119 results on '"Trachea -- Research"'
Search Results
2. Airway surface liquid depth measured in ex vivo fragments of pig and human trachea: dependence on [Na.sup.+] and [Cl.sup.-] channel function
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Song, Yuanlin, Namkung, Wan, Nielson, Dennis W., Lee, Jae-Woo, Finkbeiner, Walter E., and Verkman, A.S.
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Cystic fibrosis -- Development and progression ,Cystic fibrosis -- Patient outcomes ,Ion channels -- Physiological aspects ,Trachea -- Physiological aspects ,Trachea -- Research ,Biological sciences - Abstract
Song Y, Namkung W, Nieison DW, Lee J, Finkbeiner WE, Verkman AS. Airway surface liquid depth measured in ex vivo fragments of pig and human trachea: dependence on [Na.sup.+] and [Cl.sup.-] channel function. Am J Physiol Lung Cell Mol Physiol 297: L1131-L1140, 2009. First published October 9, 2009; doi: 10.1152/ajplung.00085.2009.--The airway surface liquid (ASL) is the thin fluid layer lining the airways whose depth may be reduced in cystic fibrosis. Prior measurements of ASL depth have been made in airway epithelial cell cultures. Here, we established methodology to measure ASL depth to -1-[micro]m accuracy in ex vivo fragments of freshly obtained human and pig tracheas. Airway fragments were mounted in chambers designed for perfusion of the basal surface and observation of the apical, fluorescently stained ASL by scanning confocal microscopy using a high numerical aperture lens immersed in perfluorocarbon. Measurement accuracy was verified using standards of specified fluid thickness. ASL depth in well-differentiated primary cultures of human nasal respiratory epithelium was 8.0 [+ or -] 0.5 [micro]m (SE 10 cultures) under basal conditions, 8.4 [+ or -] 0.4 [micro]m following ENaC inhibition by amiloride, and 14.5 [+ or -] 1.2 [micro]m following CFTR stimulation by cAMP agonists. ASL depth in human trachea was 7.0 [+ or -] 0.7/[micro]m under basal conditions, 11.0 [+ or - ] 1.7 [mciro]m following amiloride, 17.0 [+ or -] 3.4 [micro]m following cAMP agonists, and 7.1 [+ or -] 0.5 [micro]m after CFTR inhibition. Similar results were found in pig trachea. This study provides the first direct measurements of ASL depth in intact human airways and indicates the involvement of ENaC sodium channels and CFTR chloride channels in determining ASL depth. We suggest that CF lung disease may be caused by the inability of CFTR-deficient airways to increase their ASL depth transiently following secretory stimuli that in non-CF airways produce transient increases in ASL depth. cystic fibrosis; fluorescence microscopy; cystic fibrosis transmembrahe conductance regulator doi: 10.1152/ajplung.00085.2009. more...
- Published
- 2009
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3. Lubiprostone stimulates secretion from tracheal submucosal glands of sheep, pigs, and humans
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Joo, N.S., Wine, J.J., and Cuthbert, A.W.
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Lubiprostone -- Health aspects ,Trachea -- Physiological aspects ,Trachea -- Research ,Cystic fibrosis -- Risk factors ,Cystic fibrosis -- Drug therapy ,Cystic fibrosis -- Research ,Biological sciences - Abstract
Lubiprostone, a putative ClC-2 chloride channel opener, has been investigated for its effects on airway epithelia (tracheas). Lubiprostone is shown to increase submucosal gland secretion in pigs, sheep, and humans and to increase short-circuit current (SCC) in the surface epithelium of pigs and sheep. Use of appropriate blocking agents and ion-substitution experiments shows anion secretion is the driving force for fluid formation in both glands and surface epithelium. From SCC concentration-response relations, it is shown that for apical lubiprostone [K.sub.d] = 10.5 nM with a Hill slope of 1.08, suggesting a single type of binding site and, from the speed of the response, close to the apical surface, confirmed the rapid blockade by Cd ions. Responses to lubiprostone were reversible and repeatable, responses being significantly larger with ventral compared with dorsal epithelium. Submucosal gland secretion rates following basolateral lubiprostone were, respectively, 0.2, 0.5, and 0.8 nl [gl.sup.-1] [min.sup.-1] in humans, sheep, and pigs. These rates dwarf any contribution surface secretion adds to the accumulation of surface liquid under the influence of lubiprostone. Lubiprostone stimulated gland secretion in two out of four human cystic fibrosis (CF) tissues and in two of three disease controls, chronic obstructive pulmonary disease and idiopathic pulmonary fibrosis (COPD/IPF), but in neither type of tissue was the increase significant. Lubiprostone was able to increase gland secretion rates in normal human tissue in the continuing presence of a high forskolin concentration. Lubiprostone had no spasmogenic activity on trachealis muscle, making it a potential agent for increasing airway secretion that may have therapeutic utility. airway surface epithelium; airway submucosal glands; sheep, pig, and human tracheas; cystic fibrosis more...
- Published
- 2009
4. Assessment of endotracheal cuff pressure by continuous monitoring: a pilot study
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Sole, Mary Lou, Penoyer, Daleen Aragon, Su, XiaoGang, Jimenez, Edgar, Kalita, Samar J., Paolillo, Elizabeth, Byers, Jacqueline F., Bennett, Melody, and Ludy, Jeffery E.
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Patient monitoring -- Research ,Intensive care nursing -- Research ,Trachea -- Intubation ,Trachea -- Management ,Trachea -- Research ,Company business management ,Health ,Health care industry - Published
