Normal Respiration Research Articles

Reactivity of cardiorespiratory system in bronchial asthma patients according to the tests with respiratory maneuvers performance

Today asthma is defined as allergic inflammation of the respiratory tract, which is associated with hyperreactivity of the bronchi to various stimuli. The basis of asthma clinical picture forms broncho-obstructive syndrome, which is polymorphic in the mechanism of formation, and this determines the heterogeneity of asthma pathogenesis. Due to the anatomical and functional relationship with the cardiovascular system, this mechanism should be considered in a complex manner studying the composition changes in the associated cardiopulmonary system.The objective: to determine the regulatory features in asthma course of various degrees of severity during respiratory maneuvers performance.Materials and methods. In total, 86 patients (female (59 %) and male (41 %)), aged 41.0 ± 0.8 years old were divided into 2 groups. The first (comparison group) included 27 patients, the second (main) consisted of 59 patients with clinically confirmed persistent or uncontrolled asthma. At the outpatient stage of treatment, a comprehensive multifunctional method for the cardiorespiratory system examination – spiroarteriocardiorhythmography (SACR) was used. There were three consecutive two-minute registrations: at normal respiration (NR), at respiratory rate 6 times per minute (RR6) and at respiratory rate 15 times per minute (RR15). Regulatory influences were determined based on the spectral analysis of heart rate (HRV) and respiration (RV) variability. Spectral analysis was performed in three frequency bands: over low-frequency (VLF, 0–0.04 Hz), low frequency (LF, 0.04–0.15 Hz) and high-frequency (HF, 0.15–0.4 Hz).Results. Cardiorespiratory system of patients with uncontrolled course of asthma is characterized by an increase in heart rate at RR15; reduced absolute HRV indicators; an increase in the contribution of LFn and a decrease in the contribution of HFn; a decrease in the arterial baroreflex sensitivity; an increase in EB; there was also an increase in RV, RV/Tih, RV/Texh, as well as worsening of frequency and volume synchronization of the cardiorespiratory system.Conclusions. The use of respiratory maneuvers performance tests allowed revealing the characteristic regulatory features of bronchial asthma development and course, so it can be proposed for wide practical implementation in the diagnosis and monitoring of bronchial asthma course.

The Effects of Mompyeogi Movement Exercise on Body Skin Temperature

Background: Spine stretching and flexibility exercise is introduced by the group of Mompyeogi movement exercise ('mom' as body and 'pyeogi as stretching) that is growing in the Republic of Korea. Although it does not move as fast as an aerobic exercise, the benefit of body organ stretching movement position on this movement exercise can be perceived by Mompyeogi participants.Purpose: This study aimed to investigate the effects of Mompyeogi movement exercise on the alteration of body skin temperature.Methods: A pre-post experimental study was carried out to 20 participants who were divided into two groups: male and female. Each group was assigned to do either normal breathing (chest respiration) or deep breathing (abdominal respiration) when performing Mompyeogi movement exercise. Body skin temperatures were measured a couple of times before, during, and after the exercise using thermal infrared cameras. The collected data were analyzed descriptively in frequency and percentage.Results: Results showed that Mompyeogi movement exercise combined with deep abdominal breathing methods increased body skin temperature. Participants who were in low group temperature (t<33°C), underweight, and had normal body mass index showed an increased body skin temperature after the exercise. On the other hand, participants who were in the group age of 60-74 years old performing normal chest respiration showed a stable body skin temperature after the exercise.Conclusion: Stretching organ as a part of basic Mompyeogi movement exercise combined with deep abdominal breathing increased the body skin temperature. Future research of Mompyeogi movement exercise needs to explore a self-healing effort as a preventing and promoting programs contributed to holistic nursing practice.

Do angiosperms with highly divergent mitochondrial genomes have altered mitochondrial function?

