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Morphological studies are useful to develop analysis with taxonomic, phylogenetic, ecological, physiological and evolutionary approaches. During the life cycle, Anurans carry out gas exchange through different structures such as gills, skin and lungs. In general, the development of lungs during the larval period is scarce known and most studies analyse the morphology and ultrastructure of the lung wall at the adult stage. This study describes the development and morphology of the lung of Trachycephalus typhonius during the prometamorphic and metamorphic periods and adult stage. Lung development starts at premetamorphic stages and continues along the prometamorphic and metamorphic periods with the development of the lung wall vascularization and pulmonary septa. There are remarkable differences comparing the lung framework at the end of metamorphosis to the one in the adult stage, regarding different‐order septa and lung wall structure with a well‐developed vascular network. Therefore, the final organization occurs during the juvenile period. This work is the first approach to the study of lung development during larval stages in this species and complements previous studies on lung morphology. Also, contributes to the knowledge of lung morphogenesis and could be useful to interpret the respiratory physiology in different environmental conditions. [ABSTRACT FROM AUTHOR]

Abstract Background Acute respiratory distress syndrome (ARDS) patients with different lung morphology have distinct pulmonary mechanical dysfunction and outcomes. Whether lung morphology impacts the association between ventilatory variables and mortality remains unclear. Moreover, the impact of a novel combined ventilator variable [(4×DP) + RR] on morality in ARDS patients needs external validation. Methods We obtained data from the Chinese Database in Intensive Care (CDIC), which included adult ARDS patients who received invasive mechanical ventilation for at least 24 h. Patients were further classified into two groups based on lung morphology (focal and non-focal). Ventilatory variables were collected longitudinally within the first four days of ventilation. The primary outcome was 28-day mortality. Extended Cox regression models were employed to explore the interaction between lung morphology and longitudinal ventilatory variables on mortality. Findings We included 396 ARDS patients with different lung morphology (64.1% non-focal). The overall 28-day mortality was 34.4%. Patients with non-focal lung morphology have more severe and persistent pulmonary mechanical dysfunction and higher mortality than those with focal lung morphology. Time-varying driving pressure (DP) was more significantly associated with 28-day mortality in patients with non-focal lung morphology compared to focal lung morphology patients (P for interaction = 0.0039). The impact of DP on mortality was more significant than that of respiratory rate (RR) only in patients with non-focal lung morphology. The hazard ratio (HR) of mortality for [(4×DP) + RR] was significant in patients with non-focal lung morphology (HR 1.036, 95% CI 1.027–1.045), not in patients with focal lung morphology (HR 1.019, 95% CI 0.999–1.039). Interpretation The association between ventilator variables and mortality varied among patients with different lung morphology. [(4×DP) + RR] was only associated with mortality in patients with non-focal lung morphology. Further validation is needed.

Purpose of the study. An analysis of morphological features of the lung sarcoma 45 ectopic growth in rats of different sexes in course of experimental therapy with 1,3‑diethylbenzimidazolium triiodide.Materials and methods. Studies were carried out on 60 white nonlinear female and male rats weighing 180–220 g with transfusion of sarcoma cells 45 suspension from the subclavian vein into the lung, which resulted in subsequent ectopic tumor growth. At the same time, per os, 0.5 ml of an aqueous solution of 1,3‑diethylbenzimidazolium triiodide in a single dose of 0.4 mg/kg was administered. Morphological control of the lung tumor growth was carried out in stages, weeks 1 through 8, while assessing visual changes with Axiovert microscope (Carl 44 Zeiss, Germany) as well as with Axiovision 4 image visualization program (Carl Zeiss, Germany).Results. It was found out that, instead of the initial acute phase of blood flow reduction due to introduction of tumor cells resulting in neoplastic growth, activation of the immunity cellular link occurred under the influence of 1,3‑diethylbenzimidazolium triiodide along with a compensatory increase in bronchoalveolar structures, regression of tumor nodes and proliferation of connective tissue. At the same time, in females, a more rapid restructuring of the protective cellular systems of the lung occurs, and tumor regression is observed.Conclusion. The morphological manifestations of triiodide indicate the antitumor effect of 1,3‑diethylbenzimidazolium on the possibility of inhibiting lung sarcoma 45 ectopic growth and demonstrate a high reactivity of female rats to the damaging effect of the tumor and the rate of disturbed pulmonary structures compensation.

Background There are limited data on the clinical effects of prone positioning according to lung morphology. We aimed to determine whether the gas exchange response to prone positioning differs according to lung morphology. Methods This retrospective study included adult patients with moderate-to-severe acute respiratory distress syndrome (ARDS). The lung morphology of ARDS was assessed by chest computed tomography scan and classified as “diffuse” or “focal.” The primary outcome was change in partial pressure of arterial oxygen to fraction of inspired oxygen (PaO2/FiO2) ratio after the first prone positioning session: first, using the entire cohort, and second, using subgroups of patients with diffuse ARDS matched 2 to 1 with patients with focal ARDS at baseline. Results Ninety-five patients were included (focal ARDS group, 23; diffuse ARDS group, 72). Before prone positioning, the focal ARDS group showed worse oxygenation than the diffuse ARDS group (median PaO2/FiO2 ratio, 79.9 mm Hg [interquartile range (IQR)], 67.7–112.6 vs. 104.0 mm Hg [IQR, 77.6–135.7]; P=0.042). During prone positioning, the focal ARDS group showed a greater improvement in the PaO2/FiO2 ratio than the diffuse ARDS group (median, 55.8 mm Hg [IQR, 11.1–109.2] vs. 42.8 mm Hg [IQR, 11.6–83.2]); however, the difference was not significant (P=0.705). Among the PaO2/FiO2-matched cohort, there was no significant difference in change in PaO2/FiO2 ratio after prone positioning between the groups (P=0.904). Conclusions In patients with moderate-to-severe ARDS, changes in PaO2/FiO2 ratio after prone positioning did not differ according to lung morphology. Therefore, prone positioning can be considered as soon as indicated, regardless of ARDS lung morphology.