- 2009
5. Instilling normal saline with suctioning: beneficial technique or potentially harmful sacred cow?
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Halm, Margo A. and Krisko-Hagel, Kathryn
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Physiologic salines -- Dosage and administration ,Suction (Medical care) -- Research ,Trachea -- Intubation ,Trachea -- Research ,Health ,Health care industry - Published
- 2008
6. Survey of cuff management practice in intensive care units in Australia and New Zealand
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Rose, Louise and Redl, Leanne
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Trachea -- Intubation ,Trachea -- Methods ,Trachea -- Research ,Health ,Health care industry - Published
- 2008
7. Influence of physical restraint on unplanned extubation of adults intensive care patients: a case-control study
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Chang, Li-Yin, Wang, Kwai-Wei Katherine, and Chao, Yann-Fen
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Trachea -- Intubation ,Trachea -- Research ,Intensive care nursing -- Research ,Health ,Health care industry - Published
- 2008
8. Antimicrobial-coated endotracheal tubes: an experimental study
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Berra, Lorenzo, Curto, Francesco, Li Bassi, Gianluigi, Laquerriere, Patrice, Pitts, Betsey, Baccarelli, Andrea, and Kolobow, Theodor
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Antibacterial agents -- Dosage and administration ,Antibacterial agents -- Research ,Microbial mats -- Health aspects ,Microbial mats -- Research ,Bacterial pneumonia -- Risk factors ,Bacterial pneumonia -- Diagnosis ,Bacterial pneumonia -- Prevention ,Bacterial pneumonia -- Research ,Pneumonia -- Risk factors ,Pneumonia -- Diagnosis ,Pneumonia -- Prevention ,Pneumonia -- Research ,Trachea -- Intubation ,Trachea -- Methods ,Trachea -- Complications and side effects ,Trachea -- Research ,Health care industry - Abstract
Byline: Lorenzo Berra (1), Francesco Curto (2), Gianluigi Li Bassi (2), Patrice Laquerriere (3), Betsey Pitts (4), Andrea Baccarelli (5), Theodor Kolobow (2) Keywords: Endotracheal tube; Mechanical ventilation; Bacterial biofilm; Ventilator-associated pneumonia; Silver sulfadiazine Abstract: Objective Antibiotic-resistant bacterial biofilm may quickly form on endotracheal tubes (ETTs) and can enter the lungs, potentially causing pneumonia. In an attempt to prevent bacterial colonization, we developed and tested in an in-vitro study and animal study several antibacterial-coated ETTs (silver sulfadiazine with and without carbon in polyurethane, silver sulfadiazine and chlorhexidine with and without carbon in polyurethane, silver--platinum with and without carbon in polyurethane, chlorhexidine in polyurethane, and rose bengal for UV light). Design, setting, animals, interventions After preliminary studies, silver sulfadiazine in polyurethane (SSD-ETT) was selected among the coatings to be challenged every 24a-h with 10.sup.4--10.sup.6 Pseudomonas aeruginosa/ml and evaluated at 6a-h, 24a-h, and 72a-h with standard microbiological studies, scanning electron microscopy, and confocal scanning microscopy. Subsequently, eight sheep were randomized to receive either a SSD-ETT or a standard ETT (St-ETT). After 24a-h of mechanical ventilation, standard microbiological studies were performed together with scanning electron microscopy and confocal microscopy. Measurements and results In the in-vitro study SSD-ETT remained bacteria-free for up to 72a-h, whereas St-ETT showed heavy P. aeruginosa growth and biofilm formation (pa- Conclusion This study describes several effective and durable antibacterial coatings for ETTs. Particularly, SSD-ETT showed prevention against P. aeruginosa biofilm formation in a 72-h in-vitro study and lower respiratory tract colonization in sheep mechanically ventilated for 24a-h. Author Affiliation: (1) Department of Anesthesia and Critical Care, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, WHT-4-436, Boston, MA, USA (2) Pulmonary and Critical Care Medicine Branch, NHLBI, National Institutes of Health, 9000 Rockville Pike, 20892, Bethesda, MD, USA (3) Laboratoire de Microscopie Electronique, UFR Sciences, University of Reims Champagne Ardenne, INSERM-ERM 0203, 21 rue Clement Ader, BP 138, 51685, Reims, Cedex 2, France (4) Center for Biofilm Engineering and Department of Chemical Engineering, Montana State University Bozeman, 59717-3980, Bozeman, MT, USA (5) Department of Environmental Health, Harvard School of Public Health, 02215, Boston, MA, USA Article History: Registration Date: 11/03/2008 Received Date: 07/04/2006 Accepted Date: 10/12/2007 Online Date: 17/04/2008 Article note: This article is discussed in the editorial available at: http://dx.doi.org/10.1007/s00134-008-1101-0. more...
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- 2008
9. A double-layer tracheal tube cuff designed to prevent leakage: a bench-top study
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Zanella, Alberto, Cressoni, Massimo, Epp, Myra, Stylianou, Mario, and Kolobow, Theodor
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Trachea -- Physiological aspects ,Trachea -- Health aspects ,Trachea -- Research ,Trachea -- Intubation ,Trachea -- Methods ,Health care industry - Abstract
Byline: Alberto Zanella (1), Massimo Cressoni (1), Myra Epp (1), Mario Stylianou (2), Theodor Kolobow (1) Keywords: Tube, endotracheal; Cuff; Leakage, fluid; Aspiration; Ventilator-associated pneumonia Abstract: Objective We designed a new endotracheal tube (ETT) cuff that does not form the folds that cause leakage of colonized subglottic secretions upon inflation within the trachea: a standard high-volume low-pressure cuff was draped with a second, highly elastic cuff made of a low-protein guayule natural latex rubber with 0.5a-ml gel between the cuffs. We compared this prototype ETT cuff with four commercially available ETTs for efficacy in the prevention of fluid leakage across the cuff. Design In vitro study. Measurements and results We compared fluid leakage in our prototype cuff with that in four commercially available ETTs. Three cylindrical glass tubes 16, 20, and 22a-mm in diameter were used as model tracheas, and five different intracuff pressures (20, 25, 30, 40, and 50a-cm[H.sub.2]O) were tested. Each test was repeated three times with new ETTs. The guayule latex ETT cuff showed an average fluid leakage of 0.0007a-+-a-0.002a-ml/min which was significantly lower than that in any of the other ETTs (Microcuff 0.07a-+-a-0.09, Mallinckrodt/Hi-Lo Evac 5a-+-a-5, Euromedical 7a-+-a-4, Sheridan/CF 41a-+-a-69). Conclusions Our prototype ETT cuff significantly reduced fluid leakage in this bench-top study. In vivo testing and evaluation is to follow. Author Affiliation: (1) Pulmonary and Critical Care Medicine Branch, NHLBI, National Institutes of Health, 9000 Rockville Pike, 20892-1150, Bethesda, MD, USA (2) Office of Biostatistics Research, OD, NHLBI, National Institutes of Health, 9000 Rockville Pike, 20892-1150, Bethesda, MD, USA Article History: Registration Date: 15/01/2008 Received Date: 30/08/2007 Accepted Date: 10/01/2008 Online Date: 08/02/2008 Article note: Electronic supplementary material The online version of this article (doi: 10.1007/s00134-008-1016-9) contains supplementary material, which is available to authorized users. more...
- Published
- 2008
10. Short-term effects of endotracheal intubation on voice
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Hamdan, Abdul-Latif, Sibai, Abla, Rameh, Charbel, and Kanazeh, Ghassan
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Voice -- Evaluation ,Anesthesia -- Usage ,Trachea -- Intubation ,Trachea -- Physiological aspects ,Trachea -- Complications and side effects ,Trachea -- Research ,Arts, visual and performing ,Health - Published
- 2007
11. Antispasmodic activity of an extract from Plantago lanceolata L. and some isolated compounds
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Fleer, H. and Verspohl, E.J.
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Research ,Trachea -- Research ,Plantain (Plantago) -- Research ,Ileum -- Research ,Antispasmodics -- Research ,English plantain -- Research - Abstract
An ethanolic spissum extract of the aerial parts of Plantago lanceolata L. was examined for antispasmodic activity on isolated ileum and trachea of the guinea-pig. Isolated constituents were investigated as [...] more...