Angiosperm mitochondrial (mt) genes are generally slow-evolving, but multiple lineages have undergone dramatic accelerations in rates of nucleotide substitution and extreme changes in mt genome structure. While molecular evolution in these lineages has been investigated, very little is known about their mt function. Some studies have suggested altered respiration in individual taxa, although there are several reasons why mt variation might be neutral in others. Here, we develop a new protocol to characterize respiration in isolated plant mitochondria and apply it to species of Silene with mt genomes that are rapidly evolving, highly fragmented, and exceptionally large (~11 Mbp). This protocol, complemented with traditional measures of plant fitness, cytochrome c oxidase activity assays, and fluorescence microscopy, was also used to characterize inter- and intraspecific variation in mt function. Contributions of the individual “classic” OXPHOS complexes, the alternative oxidase, and external NADH dehydrogenases to overall mt respiratory flux were found to be similar to previously studied angiosperms with more typical mt genomes. Some differences in mt function could be explained by inter- and intraspecific variation. This study suggests that Silene species with peculiar mt genomes still show relatively normal mt respiration. This may be due to strong purifying selection on mt variants, coevolutionary responses in the nucleus, or a combination of both. Future experiments should explore such questions using a comparative framework and investigating other lineages with unusual mitogenomes.

Apoptosis Resistance in Fibroblasts Precedes Progressive Scarring in Pulmonary Fibrosis and Is Partially Mediated by Toll-Like Receptor 4 Activation

Inhalation of environmental toxicants such as cigarette smoke, metal or wood dust, silica, or asbestos is associated with increased risk for idiopathic pulmonary fibrosis (IPF). IPF involves progressive scarring of lung tissue, which interferes with normal respiration and is ultimately fatal; however, the complex cellular mechanisms of IPF pathogenesis remain unclear. Fibroblast apoptosis is essential in normal wound healing but is dysregulated in IPF. Recent studies suggest that Toll-like receptor 4 (TLR4) is key in the onset of IPF. Here, radiation-induced PF was used as a model for IPF because it very closely mimics the progressive and intractable nature of IPF. Female C57BL/6J (C57) and C57BL/6J TLR4-/- mice were exposed to a single dose of 13 Gy whole-thorax ionizing radiation. Although both strains showed similar levels of immediate radiation-induced damage, C57 mice exhibited more extensive fibrosis at 22-week postirradiation (PI) than TLR4-/- mice. Isolated C57 primary 1° MLFs showed decreased apoptosis susceptibility as early as 8-week postirradiation, a phenotype that persisted for the remainder of the radiation response. TLR4-/- 1° mouse lung fibroblasts did not exhibit significant apoptosis resistance at any point. Systemic release of high mobility group box 1, a TLR4 agonist, during the pneumonitis phase of the radiation response may act through TLR4 to contribute to fibroblast apoptosis resistance and thus interfere with wound resolution. These findings demonstrate that apoptosis resistance occurs earlier in pulmonary fibrosis pathogenesis than previously assumed, and that TLR4 signaling is a key mediator in this process.

Prospective Respiration-Gated Photoacoustic Microscopy.

Photoacoustic microscopy (PAM) is a promising biomedical imaging technique that relies on sequential excitation to generate three-dimensional images. It combines the high contrast of optical imaging with high penetration depth of ultrasound imaging. The normal respiration rate of mice is greater than 3 Hz, which leads to motion artifacts in most reported PAM for in vivo imaging. Here, we introduce a prospective respiratory gating (PRG) method for PAM to address this problem. We captured the mouse's respiratory signal with a laser displacement sensor, and the photoacoustic signal was acquired at specific phase points of the respiratory signal. The scanning mode and the scanning timing were also designed and evaluated. We combined this method with our PAM to demonstrate its feasibility. Our experiments show that the proposed method can help remove motion artifacts well, and the subcutaneous vascular imaging results of the mouse abdominal region with PRG are much better than those without any gating.

