-, and 2-hydroxyphenanthrene, 2-, 3-, and 9-hydroxyfluorene and 3- and 4-hydroxyphenanthrene. Exposure to PAH may negatively affect lung function in the Canadian population. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

  19. Automated lung segmentation in digital chest tomosynthesis

    PubMed Central

    Wang, Jiahui; Dobbins, James T.; Li, Qiang

    2012-01-01

    Purpose: The purpose of this study was to develop an automated lung segmentation method for computerized detection of lung nodules in digital chest tomosynthesis. Methods: The authors collected 45 digital tomosynthesis scans and manually segmented reference lung regions in each scan to assess the performance of the method. The authors automated the technique by calculating the edge gradient in an original image for enhancing lung outline and transforming the edge gradient image to polar coordinate space. The authors then employed a dynamic programming technique to delineate outlines of the unobscured lungs in the transformed edge gradient image. The lung outlines were converted back to the original image to provide the final segmentation result. The above lung segmentation algorithm was first applied to the central reconstructed tomosynthesis slice because of the absence of ribs overlapping lung structures. The segmented lung in the central slice was then used to guide lung segmentation in noncentral slices. The authors evaluated the segmentation method by using (1) an overlap rate of lung regions, (2) a mean absolute distance (MAD) of lung borders, (3) a Hausdorff distance of lung borders between the automatically segmented lungs and manually segmented reference lungs, and (4) the fraction of nodules included in the automatically segmented lungs. Results: The segmentation method achieved mean overlap rates of 85.7%, 88.3%, and 87.0% for left lungs, right lungs, and entire lungs, respectively; mean MAD of 4.8, 3.9, and 4.4 mm for left lungs, right lungs, and entire lungs, respectively; and mean Hausdorrf distance of 25.0 mm, 25.5 mm, and 30.1 mm for left lungs, right lungs, and entire lungs, respectively. All of the nodules inside the reference lungs were correctly included in the segmented lungs obtained with the lung segmentation method. Conclusions: The method achieved relatively high accuracy for lung segmentation and will be useful for computer-aided detection

  20. Fluorometry of ischemia reperfusion injury in rat lungs in vivo

    NASA Astrophysics Data System (ADS)

    Sepehr, R.; Staniszewski, K.; Jacobs, E. R.; Audi, S.; Ranji, Mahsa

    2013-02-01

    Previously we demonstrated the utility of optical fluorometry to evaluate lung tissue mitochondrial redox state in isolated perfused rats lungs under various chemically-induced respiratory states. The objective of this study was to evaluate the effect of acute ischemia on lung tissue mitochondrial redox state in vivo using optical fluorometry. Under ischemic conditions, insufficient oxygen supply to the mitochondrial chain should reduce the mitochondrial redox state calculated from the ratio of the auto-fluorescent mitochondrial metabolic coenzymes NADH (Nicotinamide Adenine Dinucleotide) and FAD (Flavoprotein Adenine Dinucleotide). The chest of anesthetized, and mechanically ventilated Sprague-Dawley rat was opened to induce acute ischemia by clamping the left hilum to block both blood flow and ventilation to one lung for approximately 10 minutes. NADH and FAD fluorescent signals were recorded continuously in a dark room via a fluorometer probe placed on the pleural surface of the left lung. Acute ischemia caused a decrease in FAD and an increase in NADH, which resulted in an increase in the mitochondrial redox ratio (RR=NADH/FAD). Restoration of blood flow and ventilation by unclamping the left hilum returned the RR back to its baseline. These results (increase in RR under ischemia) show promise for the fluorometer to be used in a clinical setting for evaluating the effect of pulmonary ischemia-reperfusion on lung tissue mitochondrial redox state in real time.

  1. Pulmonary hypertension in chronic obstructive and interstitial lung diseases.

    PubMed

    Andersen, Charlotte U; Mellemkjær, Søren; Nielsen-Kudsk, Jens Erik; Bendstrup, Elisabeth; Hilberg, Ole; Simonsen, Ulf