Background: Acute respiratory distress syndrome (ARDS) patients with different lung morphology have distinct pulmonary mechanical dysfunction and outcomes. Whether lung morphology impacts the association between ventilatory variables and mortality remains unclear. Moreover, the impact of a novel combined ventilator variable [(4×DP) + RR] on morality in ARDS patients needs external validation. Methods: We obtained data from the Chinese Database in Intensive Care (CDIC), which included adult ARDS patients who received invasive mechanical ventilation for at least 24 h. Patients were further classified into two groups based on lung morphology (focal and non-focal). Ventilatory variables were collected longitudinally within the first four days of ventilation. The primary outcome was 28-day mortality. Extended Cox regression models were employed to explore the interaction between lung morphology and longitudinal ventilatory variables on mortality. Findings: We included 396 ARDS patients with different lung morphology (64.1% non-focal). The overall 28-day mortality was 34.4%. Patients with non-focal lung morphology have more severe and persistent pulmonary mechanical dysfunction and higher mortality than those with focal lung morphology. Time-varying driving pressure (DP) was more significantly associated with 28-day mortality in patients with non-focal lung morphology compared to focal lung morphology patients (P for interaction = 0.0039). The impact of DP on mortality was more significant than that of respiratory rate (RR) only in patients with non-focal lung morphology. The hazard ratio (HR) of mortality for [(4×DP) + RR] was significant in patients with non-focal lung morphology (HR 1.036, 95% CI 1.027–1.045), not in patients with focal lung morphology (HR 1.019, 95% CI 0.999–1.039). Interpretation: The association between ventilator variables and mortality varied among patients with different lung morphology. [(4×DP) + RR] was only associated with mortality in patients with non-focal lung morphology. Further validation is needed. [ABSTRACT FROM AUTHOR]

Nestling white-footed mice (Peromyscus leucopus) are born in the earliest days of spring in cold climates. If the nestlings are by accident exposed to ambient temperatures near freezing (0–7 °C) at early ages (2–10 days old), they may experience body temperatures (Tbs) equally low. During such hypothermia, although their heart keeps beating, they become apneic (cease inhaling and exhaling). However, they have an exceptional ability (e.g., compared to Mus musculus) to tolerate these conditions for at least several hours, after which they revive if rewarmed by parents. This paper addresses the physiology of the apneic period. We show that apneic, hypothermic nestlings undergo physiologically important exchanges of gases with the atmosphere. These gas exchanges do not occur across the skin. Instead they occur via the trachea and lungs even though the animals are apneic. Most significantly, when hypothermic neonates are in apnea in ordinary air, they take up O2 steadily from the atmosphere throughout the apneic period, and the evidence available indicates that this O2 uptake is essential for the nestlings’ survival. At Tbs of 2–7 °C, the nestlings’ rate of O2 consumption varies quasi-exponentially with Tb and averages 0.04 mL O2 g− 1 h− 1, closely similar to the rate expressed by adult mammalian hibernators in hibernation at similar Tbs. Morphometric analysis indicates that, at all focal ages, O2 transport along the full length of the trachea can take place by diffusion at rates adequate to meet the measured rates of metabolic O2 consumption. [ABSTRACT FROM AUTHOR]

Introduction: Lung fissures are partially incomplete in 50% of different populations. Incomplete formation of the fissures leads to a merging of lobes and conversely accessory lobes form due to the formation of new fissures. This study aims to describe the morphology of the lungs in terms of fissures and lobes. Materials and methods: A descriptive observational study was done on a total of 82 formalin fixed bodies. Both the left and right lungs of each body were examined for accessory lobes and fissures. Results: A wide range of variations was seen in the present study. On the right, the horizontal fissure was absent in six lungs (7.3%), incomplete in 32 lungs (39.0%) and complete in 33 lungs (40.2%). No lungs had an absent oblique fissure. The oblique fissure was incomplete in 24 lungs (29.3%) and complete in 47 lungs (57.3%). No right lung solely had an oblique fissure absent. However, both the horizontal and oblique fissures were absent in one lung (1.2%). In the left lungs, the obliques fissure was absent in one lung (1.2%), incomplete in 24 lungs (29.3%) and complete in 47 lungs (57.3%). An accessory fissure was seen in the territory of the upper lobe forming a partial separation in the right superior lobe of one lung. Conclusion: The high prevalence of morphological variations in this study emphasizes the need for greater understanding of lung fissure anatomy. For example, in video-assisted thoracoscopic surgery lobectomies, higher morbidity in patients is linked with incomplete fissures [12]. Thus, more knowledge of lung fissure and lobe variations will be of significant clinical relevance to anatomy students, cardiothoracic surgeons, and radiologists.