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- 2007
12. SPDEF regulates goblet cell hyperplasia in the airway epithelium
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Park, Kwon-Sik, Korfhagen, Thomas R., Bruno, Michael D., Kitzmiller, Joseph A., Wan, Huajing, Wert, Susan E., Hershey, Gurjit K. Khurana, Chen, Gang, and Whitsett, Jeffrey A.
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Research ,Trachea -- Research ,Hyperplasia -- Research ,Gene expression -- Research - Abstract
Goblet cell hyperplasia and mucous hypersecretion contribute to the pathogenesis of chronic pulmonary diseases including cystic fibrosis, asthma, and chronic obstructive pulmonary disease. In the present work, mouse SAM pointed [...] more...
- Published
- 2007
13. Wide-band tracheids in genera of Portulacaceae: novel, non-xylary tracheids possibly evolved as an adaptation to water stress
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Landrum, James V.
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Succulent plants -- Research ,Succulent plants -- Physiological aspects ,Trachea -- Structure ,Trachea -- Research ,Science and technology - Published
- 2006
14. Distinct functions of the leucine-rich repeat transmembrane proteins Capricious and Tartan in the Drosophila tracheal morphogenesis
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Krause, Cindy, Wolf, Christian, Hemphala, Johanna, Samakovlis, Christos, and Schuh, Reinhard
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Drosophila -- Research ,Morphogenesis -- Research ,Cell interaction -- Analysis ,Membrane proteins -- Research ,Trachea -- Research ,Biological sciences - Abstract
The role of leucine-rich repeat transmembrane proteins, Capricious and Tartan, in development of tracheal system during morphogenesis in Drosophila, is analyzed. These proteins help tracheal cells to interact with mesodermal cells. more...
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- 2006
15. The effect of inhaled air ions generated by technical ionizers and a bioionizer on rat trachea mucosa and the phagocytic activity of blood cells
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Sirota, Tatjana V., Novoselov, Vladimir I., Safronova, Valentina G., Yanin, Vadim A., Tsvetkov, Viktor D., Amelina, Svetlana E., Lushnikova, Antonina L., Maltseva, Valentina N., Tikhonov, Vladimir P., and Kondrashova, Marie N. more...
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Chemiluminescence -- Research ,Enzymes -- Research ,Ions -- Environmental aspects ,Ions -- Research ,Trachea -- Research ,Business ,Chemistry ,Electronics ,Electronics and electrical industries - Abstract
It was shown for the first time that inhaling negative air ions (NAI) leads to changes in the functional state of the rat trachea mucosa, which in turn affects the phagocytic activity of blood cells. The effect depends on the concentration of the NAI, the duration of their action, and the sources of the NAI generation. For air ionization, technical ionizers and a bioionizer (a plant electrified through soil) developed by the Diod Company, Moscow, Russia were used. It was shown that the NAI at high doses (600 000 ion/[cm.sup.3]), generated by an Elion 131M device, induce a damage to the rat trachea mucosa, an inhibition of the activity of its antioxidant enzymes, and a decrease in the phagocytic activity of whole blood cells. Low doses of the NAI from the same source (25000-50000 ion/[cm.sup.3]) and high doses of the NAI from devices Elion 132S and 132R (320000-500000 ion/[cm.sup.3]), and a bioionizer (500 000 ion/[cm.sup.3]) produced a milder effect, activating the secretion of goblet cells of the trachea mucosa without its damage. A possible mechanism of the effect of inhaled NAI as exogenous reactive oxygen species (ROS) on internal processes in the organism is discussed. The involvement of the ROS in the action of ionized air found in the study is probably the general property of different electrical influences on biological objects. Therefore, the result of the investigation may be of interest for a wide circle of specialists dealing with ElectroMed influences. Index Terms--Air ions, antioxidant enzymes, chemiluminescence, phagocytic activity, reactive oxygen species (ROS), trachea mucosa. more...
- Published
- 2006
16. Structure of tracheal cytotoxin in complex with a heterodimeric pattern-recognition receptor
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Chang, Chung-I, Chelliah, Yogarany, Borek, Dominika, Mengin-Lecreulx, Dominique, and Deisenhofer, Johann
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Trachea -- Research ,Peptidoglycans -- Research ,Peptidoglycans -- Structure ,Peptidoglycans -- Analysis ,Drosophila -- Research ,Drosophila -- Analysis - Published
- 2006
17. Congenital diaphragmatic hernia, tracheal occlusion, thyroid transcription factor-1, and fetal pulmonary epithelial maturation
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Chapin, Cheryl J., Ertsey, Robert, Yoshizawa, Jyoji, Hara, Akihiko, Sbragia, Lourenco, Greer, John J., and Kitterman, Joseph A.
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Trachea -- Diseases ,Trachea -- Research ,Diaphragm -- Hernia ,Diaphragm -- Research ,Biological sciences - Abstract
Congenital diaphragmatic hernia (CDH) occurs in ~1:2,500 human births and has high morbidity and mortality rates, primarily due to pulmonary hypoplasia and pulmonary hypertension. Tracheal occlusion (TO), in experimental animals, distends lungs and increases lung growth and alveolar type I cell maturation but decreases surfactant components and reduces alveolar type II cell density. We examined effects of CDH and CDH+TO on lung growth and maturation in fetal rats. To induce CDH, we administered nitrofen (100 mg) to dams at 9.5 days of gestation. We compared lungs from fetuses with CDH, CDH+TO, and those exposed to nitrofen without CDH. CDH decreased lung wet weight bilaterally (P < 0.0001) and DNA content in lung ipsilateral to CDH (P < 0.05). CDH+TO significantly increased lung wet weights bilaterally; DNA content was intermediate between CDH and NC. To evaluate effects on the distal pulmonary epithelium, we examined surfactant mRNA and protein levels, type I and II cell-specific markers (RT[I.sub.40] and RT[II.sub.70], respectively), and transcriptional regulator thyroid transcription factor-1 (TTF-1). Decreased lung distension (due to CDH) increased SP-C mRNA and TTF-1 protein expression and reduced RT[I.sub.40] (P < 0.05 for all). Increased lung distension (due to CDH+TO) reduced expression of SP mRNAs and pro-SP-C and TTF-1 proteins and enhanced expression of RT[I.sub.40] (mRNA and protein; P < 0.05 for all). We conclude that CDH+TO partially reverses effects of CDH; it corrects the pulmonary hypoplasia and restores type I cell differentiation but adversely affects SP expression in type II cells. These effects may be mediated through changes in TTF-1 expression. fetal lung development; pulmonary surfactant; alveolar type I and type II cells more...
- Published
- 2005
18. Effect of 1,1-dimethylphenyl 1,4-piperazinium on mouse tracheal smooth muscle responsiveness
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Dorion, G., Israel-Assayag, E., Beaulieu, M.J., and Cormier, Y.