Renal Dysfunction Exacerbates Ischemic Muscle Injury in Mice Subjected to Hindlimb Ischemia

Patients with critical limb ischemia (CLI) have multiple concomitant comorbidities which are associated with poorer overall health outcomes. CLI patients with impaired kidney function and/or diabetes are at greater risk for limb amputation and death. While the negative impacts of renal dysfunction and diabetes on CLI outcomes are known clinically, the underlying biologic mechanism(s) responsible are poorly understood. Thus, we sought to evaluate the impact of impaired renal function and diabetes on the skeletal muscle pathology in mice following unilateral hindlimb ischemia (HLI). Renal dysfunction (RD) was induced by dietary administration of adenine which causes renal tubular injury, while diabetes was induced by streptozocin injection. HLI was induced by ligation and excision of the femoral artery, while the contralateral hindlimb was utilized as a control (no surgery). Three groups (n = 15; 5 per group) of C57BL/6J mice were analyzed: control, RD, and RD+ diabetes. Skeletal muscle ischemic injury was assessed using histological measurements of myofiber centralized nuclei, myofiber cross‐sectional area, ischemic lesion areas, and vascular density. High‐resolution O2 consumption was used to examine mitochondrial function in permeablized myofibers. Mice with RD, regardless of diabetes, exhibited greater ischemic lesions within the tibialis anterior muscle (Con = 2.53 ± 0.51% vs. RD = 60.554 ± 24.15% vs. RD+STZ = 79.99 ± 19.99%; P < 0.0001) despite similar capillary density (Con = 466.36 ± 44.98 vs. RD = 455.20 ± 79.55 vs. RD+STZ = 578.20 ± 87.16 capillaries/field; P = 0.9011). Mice with RD exhibited a ~45% decrease in mitochondrial respiratory capacity across numerous substrates, whereas control mice had normal respiration in the ischemic limb muscle seven days post‐HLI. These observations demonstrate that impaired kidney function exacerbates ischemic muscle injury in mice. Future studies are needed to uncover the molecular mechanisms by which RD negatively impacts skeletal muscle.Support or Funding InformationSupported by AHA Grant 18CDA34110044 to TER.This abstract is from the Experimental Biology 2019 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.

Premature Lambs Exhibit Normal Mitochondrial Respiration after Long-Term Extrauterine Support

Background: In an effort to mitigate the major morbidities and mortality associated with extreme prematurity, we have developed an EXTrauterine Environment for Neonatal Development (EXTEND) designed to provide physiologic support of extremely premature infants. Objectives: We have previously shown that long-term, physiologic support of premature fetal lambs is possible with EXTEND, but in this study, we sought to demonstrate bioenergetic equipoise at the tissue level. Methods: Four premature fetal lambs were delivered by hysterotomy at gestational ages (GA) of 105–107 days (term ∼145 days), cannulated via the umbilical vessels, and transitioned to support on EXTEND for 3–4 weeks. Five control fetuses were age-matched to the GA of experimental fetuses at the time of study end (128–134 days GA) and immediately sacrificed after hysterotomy. Mitochondria were isolated from the heart, liver, kidney, and skeletal muscle of fetuses at the time of sacrifice, and oxygen consumption rates (OCRs) were measured. Results: There were no differences in basal mitochondrial OCR between EXTEND and control fetuses for heart, kidney, or skeletal muscle. For liver, the basal OCR was higher in EXTEND fetuses compared to controls. There were no differences in physiologic maximal OCR or reserve capacity for any tissue analyzed. Conclusions: Fetal lambs supported by EXTEND demonstrate physiologic mitochondrial function as evidenced by adequate basal and physiologic maximal cellular respiration as well as preserved reserve capacity.