Animal testing is mandatory in drug testing and is the gold standard for toxicity and efficacy evaluations. This situation is expected to change in the future as the 3Rs principle, which stands for the replacement, reduction, and refinement of the use of animals in science, is reinforced by many countries. On the other hand, technologies for alternatives to animal testing have increased. The need to develop and use alternatives depends on the complexity of the research topic and also on the extent to which the currently used animal models can mimic human physiology and/or exposure. The lung morphology and physiology of commonly used animal species differs from that of human lungs, and the realistic inhalation exposure of animals is challenging. In vitro and in silico methods can assess important aspects of the in vivo effects, namely particle deposition, dissolution, action at, and permeation through, the respiratory barrier, and pharmacokinetics. This review discusses the limitations of animal models and exposure systems and proposes in vitro and in silico techniques that could, when used together, reduce or even replace animal testing in inhalation testing in the future. [ABSTRACT FROM AUTHOR]

Preoperative serial imaging of the torso is typically carried out in the supine position (e.g. magnetic resonance imaging [MRI], CT), however, intraoperative patient positioning is often lateral, and for some procedures may involve deflation and/or ventilation of the lungs. This study examined the differences in lung anatomy between the supine and lateral decubitus positions. MRI data for 10 healthy female adult volunteers lying in supine and left lateral decubitus positions were analysed. 2D measurements in coronal, transverse and sagittal planes were used to calculate the cross-sectional area, height and width of the lungs and the shape of the diaphragm. 3D surface reconstructions of the lungs and bronchi were created to determine the volume change between positions. The volume of the right lung was found to increase due to the caudal shift of the insertion points of the right hemidiaphragm (mean volume increase of 25% ± 11, p ≪ 0.05). There was minimal change in the left lung parameters with no significant change in left lung volume between positions (mean volume change = 0% ± 44%, p > 0.05). This study presents new information characterising anatomical changes in the respiratory system when a patient is positioned in the lateral decubitus compared to supine position. [ABSTRACT FROM AUTHOR]

Ventilation and mechanics of breathing are an integral part of respiratory physiology that directly affect aerosol transport and deposition in the lung. Although natural breathing pattern varies widely among individuals, breathing pattern is controllable, and by using an appropriate breathing pattern, aerosol deposition can be substantially modified for desired purposes. Effects of breathing pattern have been investigated under carefully controlled inhalation conditions covering a wide range of tidal volumes (VT) and breathing frequencies (f) or respiratory times (T = 1/f). The studies have shown that lung deposition can increase or decrease as much as two times by changing the breathing pattern. Specific functional relationships have been found between lung deposition and breathing pattern parameters such that lung deposition can be estimated for any given breathing pattern. Both VT and T have shown strong effects on lung deposition, but their influence is variable depending on particle size, particularly, ultrafine vs. micron-sized particles. VT is more influential than T for micron-sized particles whereas VT and T are equally influential for ultrafine particles. Although effects of lung morphology are difficult to study systematically, comparison between normals and patients with obstructive airway disease has shown that lung deposition is closely related with the degree of airways obstruction and can be 2–3 times greater in patients with obstructive airway disease compared to normals. Thus, breathing pattern and the status of airways obstruction should be carefully considered in designing aerosol delivery and estimating deposition dose. [ABSTRACT FROM AUTHOR]

Lung alveologenesis, formation of the alveolar region, allows sufficient gas exchange surface to be packed inside the chest cavity yet with orderly connection to the trachea. The real‐life alveolar region, however, bears little resemblance to idealized cartoons owing to its three‐dimensional nature, nonuniform shape, and mostly air‐filled void. This morphological complexity is matched by its cellular complexity—comprised of intermixed and often tangled cells of the epithelial, mesenchymal, endothelial, and immune lineages. Modern imaging, genetics, and genomics are shedding light on and updating traditional views of alveologenesis. Accordingly, this review describes a cell‐centric 3‐phase definition of alveologenesis and discusses its failure in diseases and possible reactivation during regeneration. Key Findings: We propose a cell‐centric 3‐phase definition of lung alveologenesis to account for the morphological ambiguity of alveoli.The initial alveologenesis phase begins with alveolar type 1 cell flattening and forms alveolar ducts and alveolar sacs.The classical alveologenesis phase is marked by alveolar myofibroblasts.The continued alveologenesis phase increases alveolar surface and outpocketing in the absence of alveolar myofibroblasts.A distinct Car4 endothelial cell population demarcates and is required for alveolar outpocketing, and may underlie intussusceptive angiogenesis but does not support the model of double‐ to single‐layered capillary conversion. [ABSTRACT FROM AUTHOR]