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Asthma -- Research ,Asthma -- Physiological aspects ,Smooth muscle -- Research ,Smooth muscle -- Physiological aspects ,Trachea -- Research ,Trachea -- Physiological aspects ,Mice -- Research ,Mice -- Physiological aspects ,Biological sciences - Abstract
Bronchial hyperresponsiveness is one of the main features of asthma. A nicotinic receptor agonist, 1,l-dimethylphenyl 1,4-piperazinium (DMPP), has been shown to have an inhibitory effect on airway response to methacholine in an in vivo model of asthma. The aims of this study were to 1) verity whether nicotinic acetylcholine receptors (nAChR) were present on mouse tracheal smooth muscle, 2) verify whether bronchoprotection observed in mice was due to a direct effect on airway smooth muscle, and 3) compare the effects of nicotinic agonists to that of salbutamol. [[alpha].sub.3-], [[alpha].sub.4-], and [[alpha].sub.7-]nAChR subunits were detected by immunofluorescence on tracheal tissues from normal BALB/c mice. The effect of DMPP on tracheal responsiveness was verified by an isometric method. Tracheas were isolated from normal mice, placed in organ baths, and contracted with a single dose of methacholine. Cumulative doses of DMPP or salbutamol were added to the baths. Results show that mouse tracheal smooth muscle is positive for [[alpha].sub.4-] and [[alpha].sub.7-]nAChR subunits and that the epithelium is positive for [[alpha]3.sub.-], [[alpha].sub.4-], and [[alpha].sub.7-] subunits. DMPP induced a greater dose-dependent relaxation of tracheal smooth muscles precontracted with methacholine than with salbutamol. These results suggest that the smooth muscle-relaxing effect of DMPP could have some interest in the treatment of obstructive pulmonary diseases. airway responsiveness; salbutamol; nicotinic agonists more...
- Published
- 2005
19. Activation of the Arp2/3 complex by N-WASp is required for actin polymerization and contraction in smooth muscle
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Zhang, Wenwu, Wu, Yidi, Du, Liping, Tang, Dale D., and Gunst, Susan J.
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Actin -- Research ,Wiskott-Aldrich syndrome -- Research ,Trachea -- Diseases ,Trachea -- Research ,Biological sciences - Abstract
Contractile stimulation has been shown to initiate actin polymerization in smooth muscle tissues, and this actin polymerization is required for active tension development. We evaluated whether neuronal Wiskott-Aldrich syndrome protein (N-WASp)-mediated activation of the actin-related proteins 2 and 3 (Arp2/3) complex regulates actin polymerization and tension development initiated by muscarinic stimulation in canine tracheal smooth muscle tissues. In vitro, the COOH-terminal CA domain of N-WASp acts as an inhibitor of N-WASp-mediated actin polymerization; whereas the COOH-terminal VCA domain of N-WASp is constitutively active and is sufficient by itself to catalyze actin polymerization. Plasmids encoding EGFP-tagged wild-type N-WASp, the N-WASp VCA and CA domains, or enhanced green fluorescent protein (EGFP) were introduced into tracheal smooth muscle strips by reversible permeabilization, and the tissues were incubated for 2 days to allow for expression of the proteins. Expression of the CA domain inhibited actin polymerization and tension development in response to ACh, whereas expression of the wild-type N-WASp, the VCA domain, or EGFP did not. The increase in myosin light-chain (MLC) phosphorylation in response to contractile stimulation was not affected by expression of either the CA or VCA domain of N-WASp. Stimulation of the tissues with ACh increased the association of the Arp2/3 complex with N-WASp, and this association was inhibited by expression of the CA domain. The results demonstrate that 1) N-WASp-mediated activation of the Arp2/3 complex is necessary for actin polymerization and tension development in response to muscarinic stimulation in tracheal smooth muscle and 2) these effects are independent of the regulation of MLC phosphorylation. Wiskott-Aldrich syndrome protein; actin-related protein; tracheal muscle; cytoskeleton more...
- Published
- 2005
20. Endotracheal tube intraluminal diameter narrowing after mechanical ventilation: use of acoustic reflectometry
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Boque, M. C., Gualis, B., Sandiumenge, A., and Rello, J.
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Reflectometer -- Usage ,Reflectometer -- Research ,Artificial respiration -- Complications and side effects ,Artificial respiration -- Research ,Trachea -- Intubation ,Trachea -- Complications and side effects ,Trachea -- Research ,Health care industry - Abstract
Byline: M. C. Boque (1), B. Gualis (1), A. Sandiumenge (1), J. Rello (1) Keywords: Endotracheal tube obstruction; Reflectometry Abstract: Objective To quantify the incidence and degree of endotracheal tube intraluminal obstruction after mechanical ventilation and its relation to time of intubation. Design Prospective observational study. Setting A 14-bed medical-surgical intensive care unit at a university-affiliated teaching hospital. Patients Ninety-four endotracheal tubes used in 80 patients requiring mechanical ventilation for more than 12 h. Interventions and results Acoustic reflectometry was performed in every endotracheal tube after patient extubation to measure its volume reduction. The intraluminal volumes of used endotracheal tubes in mechanically ventilated patients were significantly lower than those of unused tubes of the same size (5.52+-0.92 ml.sup.3 versus 6.54+-0.79 ml.sup.3, p Conclusions Inadvertent endotracheal tube obstruction was common in patients requiring mechanical ventilation and may be significant as early as at 24 h. Moderate obstruction in endotracheal tube lumens should be suspected in cases of difficulties in weaning, even in patients who were ventilated for less than 1 day. Author Affiliation: (1) University Hospital Joan XXIII, University Rovira i Virgili, Mallafre Guasch 4, 43007, Tarragona, Spain Article History: Registration Date: 09/09/2004 Received Date: 26/09/2003 Accepted Date: 07/09/2004 Online Date: 02/10/2004 Article note: Presented, in part, at the 16th European Society Intensive Care Medicine Congress, Amsterdam, October 2003. more...
- Published
- 2004
21. Formin3 is required for assembly of the F-actin structure that mediates tracheal fusion in Drosophila
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Tanaka, Hiromasa, Takasu, Etsuko, Aigaki, Toshiro, Kato, Kagayaki, Hayashi, Shigeo, and Nose, Akinao
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Trachea -- Research ,Drosophila -- Research ,Drosophila -- Genetic aspects ,Developmental biology -- Research ,Biological sciences - Abstract
During tracheal development in Drosophila, some branches join to form a continuous luminal network. Specialized cells at the branch tip, called fusion cells, extend filopodia to make contact and become doughnut shaped to allow passage of the lumen. These morphogenetic processes accompany the highly regulated cytoskeletal reorganization of fusion cells. We identified the Drosophila formin3 (form3) gene that encodes a novel formin and plays a rote in tracheal fusion. Formins are a family of proteins characterized by highly conserved formin homology (FH) domains. The formin family functions in various actin-based processes, including cytokinesis and cell polarity. During embryogenesis, form3 mRNA is expressed mainly in the tracheal system. In form3 mutant embryos, the tracheal fusion does not occur at some points. This phenotype is rescued by the forced expression of form3 in the trachea. We used live imaging of GFP-moesin during tracheal fusion to show that an F-actin structure that spans the adjoining fusion cells and mediates the luminal connection does not form at abnormal anastomosis sites in form3 mutants. These results suggested that Form3 plays a role in the F-actin assembly, which is essential for cellular rearrangement during tracheal fusion. Keywords: Formin3; Trachea; actin; Cytoskeleton; Drosophila; Formin homology; Tracheal fusion more...