High-resolution atmospheric-pressure MALDI mass spectrometry imaging workflow for lipidomic analysis of late fetal mouse lungs

Mass spectrometry imaging (MSI) provides label-free, non-targeted molecular and spatial information of the biomolecules within tissue. Lipids play important roles in lung biology, e.g. as surfactant, preventing alveolar collapse during normal and forced respiration. Lipidomic characterization of late fetal mouse lungs at day 19 of gestation (E19) has not been performed yet. In this study we employed high-resolution atmospheric pressure scanning microprobe matrix-assisted laser desorption/ionization MSI for the lipidomic analysis of E19 mouse lungs. Molecular species of different lipid classes were imaged in E19 lung sections at high spatial and mass resolution in positive- and negative-ion mode. Lipid species were characterized based on accurate mass and on-tissue tandem mass spectrometry. In addition, a dedicated sample preparation protocol, homogenous deposition of matrices on tissue surfaces and data processing parameters were optimized for the comparison of signal intensities of lipids between different tissue sections of E19 lungs of wild type and Pex11β-knockout mice. Our study provides lipid information of E19 mouse lungs, optimized experimental and data processing strategies for the direct comparison of signal intensities of metabolites (lipids) among the tissue sections from MSI experiments. To best of our knowledge, this is the first MSI and lipidomic study of E19 mouse lungs.

Antibacterial strategies inspired by the oxidative stress and response networks.

Oxidative stress arises from an imbalance between the excessive accumulation of reactive oxygen species (ROS) and a cell's capability to readily detoxify them. Although ROS are spontaneously generated during the normal oxygen respiration and metabolism, the ROS generation is usually augmented by redox-cycling agents, membrane disrupters, and bactericidal antibiotics, which contributes their antimicrobial bioactivity. It is noted that all the bacteria deploy an arsenal of inducible antioxidant defense systems to cope with the devastating effect exerted by the oxidative stress: these systems include the antioxidant effectors such as catalases and the master regulators such as OxyR. The oxidative stress response is not essential for normal growth, but critical to survive the oxidative stress conditions that the bacterial pathogens may encounter due to the host immune response and/or the antibiotic treatment. Based on these, we here define the ROS-inspired antibacterial strategies to enhance the oxidative stress of ROS generation and/or to compromise the bacterial response of ROS detoxification, by delineating the ROSgenerating antimicrobials and the core concept of the bacterial response against the oxidative stress.

Laser-capture microdissection of murine lung for differential cellular RNA analysis.

The lung tissue contains a heterogeneous milieu of bronchioles, epithelial, airway smooth muscle (ASM), alveolar, and immune cell types. Healthy bronchiole comprises epithelial cells surrounded by ASM cells and helps in normal respiration. In contrast, airway remodeling, or plasticity, increases surrounding of bronchial epithelium during inflammation, especially in asthmatic condition. Given the profound functional difference between ASM, epithelial, and other cell types in the lung, it is imperative to separate and isolate different cell types of lungs for genomics, proteomics, and molecular analysis, which will improve the diagnostic and therapeutic approach to treat cell-specific lung disorders. Laser capture microdissection (LCM) is the technique generally used for the isolation of specific cell populations under direct visual inspection, which plays a crucial role to evaluate cell-specific effect in clinical and preclinical setup. However, maintenance of tissue RNA quality and integrity in LCM studies are very challenging tasks. It is obvious to believe that the major factor affecting the RNA quality is tissue-fixation method. The prime focus of this study was to address the RNA quality factors within the lung tissue using the different solvent system to fix tissue sample to obtain high-quality RNA. Paraformaldehyde and Carnoy's solutions were used for fixing the lung tissue and compared RNA integrity in LCM captured lung tissue samples. To further confirm the quality of RNA, we measured cellular marker genes in collected lung tissue samples from control and mixed allergen (MA)-induced asthmatic mouse model using qRT-PCR technique. RNA integrity number showed a significantly better quality of RNA in lung tissue samples fixed with Carnoy's solution compared to paraformaldehyde solution. Isolated RNA from MA-induced asthmatic murine lung epithelium, smooth muscle, and granulomatous foci using LCM showed a significant increase in remodeling gene expression compared to control which confirm the quality and integrity of isolated RNA. Overall, the study concludes tissue fixation solvent can alter the quality of RNA in the lung and the outcome of the results.

Pharyngeal distensibility during expiration is an independent predictor of the severity of obstructive sleep apnoea.