    2013-10-03

    The purpose of the present review is to summarize the current knowledge on PH in relation to COPD and ILD from a clinical perspective with emphasis on diagnosis, biomarkers, prevalence, impact, treatment, and practical implications. PH in COPD and ILD is associated with a poor prognosis, and is considered one of the most frequent types of PH. However, the prevalence of PH among patients with COPD and ILD is not clear. The diagnosis of PH in chronic lung disease is often established by echocardiographic screening, but definitive diagnosis requires right heart catheterization, which is not systematically performed in clinical practice. Given the large number of patients with chronic lung disease, biomarkers to preclude or increase suspicion of PH are needed. NT-proBNP may be used as a rule-out test, but biomarkers with a high specificity for PH are still required. It is not known whether specific treatment with existent drugs effective in pulmonary arterial hypertension (PAH) is beneficial in lung disease related PH. Studies investigating existing PAH drugs in animal models of lung disease related PH have indicated a positive effect, and so have case reports and open label studies. However, treatment with systemically administered pulmonary vasodilators implies the risk of worsening the ventilation-perfusion mismatch in patients with lung disease. Inhaled vasodilators may be better suited for PH in lung disease, but new treatment modalities are also required.

  2. Visual anatomical lung CT scan assessment of lung recruitability.

    PubMed

    Chiumello, Davide; Marino, Antonella; Brioni, Matteo; Menga, Federica; Cigada, Irene; Lazzerini, Marco; Andrisani, Maria C; Biondetti, Pietro; Cesana, Bruno; Gattinoni, Luciano

    2013-01-01

    The computation of lung recruitability in acute respiratory distress syndrome (ARDS) is advocated to set positive end-expiratory pressure (PEEP) for preventing lung collapse. The quantitative lung CT scan, obtained by manual image processing, is the reference method but it is time consuming. The aim of this study was to evaluate the accuracy of a visual anatomical analysis compared with a quantitative lung CT scan analysis in assessing lung recruitability. Fifty sets of two complete lung CT scans of ALI/ARDS patients computing lung recruitment were analyzed. Lung recruitability computed at an airway pressure of 5 and 45 cm H(2)O was defined as the percentage decrease in the collapsed/consolidated lung parenchyma assessed by two expert radiologists using a visual anatomical analysis and as the decrease in not aerated lung regions using a quantitative analysis computed by dedicated software. Lung recruitability was 11.3 % (interquartile range 7.39-16.41) and 15.5 % (interquartile range 8.18-21.43) with the visual anatomical and quantitative analysis, respectively. In the Bland-Altman analysis, the bias and agreement bands between the visual anatomical and quantitative analysis were -2.9 % (-11.8 to +5.9 %). The ROC curve showed that the optimal cutoff values for the visual anatomical analysis in predicting high versus low lung recruitability was 8.9 % (area under the ROC curve 0.9248, 95 % CI 0.8550-0.9946). Considering this cutoff, the sensitivity, specificity, and diagnostic accuracy were 0.96, 0.76, and 0.86, respectively. Visual anatomical analysis can classify patients into those with high and low lung recruitability allowing more intensivists to get access to lung recruitability assessment.

  3. Lung Volumes and Emphysema in Smokers with Interstitial Lung Abnormalities

    PubMed Central

    Washko, George R.; Hunninghake, Gary M.; Fernandez, Isis E.; Nishino, Mizuki; Okajima, Yuka; Yamashiro, Tsuneo; Ross, James C.; Estépar, Raúl San José; Lynch, David A.; Brehm, John M.; Andriole, Katherine P.; Diaz, Alejandro A.; Khorasani, Ramin; D’Aco, Katherine; Sciurba, Frank C.; Silverman, Edwin K.; Hatabu, Hiroto; Rosas, Ivan O.

    2011-01-01

    BACKGROUND Cigarette smoking is associated with emphysema and radiographic interstitial lung abnormalities. The degree to which interstitial lung abnormalities are associated with reduced total lung capacity and the extent of emphysema is not known. METHODS We looked for interstitial lung abnormalities in 2416 (96%) of 2508 high-resolution computed tomographic (HRCT) scans of the lung obtained from a cohort of smokers. We used linear and logistic regression to evaluate the associations between interstitial lung abnormalities and HRCT measurements of total lung capacity and emphysema. RESULTS Interstitial lung abnormalities were present in 194 (8%) of the 2416 HRCT scans evaluated. In statistical models adjusting for relevant covariates, interstitial lung abnormalities were associated with reduced total lung capacity (−0.444 liters; 95% confidence interval [CI], −0.596 to −0.292; P<0.001) and a lower percentage of emphysema defined by lung-attenuation thresholds of −950 Hounsfield units (−3%; 95% CI, −4 to −2; P<0.001) and −910 Hounsfield units (−10%; 95% CI, −12 to −8; P<0.001). As compared with participants without interstitial lung abnormalities, those with abnormalities were more likely to have a restrictive lung deficit (total lung capacity <80% of the predicted value; odds ratio, 2.3; 95% CI, 1.4 to 3.7; P<0.001) and were less likely to meet the diagnostic criteria for chronic obstructive pulmonary disease (COPD) (odds ratio, 0.53; 95% CI, 0.37 to 0.76; P<0.001). The effect of interstitial lung abnormalities on total lung capacity and emphysema was dependent on COPD status (P<0.02 for the interactions). Interstitial lung abnormalities were positively associated with both greater exposure to tobacco smoke and current smoking. CONCLUSIONS In smokers, interstitial lung abnormalities — which were present on about 1 of every 12 HRCT scans — were associated with reduced total lung capacity and a lesser amount of emphysema. (Funded by the