- Published
- 2004
22. Noninvasive vs invasive ventilation in COPD patients with severe acute respiratory failure deemed to require ventilatory assistance
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Squadrone, Enzo, Frigerio, Pamela, Fogliati, Claudio, Gregoretti, Cesare, Conti, Giorgio, Antonelli, Massimo, Costa, Roberta, Baiardi, Paola, and Navalesi, Paolo
- Subjects
Lung diseases, Obstructive -- Care and treatment ,Positive pressure respiration -- Methods ,Positive pressure respiration -- Research ,Acute respiratory distress syndrome -- Care and treatment ,Trachea -- Intubation ,Trachea -- Usage ,Trachea -- Research ,Health care industry - Abstract
Byline: Enzo Squadrone (1), Pamela Frigerio (2), Claudio Fogliati (1), Cesare Gregoretti (3), Giorgio Conti (4), Massimo Antonelli (4), Roberta Costa (4), Paola Baiardi (5), Paolo Navalesi (6) Keywords: Noninvasive positive pressure ventilation; Respiratory failure; Chronic obstructive lung disease; Intensive care; Endotracheal intubation Abstract: Objective To determine whether non-invasive ventilation (NIV) may be an effective and safe alternative to invasive mechanical ventilation in chronic obstructive pulmonary disease (COPD) patients with acute respiratory failure (ARF) meeting criteria for mechanical ventilation. Design and setting Matched case-control study conducted in ICU. Patients and intervention NIV was prospectively applied to 64 COPD patients with advanced ARF. Their outcomes were compared with those of a control group of 64 COPD patients matched on age, FEV.sub.1, Simplified Acute Physiology Score II, and pH at ICU admission, previously treated in the same ICU with conventional invasive mechanical ventilation. Methods and results NIV failed in 40 patients who required intubation. Mortality rate, duration of mechanical ventilation, and lengths of ICU and post-ICU stay were not different between the two groups. The NIV group had fewer complications (P = 0.01) and showed a trend toward a lower proportion of patients remaining on mechanical ventilation after 30 days (P = 0.056). Compared to the control group, the outcomes of the patients who failed NIV were no different. Compared to the patients who received intubation, those who succeeded NIV had reduced mortality rate and lengths of ICU and post-ICU stay. Conclusions In COPD patients with advanced hypercapnic acute respiratory failure, NIV had a high rate of failure, but, nevertheless, provided some advantages, compared to conventional invasive ventilation. Subgroup analysis suggested that the delay in intubation was not deleterious in the patients who failed NIV, whereas a better outcome was confirmed for the patients who avoided intubation. Author Affiliation: (1) ICU, Azienda Ospedaliera S.Luigi Gonzaga, Orbassano, Italy (2) Dipartimento di Emergenza-Urgenza, Azienda Ospedaliera Ca' Granda Niguarda, Milan, Italy (3) ICU, Azienda Ospedaliera CTO-CRF-Maria Adelaide, Turin, Italy (4) Istituto di Anestesia e Rianimazione, Universita Cattolica del Sacro Cuore, Rome, Italy (5) Servizio di Biostatistica, Fondazione S. Maugeri, Pavia, Italy (6) Pneumologia e Terapia Intensiva Respiratoria, Fondazione S. Maugeri, Via Ferrata 8, 27100 , Pavia, Italy Article History: Registration Date: 02/04/2004 Received Date: 23/12/2003 Accepted Date: 02/04/2004 Online Date: 12/06/2004 more...
- Published
- 2004
23. A respiratory hemocyanin from an insect
- Author
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Hagner-Holler, Silke, Schoen, Axel, Erker, Wolfgang, Marden, James H., Rupprecht, Rainer, Decker, Heinz, and Burmester, Thorsten
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Trachea -- Research ,Insects -- Research ,Science and technology - Abstract
Insects possess an elaborate tracheal system that enables transport of gaseous oxygen from the atmosphere directly to the inner organs. Therefore, the presence of specialized oxygen-transport proteins in the circulatory system of insects has been considered generally unnecessary. Here, we show for the first time, to our knowledge, the presence of an ancestral and functional hemocyanin (Hc) in an insect. In the hemolymph of nymphs and adults of the stonefly Perla marginata, a hexameric Hc was identified, which consists of two distinct subunit types of 659 and 655 amino acids. P. marginata Hc displays cooperative oxygen binding with a moderately high oxygen affinity [(half-saturation pressure, [P.sub.50] [approximately equal to] 8 torr (1 torr = 133 Pa)]. No evidence was found for the presence of Hcs in the more evolutionarily advanced holometabolan insects, suggesting that this type of respiratory protein was lost later in insect evolution. However, our results demonstrate that, in contrast to the accepted paradigm, certain basal insects have retained an ancestral blood-based mechanism of gas exchange. more...
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- 2004
24. Zonation of Ciliated Cells on the Epithelium of the Rat Trachea
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Oliveira, M. J. R., Pereira, A. S., Guimaraes, L., Grande, N. R., Moreira de Sa, C., and Aguas, A. P.
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Airway (Medicine) -- Research ,Scanning microscopy -- Evaluation ,Scanning microscopy -- Usage ,Trachea -- Research - Abstract
Byline: M. J. R. Oliveira (1), A. S. Pereira (1), L. Guimaraes (2), N. R. Grande (1), C. Moreira de Sa (3), A. P. Aguas (1) Keywords: Scanning electron microscopy; Cartilage; Serous cells; Particle clearance; Quantification Abstract: We have used scanning electron microscopy (SEM) to screen the entire epithelial surface of the cervical trachea of the adult rat. This scrutiny revealed that the density of ciliated cells along this epithelium follows a repetitive pattern: circular strips of high density of ciliated cells alternate with areas of low density of the same cells. Cilia-poor strips of the tracheal epithelium were seen on areas of cartilage rings here, ciliated cells made up 32% of the total surface of the tracheal lining. Cilia-rich areas filled the epithelial surface at the tracheal ligaments (i.e., the regions located in-between the rings) here, ciliated cells occupied 65% of the tracheal lumen. In the cilia-poor zones, the density of ciliated cells decreased from its periphery into its center, where cilia were virtually absent. No differences in this pattern of the tracheal epithelium were seen between young adult and older rats. We conclude that the respiratory epithelium expresses density zonation of ciliated cells on the trachea of adult rats. We propose that the high concentration of ciliated cells on the regions of epithelium located at the tracheal ligaments suggests that these zones are electively committed in the clearance of the respiratory airway. Author Affiliation: (1) Department of Anatomy, ICBAS, Abel Salazar Institute for Biomedical Sciences, UMIB and IBMC, 4099-003 Porto, Portugal, European Union (2) Department of Population Studies, ICBAS, Abel Salazar Institute for Biomedical Sciences, 4099-003 Porto, Portugal, European Union (3) CEMUP, University of Porto, Portugal, European Union Article History: Registration Date: 01/01/2003 Accepted Date: 10/06/2003 more...