Pharyngeal distensibility and collapsibility reflect the passive properties of tissue in the airway, are an indicator of the ease with which an airway can be deformed and are related to the severity of obstructive sleep apnoea (OSA). During normal tidal respiration, the collapsibility of the pharynx during expiration is passive without confounding by neuromuscular activation that occurs during inspiration. We evaluated the distensibility and collapsibility of the upper airway in subjects with OSA during wakefulness using sophisticated dynamic computed tomography (CT) imaging. We hypothesized that the dynamic changes of the upper airway during expiration would be related to the severity of OSA. Twenty-three patients with OSA and eight normal subjects underwent simultaneous measurement of respiratory flow and airway calibre using ultrafast CT. The change in pharyngeal cross-sectional area divided by the change in concomitant flow (as distensibility or collapsibility) was measured and compared across different severities of OSA. The slope of this relationship between delta area and delta flow during expiration was significantly higher in severe OSA when compared with normal controls and mild-moderate OSA. Differences in airway distensibility or collapsibility between severity groups were significant in expiration but not in inspiration. Distensibility or collapsibility contributed most to the apnoea-hypopnoea index in regression modelling. Age, gender, and body mass index (BMI) were not significant independent predictors. Our study demonstrates that airway distensibility during the expiratory phase of awake respiration is correlated with the severity of OSA.

Evaluation of particulate matter deposition in the human respiratory tract during winter in Nanjing using size and chemically resolved ambient measurements

Size-segregated ambient aerosols were collected by a five-stage impactor at a suburban Nanjing site during the winter of 2016–2017 to estimate the chemical composition and size distribution of particles deposited in different parts of the human respiratory tract. Chemical compositions of carbonaceous aerosols, water-soluble ions, and trace heavy metals were measured. Particulate matter (PM) mass deposited in nasopharyngeal (NOPL), tracheobronchial (TB), and pulmonary (P) was obtained by integrating the size-dependent deposition fractions. During the sampling period, the average PM10 and PM2.5 concentrations were 108.8 ± 30.8 and 77.2 ± 24.2 μg/m3, respectively. Organic matter and water-soluble ions were major components in fine particles. The fine particles had a significant contribution to the particulate pollution in winter Nanjing. The mass concentration of particles increases significantly from the clean days to the pollution days, especially for particles in 1–2.5 μm. The proportion of NO3− and undetected components in particulate matter increases on pollution days, while the proportion of elemental carbon (EC), SO42−, and NH4+ decreases. During the study period, the total particulate matter deposit per minute in the NOPL, TB, and P was 1.06 ± 0.35, 0.10 ± 0.03, and 0.42 ± 0.14 μg, respectively, assuming normal respiration of tidal volumes of 1450 cm3 per breath and 15 breaths per minute. Particles in 2.5–10 μm had the highest deposition mass in NOPL of 0.57 ± 0.16 μg, while particles in < 0.5 μm had the highest deposition mass in TB (0.03 ± 0.01 μg), and particles in 1–2.5 μm had the highest deposition mass in P (0.14 ± 0.06 μg). The total particulate matter deposited in the NOPL, TB, and P increased from 0.79 ± 0.25, 0.08 ± 0.02, and 0.30 ± 0.09 μg on the clean days to 1.23 ± 0.29 μg, 0.12 ± 0.03 μg, and 0.49 ± 0.11 μg on the pollution days. More secondary inorganic aerosol (SNA) and metals (especially Zn, Cr, and Cu) were in the PM deposited in TB and P than in the ambient PM, while more undetected components in the PM deposited in NOPL. The chemical composition fractions deposited in a specific region were different from those measured in the ambient atmosphere, indicating that health effect studies of PM should consider the deposition rates of PM in the human respiratory tract, in addition to the ambient size and chemical characteristics of ambient PM.