Abstract Background High frequency percussive ventilation (HFPV) combines diffusive (high frequency mini-bursts) and convective ventilation patterns. Benefits include enhanced oxygenation and hemodynamics, and alveolar recruitment, while providing hypothetic lung-protective ventilation. No study has investigated HFPV-induced changes in lung aeration in patients with early acute respiratory distress syndrome (ARDS). Methods Eight patients with early non-focal ARDS were enrolled and five swine with early non-focal ARDS were studied in prospective computed tomography (CT) scan and animal studies, in a university-hospital tertiary ICU and an animal laboratory. Patients were optimized under conventional “open-lung” ventilation. Lung CT was performed using an end-expiratory hold (Conv) to assess lung morphology. HFPV was applied for 1 hour to all patients before new CT scans were performed with end-expiratory (HFPV EE) and end-inspiratory (HFPV EI) holds. Lung volumes were determined after software analysis. At specified time points, blood gases and hemodynamic data were collected. Recruitment was defined as a change in non-aerated lung volumes between Conv, HFPV EE and HFPV EI. The main objective was to verify whether HFPV increases alveolar recruitment without lung hyperinflation. Correlation between pleural, upper airways and HFPV-derived pressures was assessed in an ARDS swine-based model. Results One-hour HFPV significantly improved oxygenation and hemodynamics. Lung recruitment significantly rose by 12.0% (8.5–18.0%), P = 0.05 (Conv-HFPV EE) and 12.5% (9.3–16.8%), P = 0.003 (Conv-HFPV EI). Hyperinflation tended to increase by 2.0% (0.5–2.5%), P = 0.89 (Conv-HFPV EE) and 3.0% (2.5–4.0%), P = 0.27 (Conv-HFPV EI). HFPV hyperinflation correlated with hyperinflated and normally-aerated lung volumes at baseline: r = 0.79, P = 0.05 and r = 0.79, P = 0.05, respectively (Conv-HFPV EE); and only hyperinflated lung volumes at baseline: r = 0.88, P = 0.01 (Conv-HFPV EI). HFPV CT-determined tidal volumes reached 5.7 (1.1–8.1) mL.kg-1 of ideal body weight (IBW). Correlations between pleural and HFPV-monitored pressures were acceptable and end-inspiratory pleural pressures remained below 25cmH20. Conclusions HFPV improves alveolar recruitment, gas exchanges and hemodynamics of patients with early non-focal ARDS without relevant hyperinflation. HFPV-derived pressures correlate with corresponding pleural or upper airways pressures. Trial registration ClinicalTrials.gov, NCT02510105. Registered on 1 June 2015. The trial was retrospectively registered.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes coronavirus disease 2019 (COVID-19) has reached a pandemic level. There are now numerous indications that the COVID-19 coronavirus can severely affect the heart, blood vessels, nerves, brain, kidneys and skin. Of course, the lungs and airways are the main focus of attention with the COVID-19 respiratory disease. In this article the evaluation of pulmonary circulation indicators in the dynamics of respiratory cycle phases in intact animals was performed. This was done using self-registration method of reopulmonography in rats. In experiments on rats with the coloring of lungs tissue with hematoxylin and eosin were studied morphofunctional changes of pulmonary circulation during the combined influence of immobilization and hypothermia. It was determined that abnormalities run at the level of microvasculature vessels of lungs tissue and are accompanied by blood filling reduction, development of arteriolospasm signs, capillaries and post-capillary venules plethora with sustainable increase of vascular wall permeability. [ABSTRACT FROM AUTHOR]

Objective: To investigate the therapeutic roles of hyperbaric oxygen exposure on high-altitude pulmonary edema and to determine whether aquaporin-1 and aquaporin-5 were involved in the pathogenesis of HAPE in rats. Methods: Rats were divided into 5 groups: The control group, the HAPE group (HAPE model), the HBO group (hyperbaric oxygen exposure), the NBO group (normobaric oxygen exposure), and the NA group (normal air exposure). Western blot and real-time PCR were used to analyze the pulmonary expressions of AQP1 and AQP5. The wet-to-dry (W/D) weight ratio and the morphology of the lung were also examined. Results: The lung W/D weight ratio in the HAPE group was increased compared with the control group. The injury score in the HBO group was noticeably lower than that in the control group. The mRNA and proteins expressions of AQP1 and AQP5 were significantly downregulated in the HAPE group. Conclusions: Oxygen exposure alleviated high-altitude hypobaric hypoxia-induced lung injury in rats. Additionally, HBO therapy had significant advantage on interstitial HAPE. [ABSTRACT FROM AUTHOR]

The article informs about respiratory evolution in archosaurs. Topics discussed include Archosauria evolution is marked by the appearance of diverse respiratory and metabolic strategies; focusing on the anatomy and biomechanics of the respiratory system, and their physiological consequences; and the evolution of ventilation mechanics across archosaurs, citing new biomechanical data from extant taxa.

Background: Preterm birth is associated with abnormal lung architecture, and a reduction in pulmonary function related to the degree of prematurity. A thorough understanding of the impact of gestational age on lung microarchitecture requires reproducible quantitative analysis of lung structure abnormalities. The objectives of this study were (1) to use quantitative histological software (ImageJ) to map morphological patterns of injury resulting from delivery of an identical ventilation strategy to the lung at varying gestational ages and (2) to identify associations between gestational age-specific morphological alterations and key functional outcomes.Method: Lung morphology was compared after 60 min of a standardized ventilation protocol (40 cm H2O sustained inflation and then volume-targeted positive pressure ventilation with positive end-expiratory pressure 8 cm H2O) in lambs at different gestations (119, 124, 128, 133, 140d) representing the spectrum of premature developmental lung states and the term lung. Age-matched controls were compared at 124 and 128d gestation. Automated and manual functions of Image J were used to measure key histological features. Correlation analysis compared morphological and functional outcomes in lambs aged ≤128 and >128d.Results: In initial studies, unventilated lung was indistinguishable at 124 and 128d. Ventilated lung from lambs aged 124d gestation exhibited increased numbers of detached epithelial cells and lung tissue compared with 128d lambs. Comparing results from saccular to alveolar development (120–140d), lambs aged ≤124d exhibited increased lung tissue, average alveolar area, and increased numbers of detached epithelial cells. Alveolar septal width was increased in lambs aged ≤128d. These findings were mirrored in the measures of gas exchange, lung mechanics, and molecular markers of lung injury. Correlation analysis confirmed the gestation-specific relationships between the histological assessments and functional measures in ventilated lambs at gestation ≤128 vs. >128d.Conclusion: Image J allowed rapid, quantitative assessment of alveolar morphology, and lung injury in the preterm lamb model. Gestational age-specific patterns of injury in response to delivery of an identical ventilation strategy were identified, with 128d being a transition point for associations between morphological alterations and functional outcomes. These results further support the need to develop individualized respiratory support approaches tailored to both the gestational age of the infant and their underlying injury response.