  4. Part One: Open Access, Open Admissions, Open Warfare.

    ERIC Educational Resources Information Center

    Marshak, Robert E.; Wurtemburg, Gladys

    1981-01-01

    A view of events at City College of New York during the 1970s when an open admissions policy was initiated is discussed by the eighth president of the college. At CUNY, the objective was to provide remediation, counseling, and tutoring in order to maximize the possibility of success. (MLW)

  5. Lung cancer in Brazil.

    PubMed

    Algranti, E; Menezes, A M; Achutti, A C

    2001-04-01

    Lung cancer is the second leading cause of death in Brazil, after exclusion of external causes. Registries in the country are not reliable because of under-registration and limited coverage. Incidence rates for Brazil are less then half those for selected areas with good registries. Crude and adjusted incidence and mortality rates for lung cancer are rising, particularly among women. The main reason is the acceleration in tobacco consumption and the spread of smoking among women. At present, approximately 40% of men and 25% of women, 15 years of age or older, are current smokers. In the state of Rio Grande do Sul, where registries are reliable, incidence and mortality for males are similar to US data and the figures for women are rapidly approaching those for men. Occupations associated with risks of exposure to respiratory carcinogens show a rise in the incidence of lung cancer in the industrialized area of São Paulo. The main occupational risk in Brazil is exposure to mineral dusts, silica, or asbestos. Although about 15 million Brazilians are exposed to pesticides, agricultural workers were not a risk group for lung cancer in a case-control study. Pesticides containing arsenic and dichlorodiphenyltrichloroethane (DDT) are banned. In recent years, a trend towards a decrease in male smoking has been noted, but there is still a high tobacco exposure burden in both males and females, with a forecast of a further increase in rates of lung cancer incidence and deaths. Control of respiratory carcinogens at work continues to be a problem, particularly in the present scenario of economic and political pressures on Brazil and other developing nations. Semin Oncol 28:143-152. Copyright 2001 by W.B. Saunders Company.

  6. Dust exposure, respiratory symptoms, and longitudinal decline of lung function in young coal miners.

    PubMed Central

    Carta, P; Aru, G; Barbieri, M T; Avataneo, G; Casula, D

    1996-01-01

    OBJECTIVES: To study the role of dust exposure on incidence of respiratory symptoms and decline of lung function in young coal miners. METHODS: The loss of lung function (forced vital capacity (FVC), forced expiratory volume in one second (FEV1), forced expiratory flow (MEF), carbon monoxide transfer factor (TLCO)) with time and the incidence of respiratory symptoms in 909 Sardinian coal miners (followed up between 1983 and 1993 with seven separate surveys) has been compared with the past and current individual exposures to respirable mixed coal dust. Multiple linear and logistic regression models were used simultaneously controlling for age, smoking, past occupational exposures, and other relevant covariates. RESULTS: According to the relatively low dust exposures experienced during the follow up few abnormal chest x ray films were detected. In the cross sectional analysis of initial data, significant associations between individual cumulative exposure to dust, decrements in FEV1 and MEFs, and increasing prevalence of respiratory symptoms were detected after allowing for the covariates included in the model. The yearly decline of FVC, FEV1, and single breath carbon monoxide transfer factor (TLCO/VA) was still significantly related to the individual exposure to dust experienced during the follow up, even after allowing for age, smoking, initial cumulative exposure to dust, and initial level of each functional variable. In logistic models, dust exposure was a significant predictor of the onset of respiratory symptoms besides age and smoking. CONCLUSIONS: The results show that even moderate exposures to mixed coal dust, as in our study, significantly affect lung function and incidence of symptoms of underground miners. Although the frequency of chest x ray examination might be fixed at every three or four years, yearly measurements of lung function (spirometry, MEFs, and TLCO) are recommended for evaluation of the respiratory risk from the coal mine environment to