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- 2003
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25. Fetal cricotracheal manipulation: effects on airway healing, cricoid growth and lung development
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Ciprandi, Guido, Nicollas, Richard, Triglia, Jean Michel, and Rivosecchi, Massimo
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Trachea -- Stenosis ,Trachea -- Patient outcomes ,Trachea -- Research ,Fetus -- Surgery ,Fetus -- Patient outcomes ,Fetus -- Research ,Health - Abstract
Byline: Guido Ciprandi (1), Richard Nicollas (2), Jean Michel Triglia (2), Massimo Rivosecchi (1) Keywords: Fetal surgery; Subglottic stenosis; Airway healing; Cricoid growth; Lung development Abstract: The last decade has seen significant advance in the surgical management of pediatric subglottic stenosis, which remains one of the most fascinating problems of the laryngotracheal complex (LTC). Refined techniques for operating on these fragile structures should reduce cricotracheal scarring to a minimum, thus avoiding a lot of severe postoperative complications in a tricky moment of laryngeal's growing up. Experimental works indicates that the LTC growth is variously affected by longitudinal anterior, posterior or lateral incisions and actually the indications for laringotracheoplasty or cricotracheal resection in children with subglottic stenosis are still unclear. Reports on fetal manipulation of cricotracheal tissues are lacking as well as early effects on airway healing, LTC growth and lung development. The aim of this study was to evaluate if the airway mucosal healing is regenerative and scarless after cricotracheal manipulation in fetuses of New Zealand White Rabbits (NZWRFs). The consequences of fetal incisions on the cricoid growth and lung development are also examined, in a group of 12 NZWRFs, manipulated at 25+-1 days of gestational age. The does underwent halothane anesthesia and all received a bilateral longitudinal cricoidotracheotomy. Twenty sham-operated fetuses were submitted to a limited cervicotomy (control's group). At the time of retrieval (31+-0.5 days), en bloc laryngotracheobronchial tree and lungs were collected and processed for histological and morphometric analysis. Parameters recorded included: 1)histological full-thicknes examinations focusing on inflammation, foreign body reaction, fibrosis, neochondrogenesis 2)morphometric analysis, including the fetal Subglottic Diameter (FSD), the fetal Subglottic Area (FSA), the Radial Alveolar Count (rAC) and Computer Assisted Morphometric Colorimetry (CAmc) 3)analysis of lung hypoplasia (LH) by means of lung weight/body weight (LW/BW) ratio, protein and DNA indexes 4)finally, different fractions of lung tissue phospholipids for lung maturity assessment were studied. Student's t test, when indicated, was performed for statistical analysis (p < 0.05 = significant). There was no maternal mortality in this study. Ten fetuses were available for a final evaluation (16.6% mortality). In one case only, an incomplete closure of the fetal cricoidotomy was seen and could be probably due to a technical mistake. Mean fetal subglottic diameter and area were respectively 0.13+-0.05 mm and 3.15+-0.45 mm2 in both groups. As well as in fetal dermal repair, regeneration of the airway cartilage and mucosa were complete and scarless. LW/BW ratio, DNA content and analysis of different fractions of phospholipids were similar in experimental vs. the control group. These findings suggest that the healing processes were fibrosis-free and without evidence of scars. A complete closure of the incisions was achieved without stenosis of the fetal subglottic region. In addition, it seems that the fetal cricoidotracheotomy doesn't interfere with the laryngeal function which coordinate the amount of liquid leaving the lungs via the trachea. In addition, only a small leakage of amniotic fluid is shown and this could be responsible for normal and mature lungs. Author Affiliation: (1) Department of Paediatric Surgery, Bambino Gesu' Children's Hospital, Research Institute, Via della Torre di Palidoro-Passoscuro, 00050, Rome, Italy (2) Department of Paediatric Otolaryngology, Head and Neck Surgery, La Timone Children's Hospital, Marseilles, France Article History: Accepted Date: 10/12/2002 Online Date: 18/07/2003 more...
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- 2003
26. Patient recollection of airway suctioning in the ICU: routine versus a minimally invasive procedure
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van de Leur, Johannes P., Zwaveling, Jan Harm, Loef, Bert G., and van der Schans, Cees P.
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Suction (Medical care) -- Methods ,Suction (Medical care) -- Research ,Trachea -- Intubation ,Trachea -- Methods ,Trachea -- Research ,Health care industry - Abstract
Byline: Johannes P. van de Leur (1), Jan Harm Zwaveling (2), Bert G. Loef (3), Cees P. van der Schans (4) Keywords: Recollection Airway suctioning Treatment Discomfort Abstract: Objective.. Many patients have an unpleasant recollection of routine endotracheal suctioning after discharge from the Intensive Care Unit (ICU). We hypothesized that through minimally invasive airway suctioning discomfort and stress may be prevented, resulting in less recollection. Design.. A prospective randomized clinical trial. Setting.. Two ICUs at the University Hospital of Groningen, the Netherlands. Patients and participants.. Adult patients with an intubation period exceeding 24 h were included. Interventions.. Patients received either routine endotracheal suctioning (RES) or minimally invasive airway suctioning (MIAS) during the duration of intubation. Measurements and results.. Within 3 days after ICU discharge all patients were interviewed, regarding recollection and discomfort of suctioning. The level of discomfort was quantified on a visual analogue scale (VAS). We analyzed data from 208 patients (RES: n=113, and MIAS: n=95). A significantly lower prevalence of recollection of airway suctioning was found in the MIAS group (20%) compared to the RES group (41%) (P-value =0.001). No significant difference in level of discomfort was found between the RES and the MIAS group (P-value =0.136). Conclusions.. Minimally invasive airway suctioning results in a lower prevalence of recollection of airway suction than in RES, but not in discomfort. Author Affiliation: (1) Centre for Rehabilitation, University Hospital Groningen, PO Box 30.001, 9700 RB, Groningen, The Netherlands (2) Department of General Surgery and Intensive Care, University Hospital Groningen, Groningen, The Netherlands (3) Department of Cardio-Thoracic Surgery and Intensive Care, University Hospital Groningen, Groningen, The Netherlands (4) Centre for Rehabilitation, University Hospital Groningen and University for Professional Education, Groningen, The Netherlands Article History: Received Date: 16/08/2001 Accepted Date: 10/12/2002 Article note: Electronic Publication more...
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- 2003
27. Endotracheal suctioning versus minimally invasive airway suctioning in intubated patients: a prospective randomised controlled trial
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van de Leur, Johannes P., Zwaveling, Jan H., Loef, Bert G., and van der Schans, Cees P.