The lung-air sac system of modern birds is unique among vertebrates. However, debate surrounds whether an avian-style lung is restricted to birds or first appeared in their dinosaurian ancestors, as common osteological correlates for the respiratory system offer limited information on the lungs themselves. Here, we shed light on these issues by using axial morphology as a direct osteological correlate of lung structure, and quantifying vertebral shape using geometric morphometrics in birds, crocodilians and a wide range of dinosaurian taxa. Although fully avian lungs were a rather late innovation, we quantitatively show that non-avian dinosaurs and basal dinosauriforms possessed bird-like costovertebral joints and a furrowed thoracic ceiling. This would have immobilized the lung's dorsal surface, a structural prerequisite for a thinned blood-gas barrier and increased gas exchange potential. This could have permitted high levels of aerobic and metabolic activity in dinosaurs, even in the hypoxic conditions of the Mesozoic, contributing to their successful radiation.

Background. Despite the large number of studies devoted to the study of the functional state of the cardiovascular and respiratory systems after operations on the lungs, there are still many issues regarding the mechanisms of hemodynamic disorders in the postoperative period. It stipulates considerable difficulties in the treatment and prevention of functional disorders of respiration and circulation. Objective. The aim of this study is to determine the central hemodynamics parameters depending on the condition of ventilate lung function in thoracic oncology patients during the postoperative period and to determine the morphological features of the lungs that developed under the influence of intraoperative administration of refortan and perftoran. Methods. The condition of the central heamodynamic and morphological features of the lungs at patients with lung cancers with different level of the ventilating respiratory insufficiency in the early postoperative period after application of 3 and 1,5 ml/kg of perftoran and after traditional refortan (5 ml/kg) infusion-transfusion therapy were determined. Results and conclusion. It was proved that perftoran is much more effective than pefortan. The restoration of the normodynamic type of heamodynamic after infusion of perftoran (1,5 ml/kg) to patients with the an initial level of the ventilating respiratory insufficiency of I and II degree is observed during 1st postoperative week. The restoration of the normodynamic type of heamodynamic at to patients with the initial level of the ventilating respiratory insufficiency of III degree in postoperative period is reached by using perftoran in a dose 3 ml/kg. In the dead after pneumonectomy with intraoperative administration of perftoran there is increasing of synthetic activity of alveolocyte type II along with compensatory microcirculatory changes. Citation: Tverdokhlib IV, Novikov SP. [Сentral heamodynamic сondition and morphological characteristics of lungs at patients with lung cancer depending on components of the infusion-transfusion therapy]. Morphologia. 2015;9(4):76-84. Ukrainian.

Background: High frequency percussive ventilation (HFPV) combines diffusive (high frequency mini-bursts) and convective ventilation patterns. Benefits include enhanced oxygenation and hemodynamics, and alveolar recruitment, while providing hypothetic lung-protective ventilation. No study has investigated HFPV-induced changes in lung aeration in patients with early acute respiratory distress syndrome (ARDS).Methods: Eight patients with early non-focal ARDS were enrolled and five swine with early non-focal ARDS were studied in prospective computed tomography (CT) scan and animal studies, in a university-hospital tertiary ICU and an animal laboratory. Patients were optimized under conventional "open-lung" ventilation. Lung CT was performed using an end-expiratory hold (Conv) to assess lung morphology. HFPV was applied for 1 hour to all patients before new CT scans were performed with end-expiratory (HFPV EE) and end-inspiratory (HFPV EI) holds. Lung volumes were determined after software analysis. At specified time points, blood gases and hemodynamic data were collected. Recruitment was defined as a change in non-aerated lung volumes between Conv, HFPV EE and HFPV EI. The main objective was to verify whether HFPV increases alveolar recruitment without lung hyperinflation. Correlation between pleural, upper airways and HFPV-derived pressures was assessed in an ARDS swine-based model.Results: One-hour HFPV significantly improved oxygenation and hemodynamics. Lung recruitment significantly rose by 12.0% (8.5-18.0%), P = 0.05 (Conv-HFPV EE) and 12.5% (9.3-16.8%), P = 0.003 (Conv-HFPV EI). Hyperinflation tended to increase by 2.0% (0.5-2.5%), P = 0.89 (Conv-HFPV EE) and 3.0% (2.5-4.0%), P = 0.27 (Conv-HFPV EI). HFPV hyperinflation correlated with hyperinflated and normally-aerated lung volumes at baseline: r = 0.79, P = 0.05 and r = 0.79, P = 0.05, respectively (Conv-HFPV EE); and only hyperinflated lung volumes at baseline: r = 0.88, P = 0.01 (Conv-HFPV EI). HFPV CT-determined tidal volumes reached 5.7 (1.1-8.1) mL.kg-1 of ideal body weight (IBW). Correlations between pleural and HFPV-monitored pressures were acceptable and end-inspiratory pleural pressures remained below 25cmH20.Conclusions: HFPV improves alveolar recruitment, gas exchanges and hemodynamics of patients with early non-focal ARDS without relevant hyperinflation. HFPV-derived pressures correlate with corresponding pleural or upper airways pressures.Trial Registration: ClinicalTrials.gov, NCT02510105 . Registered on 1 June 2015. The trial was retrospectively registered. [ABSTRACT FROM AUTHOR]

The purpose of this review is to give an outline of respiratory tract morphological and functional development with an emphasis on perinatal and postnatal maturational processes. In view of the rising need for qualitative and quantitative data for the development of pediatric pharmaceuticals, a comparison of the human situation to experimental animal models is made, and functional data as well as suitable models for human airway diseases and functional testing are presented. Birth Defects Research 109:1519-1539, 2017. © 2017 Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]