ANTIOXIDANT CAPACITY OF THE GREEN LEAFY VEGETABLES USING OXYGEN RADICAL ANTIOXIDANT CAPACITY (ORAC), 2,2′-AZINO-BIS (3-ETHYLBENZOTHIAZOLINE-6-SULPHONIC ACID(ABTS) AND 2,2-DIPHENYL-1-PICRYLHYDRAZYL (DPPH) ASSAYS

Antioxidants are believed to play a very important role in the body defence system against reactive oxygen species (ROS), the harmful by-products that are generated during normal aerobic cell respiration. The objective of this study was to determine the antioxidant capacity in green leafy vegetables using ORAC, ABTS, and DPPH assays of different polyphenol fractions (free phenolic, alkaline hydrolysate, acidic hydrolysate).The antioxidant capacity of the identified free and bound phenolic acid content was measured using different assays including ORAC, ABTS, and DPPH assay (end-point assay and kinetic assay). Only hydrophilic antioxidant activities of all selected samples were examined using ORAC assay. Strong correlations were observed in acidic and alkaline hydrolysate fractions (p<0.01) as determined by ORAC and ABTS assays, respectively. In the free phenolic acid extracts, the O. basilicum (Sweet basil) ranked first, had highest antioxidant capacities of 521804±4243 µmol TE/100g DW, 329.8±0.4mg TE/g DW and 9.0±1.8 µg GAE/g DW as determined by ORAC, ABTS and DPPH, respectively. . The A. occidentale (Cashew shoot) in the alkaline hydrolysate extract showed a greatest antioxidant capacity in all three assays: 889126±7193 µmol TE/100g DW, 466.5±7.9 mg TE/g DW and 3.5±0.4 µg GAE/g DW as measured by ORAC, ABTS and DPPH, separately. While, in acidic hydrolysate, the A. occidentale (Cashew shoot) extract also dominated the antioxidant capacity with (560504±5785 µmol TE/100g DW, 387±0.7 mg TE/g DW and 5.9±0.5 µg GAE/g DW) as determined by ORAC, ABTS and DPPH assays, respectively. The acidic and basic hydrolysis yielded higher antioxidant capacities in the present study. It suggests that hydrolysis with alkaline and acidic play significant roles in liberating more phenolic acids and flavonoids and generating high antioxidant capacity in the extracts.

Rationale and Options for Choosing an Optimal Closure Technique for Primary Midsagittal Osteochondrotomy of the Sternum, Part 2: A Theoretical and Critical Review of Techniques and Fixation Devices.

The intact one-piece sternum is indispensible to the thorax for its normal physiological biomechanics. To overcome tri-planar forces acting on the sternum following midsagittal osteochondrotomy, it must be reconstructed using an optimal technique to withstand distraction loads of normal respiration and violent cough. It should be fixed rigidly to reconstitute the anterior coronal column of the axial skeleton to maintain erect posture and prevent kyphosis. Sterile or infective non-union of the sternum compromises the physical endurance of patients and has an immense psychological effect. From an engineering perspective, there is no substantially proven gold standard technique to fix a divided sternum. Stainless steel wire applied in various configurations to a variety of shapes and sizes has become an acceptable standard of care due to its long-standing history and cost-effectiveness. Recently there has been a proliferation of innovative techniques to deal with primary and failed union of the sternum in an effort to prevent mechanical failure and serious deep surgical wound infection progressing to mediastinitis. Among the newer implant designs, the ones currently in use are shaped like clamps and clasps to compress the sternal halves together as well as alphabet-shaped mini-plating systems. In this section of the review series, mechanisms, pros and cons of currently available implants to reconstruct the bisected sternum, and external support systems considered necessary in high-risk clients are discussed.

Peripheral saline contrast with Valsalva and a modified Müller's maneuver may improve detection of atrial level right-to-left shunts: A preliminary observation.

As part of an evaluation for source of embolism, transthoracic echocardiography with peripheral saline contrast injection during normal respirations and also Valsalva release is routinely performed to evaluate for an atrial level shunt. We present a preliminary observation of addition of a modified Müller's maneuver early during the Valsalva release. The Müller's maneuver has been described to occur with sleep apnea and will increase right-to-left shunting through a PFO. Of 34 patients, 24 were negative for a right-to-left shunt with normal respiration or Valsalva release. Of these 24 patients, 8 were then positive for a shunt by addition of a modified Müller's maneuver. One additional patient could not perform the modified Müller's maneuver. This preliminary observation suggests that in patients referred to an echocardiography laboratory for evaluation of source of embolism, adding the modified Müller's maneuver to those negative for shunting during normal respirations and Valsalva release may yield an increase in right-to-left atrial level shunt detection.