  7. Cyclooxygenase-2 deficiency exacerbates bleomycin-induced lung dysfunction but not fibrosis.

    PubMed

    Card, Jeffrey W; Voltz, James W; Carey, Michelle A; Bradbury, J Alyce; Degraff, Laura M; Lih, Fred B; Bonner, James C; Morgan, Daniel L; Flake, Gordon P; Zeldin, Darryl C

    2007-09-01

    Cyclooxygenase (COX)-derived eicosanoids have been implicated in the pathogenesis of pulmonary fibrosis. Uncertainty regarding the influence of COX-2 on experimental pulmonary fibrosis prompted us to clarify the fibrotic and functional effects of intratracheal bleomycin administration in mice genetically deficient in COX-2. Further, the effects of airway-specific COX-1 overexpression on fibrotic and functional outcomes in wild-type and COX-2 knockout mice were assessed. Equivalent increases in airway cell influx, lung collagen content, and histopathologic evidence of fibrosis were observed in wild-type and COX-2 knockout mice 21 d after bleomycin treatment, suggesting that COX-2 deficiency did not alter the extent or severity of fibrosis in this model. However, bleomycin-induced alterations in respiratory mechanics were more severe in COX-2 knockout mice than in wild-type mice, as illustrated by a greater decrease in static compliance compared with genotype-matched, saline-treated control mice (26 +/- 3% versus 11 +/- 4% decreases for COX-2 knockout and wild-type mice, respectively; P < 0.05). The influence of COX-1 overexpression in airway Clara cells was also examined. Whereas the fibrotic effects of bleomycin were not altered in wild-type or COX-2 knockout mice overexpressing COX-1, the exaggerated lung function decrement in bleomycin-treated COX-2 knockout mice was prevented by COX-1 overexpression and coincided with decreased airway cysteinyl leukotriene levels. Collectively, these data suggest an important regulatory role for COX-2 in the maintenance of lung function in the setting of lung fibrosis, but not in the progression of the fibrotic process per se.

  8. A brief update on lung stereology.

    PubMed

    Ochs, Matthias

    2006-06-01

    Lung stereology has a long and successful tradition. From mice to men, the application of new stereological methods at several levels (alveoli, parenchymal cells, organelles, proteins) has led to new insights into normal lung architecture, parenchymal remodelling in emphysema-like pathology, alveolar type II cell hyperplasia and hypertrophy and intracellular surfactant alterations as well as distribution of surfactant proteins. The Euler number of the network of alveolar openings, estimated using physical disectors at the light microscopic level, is an unbiased and direct estimate of alveolar number. Surfactant-producing alveolar type II cells can be counted and sampled for local size estimation with physical disectors at a high magnification light microscopic level. The number of their surfactant storage organelles, lamellar bodies, can be estimated using physical disectors at the EM level. By immunoelectron microscopy, surfactant protein distribution can be analysed with the relative labelling index. Together with the well-established classical stereological methods, these design-based methods now allow for a complete quantitative phenotype analysis in lung development and disease, including the structural characterization of gene-manipulated mice, at the light and electron microscopic level.

  9. Application Period Open for NCI Biospecimen Use | Division of Cancer Prevention

    Cancer.gov

    The application period for investigators interested in obtaining biospecimens and data from the Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Trial re-opened June 1. A separate application for obtaining biospecimens and data with research funding is also open. |

  10. Openness, Web 2.0 Technology, and Open Science

    ERIC Educational Resources Information Center

    Peters, Michael A.