Different acute respiratory distress syndrome (ARDS) phenotypes may explain controversial results in clinical trials. Lung-morphology is one of the ARDS-phenotypes and physiological studies suggest different responses in terms of positive-end-expiratory-pressure (PEEP) and recruitment-manoeuvres (RM) according to loss of aeration. To evaluate whether tailored ventilator regimens may impact ARDS outcomes, our group has designed a randomised-clinical-trial of ventilator settings according to lung morphology in moderate-to-severe ARDS (LIVE study). Method Patients will be enrolled within the first 12 hours of ARDS onset. In both groups, volume-controlled ventilation with low tidal-volumes (Vt) will be used to target a plateau pressure ≤ 30 cmH 2 O. In the control group, the PEEP level and inspired fraction of oxygen (FiO 2 ) will be set using the ARDSNet table; a Vt of 6 mL/kg of predicted body weight (PBW) will be set and prone position (PP) will be applied. In the intervention arm, the ventilator will be set according to lung morphology (focal/non-focal) that will be assessed according to CT-scan ± chest x-ray + lung echography. For focal ARDS patients, a Vt of 8 mL/kg PBW will be used along with low PEEP and PP. For non-focal ARDS patients, a Vt of 6 mL/kg PBW will be used with RM and PEEP to reach a plateau pressure ≤ 30 cmH 2 O. The primary outcome is all-cause 90-day mortality and the secondary outcomes are: in-hospital mortality, mortality at day 28, 60, 180 and 365; ventilator-free days at day 30, quality of life at one year; ventilator-associated pneumonia rate; barotrauma; ICU and hospital length of stay. This RCT is registered on Clinicaltrials.gov under identifier NCT02149589 . [ABSTRACT FROM AUTHOR]

O tabaco está implicado na carcinogénese multiorgânica, com identificação de mais de cinquenta substâncias carcinogénicas que induzem mutações, alterando o ciclo celular, a resposta auto-imune e a regulação endócrina. É um dos nove factores identificados responsáveis por um terço de mortes por neoplasias malignas juntamente com erros dietéticos, obesidade, sedentarismo, consumo de álcool, promiscuidade sexual, toxicodependência e poluição ambiental geral e limitada. Está implicado nas doenças cardiovasculares que representam a primeira causa de morte nos países civilizados e, no aparelho respiratório, é o factor principal para o desenvolvimento de DPOC (doença pulmonar obstrutiva crónica), RB-ILD (bronquiolite respiratória e doença pulmonar intersticial), DIP (pneumonia intersticial descamativa), bronquiolite e fibrose intersticial bronquiolocêntrica, histiocitose de células de Langerhans, pneumonia eosinofílica, sarcoidose, metaplasia epidermóide do epitélio respiratório e carcinoma bronco-pulmonar. O estado inflamatório crónico sistémico induzido pelo tabaco constitui a base de desenvolvimento de alterações genéticas também dependentes dos contaminantes do tabaco.Tobacco is implicated in multisystemic carcinogenesis through more than fifty identified carcinogenic metabolites that produce mutations responsible for alterations in cell cycle, immune response and endocrine regulation. Is one of nine risk factors identified in one third of cancer deaths together with obesity, sedentary, alcohol consumption, sexual promiscuity, drug addiction, and open and closed air contamination. Answering for cardiovascular diseases as the first cause of death in civilized world, tobacco is also pointed as the major factor implicated in the development of COPD (chronic obstructive pulmonary disease), RB-ILD (respiratory bronchiolitis and interstitial lung disease), DIP (desquamative interstitial pneumonia), bronchiolitis and bronchiolocentric interstitial fibrosis, Langerhans cells histiocytosis, eosinophilic pneumonia, sarcoidosis, epidermoid metaplasia in respiratory epithelium and lung cancer. The chronic tobacco induced inflammatory state is the basis for the acquisition of genetic alterations dependent on the tobacco contaminants.

Objective: to investigate pulmonary morphological changes in animals with limb ischemic and reperfusion lesions, which were treated with hemocarboperfusion on sodium hypochlorite-modified sorbents.Materials and methods. The investigation was conducted on 94 mature mongrel male dogs with 4-hour limb ischemia and subsequent reperfusion. Limb ischemia was induced by applying a tourniquet to the isolated vascular fascicle of an experimental limb proximal to the origin of the deep artery of the thigh. Following 4 hours, reperfusion was made, by removing the tourniquet. Three hours of the initiation of reperfusion, one-hour hemocarboperfusion was performed thrice for 72 hours. Lung biopsy samples were used for morphological studies. Morphological changes were evaluated, by employing the hematoxylin- and eosin-stained semifine sections. The visceral histological pattern was assessed by a light trinocular microscope (OLYMPUS, Japan) (microscope objective 10).Results. The development of 4-hour limb ischemia is accompanied by significant microcirculatory disorders in the lungs that exhibit dyscirculatory and dystrophic processes concurrent with the signs of tissue dyscomplexation without the signs of an inflammatory reaction. In the reperfusion period, there was a significant progression of lung tissue morphological changes corresponding to the pattern of phase 2 respiratory distress syndrome. Sodium hypochlorite-modified CKN-1K sorbent hemocarboperfusion resulted in a virtually complete restoration of the lung architectonics in the presence of insignificant microcirculato-ry and ventilatory disorders. After standard hemocarboperfusion, the lung tissue may be defined as a slightly reduced pattern of acute pulmonary lesion.Conclusion. Sodium hypochlorite-modified CKN-1K sorbent hemocarboperfusion is an effective technique in abolishing ischemic and reperfusion lesions.