Sudden seizure during cesarean section

Rationale:A first seizure can range from a fleeting subjective experience or a twitch (myoclonic jerk) through to a tonic-clonic convulsion. A first seizure occurred in a parturient during cesarean section is very rare. We describe the case of a parturient who suffered seizure when the fetus was delivered.Patient concerns:Our patient is a 31-year-old parturient with a first seizure during cesarean section.Diagnoses:Seizure.Interventions:The patient received supportive therapy to maintain oxygen supply and propofol was administered to terminate seizure during cesarean section.Outcomes:after therapy, the patient regained full consciousness and normal spontaneous respiration. She had no recall of the seizure attack. The post-operative recovery was uneventful.Lessons:Symptoms during seizure are very important to diagnose. It will be both harmful to mother and the fetus, when the pregnant woman suffers seizure during pregnancy or cesarean delivery. In this situation, supportive therapy need to be immediately initiate and propofol may be the most suitable drug to terminate seizure during cesarean delivery.

Mitigating Respiratory Motion in Radiation Therapy: Rapid, Shallow, Non-invasive Mechanical Ventilation for Internal Thoracic Targets

Reducing respiratory motion during the delivery of radiation therapy reduces the volume of healthy tissues irradiated and may decrease radiation-induced toxicity. The purpose of this study was to assess the potential for rapid shallow non-invasive mechanical ventilation to reduce internal anatomy motion for radiation therapy purposes. Ten healthy volunteers (mean age, 38years; range, 22-54years; 6 female and 4 male) were scanned using magnetic resonance imaging during normal breathing and at 2 ventilator-induced frequencies: 20 and 25 breaths per minute for 3minutes. Sagittal and coronal cinematic data sets, centered over the right diaphragm, were used to measure internal motions across the lung-diaphragm interface. Repeated scans assessed reproducibility. Physiologic parameters and participant experiences were recorded to quantify tolerability and comfort. Physiologic observations and experience questionnaires demonstrated that rapid shallow non-invasive ventilation technique was tolerable and comfortable. Motion analysis of the lung-diaphragm interface demonstrated respiratory amplitudes and variations reduced in all subjects using rapid shallow non-invasive ventilation compared with spontaneous breathing: mean amplitude reductions of 56% and 62% for 20 and 25 breaths per minute, respectively. The largest mean amplitude reductions were found in the posterior of the right lung; 40.0mm during normal breathing to 15.5mm(P<.005) and 15.2mm(P<.005) when ventilated with 20 and 25 breaths per minute, respectively. Motion variations also reduced with ventilation; standard deviations in the posterior lung reduced from 14.8mm during normal respiration to 4.6mm and 3.5mm at 20 and 25 breaths per minute, respectively. To our knowledge, this study is the first to measure internal anatomic motion using rapid shallow mechanical ventilation to regularize and minimize respiratory motion over a period long enough to image and to deliver radiation therapy. Rapid frequency and shallow, non-invasive ventilation both generate large reductions in internal thoracic and abdominal motions, the clinical application of which could be profound-enabling dose escalation (increasing treatment efficacy) or high-dose ablative radiation therapy.

Implanted Battery-Free Direct-Current Micro-Power Supply from in Vivo Breath Energy Harvesting.