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Trachea -- Intubation ,Trachea -- Complications and side effects ,Trachea -- Research ,Artificial respiration -- Complications and side effects ,Artificial respiration -- Research ,Critical care medicine -- Research ,Health care industry - Abstract
Byline: Johannes P. van de Leur (1), Jan H. Zwaveling (2), Bert G. Loef (3), Cees P. van der Schans (1) Keywords: Airway suctioning Mechanical ventilation Complications Costs Abstract: Study objective.. Endotracheal suctioning in intubated patients is routinely applied in most ICUs but may have negative side effects. We hypothesised that on-demand minimally invasive suctioning would have fewer side effects than routine deep endotracheal suctioning, and would be comparable in duration of intubation, length of stay in the ICU, and ICU mortality. Design.. Randomised prospective clinical trial. Setting.. In two ICUs at University Hospital Groningen, the Netherlands. Patients.. Three hundred and eighty-three patients requiring endotracheal intubation for more than 24 h. Interventions.. Routine endotracheal suctioning (n=197) using a 49-cm suction catheter was compared with on-demand minimally invasive airway suctioning (n=186) using a suction catheter only 29 cm long. Measurements and results.. No differences were found between the routine endotracheal suctioning group and the minimally invasive airway suctioning group in duration of intubation [median (range) 4 (1--75) versus 5 (1--101) days], ICU-stay [median (range) 8 (1--133) versus 7 (1--221) days], ICU mortality (15% versus 17%), and incidence of pulmonary infections (14% versus13%). Suction-related adverse events occurred more frequently with RES interventions than with MIAS interventions decreased saturation: 2.7% versus 2.0% (P=0.010) increased systolic blood pressure 24.5% versus 16.8% (P Conclusions.. This study demonstrated that minimally invasive airway suctioning in intubated ICU-patients had fewer side effects than routine deep endotracheal suctioning, without being inferior in terms of duration on intubation, length of stay, and mortality. Author Affiliation: (1) Centre for Rehabilitation, University Hospital Groningen, PO Box 30.001, 9700 RB, Groningen, The Netherlands (2) Dept. of General Surgery and Intensive Care, University Hospital Groningen, Groningen, The Netherlands (3) Dept. Cardio-Thoracic Surgery and Intensive Care, University Hospital Groningen, Groningen, The Netherlands (4) University for Professional Education, Hanzehogeschool and Centre for Rehabilitation, University Hospital Groningen, Groningen, The Netherlands Article History: Received Date: 04/12/2001 Accepted Date: 10/12/2002 Article note: Electronic Publication more...
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- 2003
28. Inertial deposition effects: a study of aerosol mechanics in the trachea using laser doppler velocimetry and fluorescent dye
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Corcoran, T.E. and Chigier, Norman
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Biomedical engineering -- Research ,Biomechanics -- Research ,Aerosols -- Research ,Pharynx -- Physiological aspects ,Throat ,Respiratory organs -- Physiological aspects ,Trachea -- Research ,Laser Doppler velocimeter -- Usage ,Fluorescence -- Usage ,Larynx -- Research ,Cardiopulmonary system ,Engineering and manufacturing industries ,Science and technology - Abstract
This study characterizes the axial velocity and axial turbulence intensity patterns noted in the tracheal portion of a cadaver-based throat model at two different steady flow rates (18.1 and 41.1 LPM.) This characterization was performed using Phase Doppler Interferometry (Laser Doppler Velocimetry). Deposition, as assessed qualitatively using fluorescent dye, is related to the position of the laryngeal jet within the trachea. The position of the jet is dependent on the downstream conditions of the model. It is proposed therefore that lung/airway conditions may have important effects on aerosol deposition within the throat. There is no correspondence noted between regions of high axial turbulence intensity and deposition. [DOI: 10.1115/1.1516572] more...
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- 2002
29. Branch-specific migration cues in the Drosophila tracheal system. (What the papers say)
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Rosin, Dalia and Shilo, Ben-Zion
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Biological research -- Analysis ,Drosophila -- Physiological aspects ,Trachea -- Research ,Biological sciences - Published
- 2002
30. Complications of bronchoscopically guided percutaneous dilational tracheostomy: beyond the learning curve
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Beiderlinden, Martin, Karl Walz, Martin, Sander, Andreas, Groeben, Harald, and Peters, Jurgen
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Bronchoscopy -- Methods ,Bronchoscopy -- Complications and side effects ,Tracheotomy -- Methods ,Tracheotomy -- Complications and side effects ,Trachea -- Intubation ,Trachea -- Usage ,Trachea -- Research ,Trachea -- Physiological aspects ,Health care industry - Abstract
Byline: Martin Beiderlinden (1), Martin Karl Walz (2), Andreas Sander (1), Harald Groeben (1), Jurgen Peters (1) Keywords: Bronchoscopy Complications Tracheostomy tube fixation Suture Tracheal ring fracture Abstract: Objective: To assess the complication rate of bronchoscopically guided percutaneous dilational tracheostomy (PDT), with tracheal tube suture fixation and no elective tracheostomy tube exchange, after experience had been gained. Design: Prospective clinical study. Setting: Anaesthesiological ICU with mixed surgical and medical patients in a university hospital. Patients: Hundred thirty-three mechanically ventilated patients (mean age: 54.8 years, range: 13--87 years) with indication for PDT, many with thrombocytopenia and/or coagulation deficits. Interventions: Hundred thirty-six consecutive PDTs performed by residents under bronchoscopic guidance with stepwise dilation (n=114, Ciaglia's conventional system) or conic dilation (n=22, 'Blue Rhino' approach) and supervision of experienced staff anaesthesiologists. Tracheostomy tubes were fixed to the skin with a suture and no routine exchange of tracheostomy tubes was performed. Complications were categorised and the results were also compared to an earlier prospective study. Results: The incidence of tracheostomy tube-related complications (hypoxaemia, cannula misplacement, accidental decannulation, cuff rupture and hernia, or posterior tracheal wall lesion) was low (0.7%) and significantly less (6.2%, p=0.01) than in our earlier study. No patient died of PDT-associated complications. We recorded four (2.9%) clinically relevant bleeding episodes. Insertion of tracheal tubes was easy or only moderately difficult in 86.7%. Conclusion: With experience in performing PDT, fixation of the tracheal cannula, and omission of routine change of tracheostomy tubes complication rate of PDT is low. Author Affiliation: (1) Abteilung fur Anasthesiologie und Intensivmedizin, Universitatsklinikum Essen, Hufelandstrasse 55, 45122 Essen, Germany (2) Klinik fur Chirurgie und Zentrum fur Minimal Invasive Chirurgie, Kliniken Essen-Mitte, Henricistrasse 92, 45136 Essen, Germany Article History: Received Date: 13/06/2001 Accepted Date: 12/10/2001 Article note: Electronic Publication more...
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- 2002
31. Myosin cross-bridge kinetics in airway smooth muscle: a comparative study of humans, rats, and rabbits
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Lecarpentier, Y., Blanc, F.-X., Salmeron, S., Pourny, J.-C., Chemla, D., and Coirault, C.