Background: During ARDS, CT can reveal two distinct lung imaging patterns, focal or nonfocal, with different responses to positive end-expiratory pressure, recruitment maneuvers, and prone position. Nevertheless, their association with plasma biomarkers and their distinct functional/pathobiological mechanisms are unknown. The objective of this study was to characterize focal and nonfocal patterns of lung CT-based imaging with plasma markers of lung injury.Methods: A prospective multicenter cohort study involving 119 consecutive patients with ARDS. Plasma biomarkers (soluble form of the receptor for advanced glycation end product [sRAGE], plasminogen activator inhibitor-1, soluble intercellular adhesion molecule-1, and surfactant protein-D) were measured within 24 h of ARDS onset. Lung CT scan was performed within the first 48 h to assess lung morphology.Results: Thirty-two (27%) and 87 (73%) patients had focal and nonfocal ARDS, respectively. Plasma levels of sRAGE were significantly higher in nonfocal ARDS, compared with focal ARDS. A cut-off of 1,188 pg/mL differentiated focal from nonfocal ARDS with a sensitivity of 94% and a specificity of 84%. Nonfocal patterns were associated with higher 28- and 90-day mortality than focal patterns (31% vs 12%, P = .038 and 46% vs 21%, P = .026, respectively). Plasma levels of plasminogen activator inhibitor-1 were significantly higher in nonfocal ARDS. There was no difference in other biomarkers.Conclusions: Plasma sRAGE is associated with a nonfocal ARDS. Such novel findings may suggest a role for RAGE pathway in an underlying endotype of impaired alveolar fluid clearance and stimulate future research on the association between ARDS phenotypes and therapeutic responses. [ABSTRACT FROM AUTHOR]

Background The acute respiratory distress syndrome (ARDS) is a heterogeneous syndrome that encompasses multiple phenotypes, e.g. with regards to lung morphology as assessed by computed tomography (CT). Focal or non-focal lung morphology may influence the response to positive end-expiratory pressure (PEEP), recruitment manoeuvres and prone position. Lung morphology has been hypothesized to be associated with alveolar fluid clearance (AFC), thus explaining various responses to such therapeutic interventions; however, this hypothesis has not been specifically studied in humans. Methods We measured net AFC rates in 30 patients with ARDS as a secondary data analysis of a prospective single-centre study. Net AFC rates were compared between patients with focal ARDS and those with non-focal ARDS, as assessed by lung CT-scans. Results Net AFC rates were significantly lower in patients with non-focal ARDS ( n = 23; median [interquartile range], 1.5 [0–5.5] %/h) as compared to those with focal ARDS ( n = 7; 10.3 [4.5–15] %/h) ( P = 0.01). The area under the receiver-operating characteristic curve when net AFC rates were used to differentiate the presence from absence of non-focal ARDS was 0.93 (95% confidence interval, 0.81–1). Tidal volumes and PEEP levels differed between focal and non-focal ARDS patients, but there was no difference in arterial oxygenation or in alveolar-capillary permeability. Conclusions Non-focal lung morphology may be characterized by a functional endotype consistent with marked AFC impairment. Despite study limitations and the need for validating studies in larger cohorts, such novel findings may reinforce our understanding of the association between ARDS phenotypes and therapeutic responses. [ABSTRACT FROM AUTHOR]

The morphology of the rat lung was studied by light microscopy in different situations: after surgical and pharmacological castration and after administration of testosterone to the castrated rat to determine if the androgen is required to maintain the normal morphology of the lung. We also determined the effect of flutamide on the phospholipid composition of both the surfactant and microsomes of the lung. Rats were separated into five groups: I - control non-castrated rats, II - castrated rats sacrificed 21 days after castration, III - castrated rats that received testosterone daily from day 2 to day 21 after castration, IV - castrated rats that received testosterone from day 15 to day 21 after castration, and V - control rats injected with flutamide for 7 days. The amount of different phospholipids in the surfactant and microsomes of the lung was measured in group I and V rats. At the light microscopy level, the surgical and pharmacological castration provoked alterations in the morphology of the lung, similar to that observed in human lung emphysema. The compositions of surfactant and microsomes of the lung were similar to those previously reported by us for the surgically castrated rats. These results indicate that androgens are necessary for the normal morphology as well as for some metabolic aspects of the lung.

Embryo body and lung wet and dry mass, pulmonary morphometrics and pulmonary VEGF concentrations were determined in developing chicken embryos at days 16 and 18 (D16, D18) in three populations: incubation in normoxia (21% O 2 ) or in chronic hypoxia (15% O 2 ) or chronic hyperoxia (30% O 2 ). Lung morphology (including parabronchial exchange tissues and parabronchial lumina as a percentage of total lung tissue in cross-sectional area, atrial numbers, atrial density) was determined from morphometric examination of thin sections using light microscopy. VEGF expression was determined with ELISA. Body mass was directly correlated with incubation oxygen level, but neither oxygen level affected lung wet mass on either D16 or D18. Hypoxia had little or no effect on most measured pulmonary morphometric indices in D16 embryos. Hypoxia, however, increased by ∼65% the proportion in cross-section of the total lung occupied by parabronchi on D18. Hyperoxia caused few significant changes in pulmonary morphometrics. Pulmonary VEGF concentration was decreased by ∼30% on day 18 compared to D18 in normoxia. Hypoxia increased pulmonary VEGF concentration by ∼35–75% on both D16 and D18 and, paradoxically, VEGF expression was also similarly increased by hyperoxia on only D18. Collectively, these data suggest that pulmonary gross morphological development in the chicken embryo, while moderately plastic, is not profoundly affected by oxygen incubation level, and that role of VEGF in pulmonary development is not yet well understood. [ABSTRACT FROM AUTHOR]

The study of adaptation to terrestrial life in crabs poses several physiological questions. One of the major challenges the crabs have to face is respiration of air: most of the time, gills are unsuitable to perform oxygen exchange out of the water. Fiddler crabs, like other representatives of the Ocypodidae, have developed an additional mechanism of respiration by improving the circulation that lines the branchiostegal chamber, thus developing a branchiostegal lung. In the present study we describe the hitherto unreported complex morphology of the branchiostegal lung of the fiddler crab Uca vocans by means of corrosion casting techniques and 3D reconstruction. This complexity leads us to reconsider the degree of terrestriality of U . vocans and its evolutionary pathway towards land. [ABSTRACT FROM AUTHOR]