    2010-01-01

    Open science is a term that is being used in the literature to designate a form of science based on open source models or that utilizes principles of open access, open archiving and open publishing to promote scientific communication. Open science increasingly also refers to open governance and more democratized engagement and control of science…

  11. Organ allocation in lung transplant.

    PubMed

    Davis, Steven Q; Garrity, Edward R

    2007-11-01

    Since the first successful single-lung transplant in 1983 and double-lung transplant in 1986, thousands of patients have benefited from the procedures. Until 1995, allocation of donor lungs was based purely on time on the waiting list. In 1995, a 90-day credit was given to patients with idiopathic pulmonary fibrosis, while still maintaining allocation based on waiting list time. In 2005, the lung allocation score (LAS) was implemented, dramatically changing the way lungs are allocated. This article will explore the reasons for the creation of the LAS, the design of the score, early experience with transplant results under the new system, and further changes that may be made to the system of lung allocation. As surgical techniques and medical management evolve, so to will the management of potential donors and the allocation of their organs, with the aim of benefiting patients needing lung transplantation in the United States.

  12. Lung carcinogenesis by tobacco smoke.

    PubMed

    Hecht, Stephen S

    2012-12-15

    Cigarette smoke is a complex mixture of chemicals including multiple genotoxic lung carcinogens. The classic mechanisms of carcinogen metabolic activation to DNA adducts, leading to miscoding and mutations in critical growth control genes, applies to this mixture but some aspects are difficult to establish because of the complexity of the exposure. This article discusses certain features of this mechanism including the role of nicotine and its receptors; lung carcinogens, co-carcinogens and related substances in cigarette smoke; structurally characterized DNA adducts in the lungs of smokers; the mutational consequences of DNA adduct formation in smokers' lungs; and biomarkers of nicotine and carcinogen uptake as related to lung cancer. While there are still uncertainties which may never be fully resolved, the general mechanisms by which cigarette smoking causes lung cancer are well understood and provide insights relevant to prevention of lung cancer, the number one cancer killer in the world, causing 1.37 million deaths per year. Copyright © 2012 UICC.

  13. Lung Carcinogenesis by Tobacco Smoke

    PubMed Central

    Hecht, Stephen S.

    2012-01-01

    Cigarette smoke is a complex mixture of chemicals including multiple genotoxic lung carcinogens. The classic mechanisms of carcinogen metabolic activation to DNA adducts, leading to miscoding and mutations in critical growth control genes, applies to this mixture but some aspects are difficult to establish because of the complexity of the exposure. This paper discusses certain features of this mechanism including the role of nicotine and its receptors; lung carcinogens, co-carcinogens and related substances in cigarette smoke; structurally characterized DNA adducts in the lungs of smokers; the mutational consequences of DNA adduct formation in smokers’ lungs; and biomarkers of nicotine and carcinogen uptake as related to lung cancer. While there are still uncertainties which may never be fully resolved, the general mechanisms by which cigarette smoking causes lung cancer are well understood and provide insights relevant to prevention of lung cancer, the number one cancer killer in the world, causing 1.37 million deaths per year. PMID:22945513

  14. OpenSHS: Open Smart Home Simulator.

    PubMed

    Alshammari, Nasser; Alshammari, Talal; Sedky, Mohamed; Champion, Justin; Bauer, Carolin

    2017-05-02

    This paper develops a new hybrid, open-source, cross-platform 3D smart home simulator, OpenSHS, for dataset generation. OpenSHS offers an opportunity for researchers in the field of the Internet of Things (IoT) and machine learning to test and evaluate their models. Following a hybrid approach, OpenSHS combines advantages from both interactive and model-based approaches. This approach reduces the time and efforts required to generate simulated smart home datasets. We have designed a replication algorithm for extending and expanding a dataset. A small sample dataset produced, by OpenSHS, can be extended without affecting the logical order of the events. The replication provides a solution for generating large representative smart home datasets. We have built an extensible library of smart devices that facilitates the simulation of current and future smart home environments. Our tool divides the dataset generation process into three distinct phases: first design: the researcher designs the initial virtual environment by building the home, importing smart devices and creating contexts; second, simulation: the participant simulates his/her context-specific events; and third, aggregation: the researcher applies the replication algorithm to generate the final dataset. We conducted a study to assess the ease of use of our tool on the System Usability Scale (SUS).