In vivo biomechanical energy harvesting by implanted nanogenerators (i-NGs) is promising for self-powered implantable medical devices (IMDs). One critical challenge to reach practical applications is the requirement of continuous direct-current (dc) output, while the low-frequency body activities typically generate discrete electrical pulses. Here, we developed an ultrastretchable micrograting i-NG system that could function as a battery-free dc micro-power supply. Packaged by a soft silicone elastomer with a cavity design, the i-NG exhibited an ultralow Young's modulus of ∼45 kPa and a high biocompatibility to soft biological tissues. The i-NG was implanted inside the abdominal cavity of Sprague Dawley adult rats and directly converted the slow diaphragm movement during normal respiration into a high-frequency alternative current electrical output, which was readily transmitted into a continuous ∼2.2 V dc output after being integrated with a basic electrical circuit. A light-emitting diode was constantly operated by the breath-driven i-NG without the aid of any battery component. This solely biomechanical energy-driven dc micro-power supply offers a promising solution for the development of self-powered IMDs.

Human COX7A2L Regulates Complex III Biogenesis and Promotes Supercomplex Organization Remodeling without Affecting Mitochondrial Bioenergetics

SUMMARYThe mitochondrial respiratory chain is organized in a dynamic set of supercomplexes (SCs). The COX7A2L protein is essential for mammalian SC III2+IV assembly. However, its function in respirasome (SCs I+III2+IVn) biogenesis remains controversial. To unambiguously determine the COX7A2L role, we generated COX7A2L-knockout (COX7A2L-KO) HEK293T and U87 cells. COX7A2L-KO cells lack SC III2+IV but have enhanced complex III steady-state levels, activity, and assembly rate, normal de novo complex IV biogenesis, and delayed respirasome formation. Nonetheless, the KOs have normal respire some steady-state levels, and only larger structures (SCs I1–2+III2+IV2-n or megacomplexes) were undetected. Functional substrate-driven competition assays showed normal mitochondrial respiration in COX7A2L-KO cells in standard and nutritional-, environmental-, and oxidative-stress-challenging conditions. We conclude that COX7A2L establishes a regulatory checkpoint for the biogenesis of CIII2 and specific SCs, but the COX7A2L-dependent MRC remodeling is essential neither to maintain mitochondrial bioenergetics nor to cope with acute cellular stresses.

Unique Endoscopic Therapy of Colonic Obstruction Caused by a Fecaloma

Fecaloma is described as a mass of hardened feces being impacted mostly in the rectum and sigmoid We herein report a case of large fecaloma leading to bowel obstruction that was successfully treated by endoscopic removal of the impacted stool. A 72-year-old white male with a history of prescription opioid use for chronic back pain presented at the Emergency Room (ER) with persistent constipation for the last six days, associated with nausea and food vomiting within the previous 24 hours. Starting on the third day with an illness, the patient also had diffuse, colicky abdominal pain. On physical examination, the patient was febrile (temperature was 39.1°C orally), had a pulse rate of 90/minute, blood pressure of 130/70 mmHg and normal respiration. Abdominal examination revealed distention in the periumbilical area with diffuse tenderness over the whole abdomen. Blood tests found leukocytosis at 19 x 109 /l with absolute neutrophils (74.6%), Abdominal x-rays revealed colonic air-fluid levels; this finding prompted an abdominal CT scan, which showed a significant fecal mass at the sigmoid colon with retrograde dilated colonic loops. The patient was administered cleansing enemas, which failed to resolve the clinical presentation. After carefully discussing potential risks with our patient, we performed a colonoscopy using low insufflation pressure to prevent complications and found the fecaloma in the sigmoid colon. The colonoscopy was unable to be passed across the fecaloma since it was causing entire colon luminal obstruction. We then proceeded to inject diluted hydrogen peroxide within the fecaloma using a sclerosing needle and then washed the fecaloma surface also with hydrogen peroxide with a total volume 500 ml. After a few minutes, we started to fragment the fecalith, the consistency of which had been notably decreased by the hydrogen peroxide, using an extraction balloon and polypectomy snare. Following fecalith removal and cleansing, a dilated colonic lumen with hyperemic mucosa and a sizeable fibrin-covered ulcer was seen, reflecting ischemic injury on the colonic wall. Following fecal disimpaction, the patient's bowel transit returned to normal, and he was discharged with no complications at 24 hours after the endoscopic procedure.