Purpose:Wall thickness (WT) is an airway feature of great interest for the assessment of morphological changes in the lung parenchyma. Multidetector computed tomography (MDCT) has recently been used to evaluate airway WT, but the potential risk of radiation-induced carcinogenesis--particularly in younger patients--might limit a wider use of this imaging method in clinical practice. The recent commercial implementation of the statistical model-based iterative reconstruction (MBIR) algorithm, instead of the conventional filtered back projection (FBP) algorithm, has enabled considerable radiation dose reduction in many other clinical applications of MDCT. The purpose of this work was to study the impact of radiation dose and MBIR in the MDCT assessment of airway WT. Methods: An airway phantom was scanned using a clinical MDCT system (Discovery CT750 HD, GE Healthcare) at 4 kV levels and 5 mAs levels. Both FBP and a commercial implementation of MBIR (VeoTM, GE Healthcare) were used to reconstruct CT images of the airways. For each kV-mAs combination and each reconstruction algorithm, the contrast-to-noise ratio (CNR) of the airways was measured, and the WT of each airway was measured and compared with the nominal value; the relative bias and the angular standard deviation in the measured WT were calculated. For each airway and reconstruction algorithm, the overall performance of WT quantification across all of the 20 kV-mAs combinations was quantified by the sum of squares (SSQs) of the difference between the measured and nominal WT values. Finally, the particular kV-mAs combination and reconstruction algorithm that minimized radiation dose while still achieving a reference WT quantification accuracy level was chosen as the optimal acquisition and reconstruction settings. Results: The wall thicknesses of seven airways of different sizes were analyzed in the study. Compared with FBP, MBIR improved the CNR of the airways, particularly at low radiation dose levels. For FBP, the relative bias and the angular standard deviation of the measured WT increased steeply with decreasing radiation dose. Except for the smallest airway, MBIR enabled significant reduction in both the relative bias and angular standard deviation of the WT, particularly at low radiation dose levels; the SSQ was reduced by 50%-96% by using MBIR. The optimal reconstruction algorithm was found to be MBIR for the seven airways being assessed, and the combined use of MBIR and optimal kV-mAs selection resulted in a radiation dose reduction of 37%-83% compared with a reference scan protocol with a dose level of 1 mGy. Conclusions: The quantification accuracy of airway WT is strongly influenced by radiation dose and reconstruction algorithm. The MBIR algorithm potentially allows the desired WT quantification accuracy to be achieved with reduced radiation dose, which may enable a wider clinical use of MDCT for the assessment of airway WT, particularly for younger patients who may be more sensitive to exposures with ionizing radiation. [ABSTRACT FROM AUTHOR]

Objective To evaluate the changes in lung morphology in subjects with adolescent idiopathic scoliosis ( AIS) following posterior spinal fusion surgery. Methods From April 2009 to August 2013, 30 AIS patients (nine males and 21 females) were enrolled in this study. All scans were obtained with the patient in the supine position and the breath held in deep inspiration and performed both before and after surgery. Syngo software was used to manage the computed tomography scan imaging and to calculate the lung volume, lung height and pulmonary cross-sectional area in the apical vertebral plane. Results Left lung, right lung and total lung volumes and convex to concave lung volume ratio did not change significantly after corrective surgery. There was a statistically significant improvement in left lung and right lung heights after posterior spinal fusion surgery. However, the pulmonary cross-sectional area in the apical vertebrae plane was smaller postoperatively than preoperatively. Conclusions This study showed that lung height in AIS patients increased significantly immediately postoperatively whereas lung volume did not change significantly. Thoracic symmetry was improved postoperatively in these patients. [ABSTRACT FROM AUTHOR]

Objective To discuss the correlation between MSCT morphological index of emphysema and pulmonary function test （PFT） indexes. Methods We randomly selected 33 cases with chronic obstructive pulmonary disease （COPD），and conducted CT and PFT in a week. The whole lung was scanned by MSCT at the end of deep aspiration， and the post-processing workstation was used for quantitative determination of a total of 12 morphological indexes， including the density of lung， pulmonary diameter line ，lung volume， and etc， then their correlation with lung function index was analyzed． Results FEV1.0% had correlation with upper right lung density （r = 0.391，P = 0.391）， lower right lung density （ r= 0.465，P = 0.038），the mean lung density （r = 0.576，P = 0.576）， and total lung capacity （r = 0.471，P = 0.471），upper right lung volume （ r= 0.413，P = 0.049） . FEV1.0 / FVC had correlation with left lower lung density （r = 0.392，P = 0.024）， the mean lung density （r = 0.703，P = 0.000）， total lung transverse diameter （ r= 0.521， = 0.521）， upper right lung maximum transverse diameter （r = 0.627，P = 0.627）， and total lung capacity （r = 0.549，P = 0.549） correlation. FVC had correlation with upper right lung maximum transverse diameter （ r= 0.378，P = 0.378）， characterized by maximum transverse diameter （ r= 0.349，P = 0.037） . TLC had correlation with mean lung density （ r= 0.523，P = 0.523）， upper right lung maximum transverse diameter （r = 0.454， P= 0.454）， and total lung capacity 0.001），the right lung volume （ r= 0.492，P = 0.492） . Conclusion MSCT lung morphology quantitative indicators have good clinical application value in the diagnosis and assessment of emphysema patients. [ABSTRACT FROM AUTHOR]