  15. OpenSHS: Open Smart Home Simulator

    PubMed Central

    Alshammari, Nasser; Alshammari, Talal; Sedky, Mohamed; Champion, Justin; Bauer, Carolin

    2017-01-01

    This paper develops a new hybrid, open-source, cross-platform 3D smart home simulator, OpenSHS, for dataset generation. OpenSHS offers an opportunity for researchers in the field of the Internet of Things (IoT) and machine learning to test and evaluate their models. Following a hybrid approach, OpenSHS combines advantages from both interactive and model-based approaches. This approach reduces the time and efforts required to generate simulated smart home datasets. We have designed a replication algorithm for extending and expanding a dataset. A small sample dataset produced, by OpenSHS, can be extended without affecting the logical order of the events. The replication provides a solution for generating large representative smart home datasets. We have built an extensible library of smart devices that facilitates the simulation of current and future smart home environments. Our tool divides the dataset generation process into three distinct phases: first design: the researcher designs the initial virtual environment by building the home, importing smart devices and creating contexts; second, simulation: the participant simulates his/her context-specific events; and third, aggregation: the researcher applies the replication algorithm to generate the final dataset. We conducted a study to assess the ease of use of our tool on the System Usability Scale (SUS). PMID:28468330

  16. Keeping momentum with a mouthful of water: behavior and kinematics of humpback whale lunge feeding.

    PubMed

    Simon, Malene; Johnson, Mark; Madsen, Peter T

    2012-11-01

    Rorqual baleen whales lunge feed by engulfment of tons of prey-laden water in a large and expandable buccal pouch. According to prior interpretations, feeding rorquals are brought to a near-halt at the end of each lunge by drag forces primarily generated by the open mouth. Accelerating the body from a standstill is energetically costly and is purported to be the key factor determining oxygen consumption in lunge-feeding rorquals, explaining the shorter dive times than expected given their sizes. Here, we use multi-sensor archival tags (DTAGs) sampling at high rates in a fine-scale kinematic study of lunge feeding to examine the sequence of events within lunges and how energy may be expended and conserved in the process of prey capture. Analysis of 479 lunges from five humpback whales reveals that the whales accelerate as they acquire prey, opening their gape in synchrony with strong fluke strokes. The high forward speed (mean depth rate: 2.0±0.32 m s(-1)) during engulfment serves both to corral active prey and to expand the ventral margin of the buccal pouch and so maximize the engulfed water volume. Deceleration begins after mouth opening when the pouch nears full expansion and momentum starts to be transferred to the engulfed water. Lunge-feeding humpback whales time fluke strokes throughout the lunge to impart momentum to the engulfed water mass and so avoid a near or complete stop, but instead continue to glide at ~1-1.5 m s(-1) after the lunge has ended. Subsequent filtration and prey handling appear to take an average of 46 s and are performed in parallel with re-positioning for the next lunge.

  17. Lung function in children in relation to ethnicity, physique and socioeconomic factors.

    PubMed

    Lum, Sooky; Bountziouka, Vassiliki; Sonnappa, Samatha; Wade, Angie; Cole, Tim J; Harding, Seeromanie; Wells, Jonathan C K; Griffiths, Chris; Treleaven, Philip; Bonner, Rachel; Kirkby, Jane; Lee, Simon; Raywood, Emma; Legg, Sarah; Sears, Dave; Cottam, Philippa; Feyeraband, Colin; Stocks, Janet

    2015-12-01

    Can ethnic differences in spirometry be attributed to differences in physique and socioeconomic factors?Assessments were undertaken in 2171 London primary schoolchildren on two occasions 1 year apart, whenever possible, as part of the Size and Lung function In Children (SLIC) study. Measurements included spirometry, detailed anthropometry, three-dimensional photonic scanning for regional body shape, body composition, information on ethnic ancestry, birth and respiratory history, socioeconomic circumstances, and tobacco smoke exposure.Technically acceptable spirometry was obtained from 1901 children (mean (range) age 8.3 (5.2-11.8) years, 46% boys, 35% White, 29% Black-African origin, 24% South-Asian, 12% Other/mixed) on 2767 test occasions. After adjusting for sex, age and height, forced expiratory volume in 1 s was 1.32, 0.89 and 0.51 z-score units lower in Black-African origin, South-Asian and Other/mixed ethnicity children, respectively, when compared with White children, with similar decrements for forced vital capacity (p<0.001 for all). Although further adjustment for sitting height and chest width reduced differences attributable to ethnicity by up to 16%, significant differences persisted after adjusting for all potential determinants, including socioeconomic circumstances.Ethnic differences in spirometric lung function persist despite adjusting for a wide range of potential determinants, including body physique and socioeconomic circumstances, emphasising the need to use ethnic-specific equations when interpreting results.

  18. Using electron microscopes to look into the lung.

    PubMed

    Ochs, Matthias; Knudsen, Lars; Hegermann, Jan; Wrede, Christoph; Grothausmann, Roman; Mühlfeld, Christian

    2016-12-01

    In the nineteenth century, there was a dispute about the existence of a lung alveolar epithelium which remained unsolved until the invention of electron microscopy (EM) and its application to the lung. From the early 1960s, Ewald Weibel became the master of lung EM. He showed that the alveolar epithelium is covered with a lining layer containing surfactant. Weibel also explained the phenomenon of "non-nucleated plates" observed already in 1881 by Albert Kölliker. Weibel's most significant contribution was to the development of stereological methods. Therefore, quantitative characterization of lung structure revealing structure-function relationships became possible. Today, the spectrum of EM methods to study the fine structure of the lung has been extended significantly. Cryo-preparation techniques are available which are necessary for immunogold labeling of molecules. Energy-filtering techniques can be used for the detection of elements. There have also been major improvements in stereology, thus providing a very versatile toolbox for quantitative lung phenotype analyses. A new dimension was added by 3D EM techniques. Depending on the desired sample size and resolution, the spectrum ranges from array tomography via serial block face scanning EM and focused ion beam scanning EM to electron tomography. These 3D datasets provide new insights into lung ultrastructure. Biomedical EM is an ever-developing field. Its high resolution remains unparalleled. Moreover, EM has the unique advantage of providing an "open view" into cells and tissues within their full architectural context. Therefore, EM will remain an indispensable tool for a better understanding of the lung's functional design.

  19. The extracellular calcium-sensing receptor regulates human fetal lung development via CFTR.

    PubMed

    Brennan, Sarah C; Wilkinson, William J; Tseng, Hsiu-Er; Finney, Brenda; Monk, Bethan; Dibble, Holly; Quilliam, Samantha; Warburton, David; Galietta, Luis J; Kemp, Paul J; Riccardi, Daniela

    2016-02-25

    Optimal fetal lung growth requires anion-driven fluid secretion into the lumen of the developing organ. The fetus is hypercalcemic compared to the mother and here we show that in the developing human lung this hypercalcaemia acts on the extracellular calcium-sensing receptor, CaSR, to promote fluid-driven lung expansion through activation of the cystic fibrosis transmembrane conductance regulator, CFTR. Several chloride channels including TMEM16, bestrophin, CFTR, CLCN2 and CLCA1, are also expressed in the developing human fetal lung at gestational stages when CaSR expression is maximal. Measurements of Cl(-)-driven fluid secretion in organ explant cultures show that pharmacological CaSR activation by calcimimetics stimulates lung fluid secretion through CFTR, an effect which in humans, but not mice, was also mimicked by fetal hypercalcemic conditions, demonstrating that the physiological relevance of such a mechanism appears to be species-specific. Calcimimetics promote CFTR opening by activating adenylate cyclase and we show that Ca(2+)-stimulated type I adenylate cyclase is expressed in the developing human lung. Together, these observations suggest that physiological fetal hypercalcemia, acting on the CaSR, promotes human fetal lung development via cAMP-dependent opening of CFTR. Disturbances in this process would be expected to permanently impact lung structure and might predispose to certain postnatal respiratory diseases.

  20. Technetium-fibrinogen lung scanning in canine lung contusion

    SciTech Connect

    Geller, E.; Khaw, B.A.; Strauss, H.W.; Carvalho, A.C.; Rajagopalan, B.; Jones, R.; Zapol, W.M.

    1984-07-01

    To detect experimentally induced acute lung contusion in anesthetized dogs, serial radionuclide images of the lung were recorded following intravenous infusion of 99mTc-labelled human fibrinogen (Tc-HF). The accumulation of Tc-HF in canine lungs was serially quantitated for up to 20 hours after lung contusion. A contusion (number1) was produced in one lung, Tc-HF was injected IV after 15 minutes, and 75 minutes later a contralateral lung contusion (number2) was produced in a series of 14 dogs. At autopsy the excised lungs were scanned, sectioned, and counted for radioactivity. Radiolabelled fibrinogen accumulated within 2-4 minutes of contusion number2 and remained stable over the next 20 hours in 14 dogs; contusion number1 was barely visible in four dogs. Lung Tc-HF activity in the central region of contusion number2 remained sixfold higher than in normal lung tissue. These data suggest that following lung contusion, fibrinogen deposition occurs rapidly and remains stable over a 20-hour interval of observation.