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Physiology -- Research ,Trachea -- Research ,Smooth muscle -- Research ,Bronchi -- Research ,Airway (Medicine) -- Research ,Biological sciences - Abstract
Myosin cross-bridge kinetics in airway smooth muscle: a comparative study of humans, rats, and rabbits. Am J Physiol Lung Cell Mol Physiol 282: L83-L90, 2002.--To analyze the kinetics and unitary force of cross bridges (CBs) in airway smooth muscle (ASM), we proposed a new formalism of Huxley's equations adapted to nonsarcomeric muscles (Huxley AF. Prog Biophys Biophys Chem 7: 255-318, 1957). These equations were applied to ASM from rabbits, rats, and humans (n = 12/group). We tested the hypothesis that species differences in whole ASM mechanics were related to differences in CB mechanics. We calculated the total CB number per square millimeter at peak isometric tension ([PSI] x [10.sup.9]), CB unitary force ([PI]), and the rate constants for CB attachment ([f.sub.1]) and detachment ([g.sub.1] and [g.sub.2]). Total tension, [PSI], and [PI] were significantly higher in rabbits than in humans and rats. Values of [PI] were 8.6 [+ or -] 0.1 pN in rabbits, 7.6 [+ or -] 0.3 pN in humans, and 7.7 [+ or -] 0.2 pN in rats. Values of [psi] were 4.0 [+ or -] 0.5 in rabbits, 1.2 [+ or -] 0.1 in humans, and 1.9 [+ or -] 0.2 in rats; [f.sub.1] was lower in humans than in rabbits and rats; [g.sub.2] was higher in rabbits than in rats and in rats than in humans. In conclusion, ASM mechanical behavior of different species was characterized by specific CB kinetics and CB unitary force. molecular motors; trachea; bronchi more...
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- 2002
32. Tracheal Compression by Elongated Aortic Arch in Patients with Congenitally Corrected Transposition of the Great Arteries
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Kim, Y.M., Yoo, S.-J., Kim, T.H., Park, I.S., Kim, W.H., Kim, S.H., and Lee, Y.T.
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Aorta, Thoracic -- Research ,Trachea -- Diseases ,Trachea -- Research ,Health - Abstract
Byline: Y.M. Kim (), S.-J. Yoo (), T.H. Kim (), I.S. Park (), W.H. Kim (), S.H. Kim (), Y.T. Lee () Abstract: We investigate the tracheal compression by aortic arch in patients with congenitally corrected transposition of the great arteries. Fourteen patients whose ascending aorta was connected to descending aorta on the contralateral side were divided into two groups according to the severity of tracheal compression on lateral angiogram: group 1 (stenosis ? 50%, eight patients) and group 2 (stenosis < 50%, six patients). We compared the following variables between the groups: aortic size, lateral displacement of ascending aorta, retrosternal space, and contour of aortic arch. Spiral computed tomography (CT) was done in five patients of group 1. The ratio between measured and normal diameters of ascending aorta of group 1 was significantly larger than that of group 2 (1.57 +- 0.14 compared to 1.19 +- 0.26, p = 0.014). There was linear correlation between the tracheal compression and aortic size (r = 0.69, p = 0.001). The ascending aorta was positioned more laterally and the aortic arch was located more posteriorly in group 1. In four patients with decreased tracheal compression after surgery, aortic size decreased and the ascending aorta restored its anterior position. Spiral CT showed transversely oriented aortic arch and severe tracheal compression in the anteroposterior direction by aortic arch. The tracheal compression by aortic arch in corrected transposition is common when the descending aorta is located on the contralateral side of the ascending aorta. Aortic size, posterior position, elongation, and end-on appearance of the aortic arch are the useful predictors of tracheal compression. Author Affiliation: () Department of Radiology, Sejong General Hospital and Sejong Heart Institute 91-121 Sosa-dong, Sosa-gu, Pucheon, Kyunggi-do 422-232, South Korea, KR () Department of Pediatrics, Sejong General Hospital and Sejong Heart Institute 91-121 Sosa-dong, Sosa-gu, Pucheon, Kyunggi-do 422-232, South Korea, KR () Department of Cardiac Surgery, Sejong General Hospital and Sejong Heart Institute 91-121 Sosa-dong, Sosa-gu, Pucheon, Kyunggi-do 422-232, South Korea, KR more...
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- 2001
33. In Utero and Postnatal Exposure of Wistar Rats to Low Frequency/High Intensity Noise Depletes the Tracheal Epithelium of Ciliated Cells
- Author
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Oliveira, M.J.R., Pereira, A.S., Castelo Branco, N.A.A., Grande, N.R., and Aguas, A.P.
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Lung diseases -- Research ,Trachea -- Research - Abstract
Byline: M.J.R. Oliveira (), A.S. Pereira (), N.A.A. Castelo Branco (), N.R. Grande (), A.P. Aguas () Abstract: Author Affiliation: () Department of Anatomy, Abel Salazar Institute for Biomedical Sciences (ICBAS), UMIB and IBMC, University of Porto, 4099-003 Porto, Portugal, PT Article History: Accepted Date: 23/10/2001 more...
- Published
- 2001
- Full Text
- View/download PDF
34. Frequency of transient streptococcal bacteremia following urgent orotracheal intubation in critically ill patients
- Author
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Rijnders, B.J.A., Wilmer, A., Van Eldere, J., and Van Wijngaerden, E.
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Streptococcal infections -- Research ,Streptococcal infections -- Care and treatment ,Trachea -- Intubation ,Trachea -- Research ,Trachea -- Methods ,Health care industry - Abstract
Byline: B.J.A. Rijnders (1), A. Wilmer (1), J. Van Eldere (1), E. Van Wijngaerden (1) Keywords: Intubation Orotracheal Bacteremia Intensive care units Streptococcus Prospective studies Abstract: Objectives: To examine whether urgent orotracheal intubation (OI) can induce bacteremia. To find predictive factors for post-intubation bacteremia. Design: Prospective observational study. Setting: Seventeen-bed medical intensive care unit in a university hospital. Patients: Sixty-eight adult intensive care patients undergoing urgent OI. Measurements and results: Patients in need of OI could be included if no cardiopulmonary resuscitation was performed. A blood culture was taken immediately before, as soon as possible after, and 60 min after intubation. The indication for intubation, ease of intubation, and the antibiotics used before intubation were registered. Six patients (6/68 or 9%) had streptococcal bacteremia immediately (mean 10.8 min) after intubation. No patient (0/62) had streptococcal bacteremia 60 min after intubation (P=0.01). Four of the six patients showing streptococcal bacteremia after intubation were intubated by a second doctor because of difficulties during intubation, whereas this was the case in only 9/62 in those without streptococcal bacteremia (P=0.01). Four of the 13 patients (31%) who needed to be intubated by a second doctor showed transient streptococcal bacteremia. Of the 20 patients not receiving antibiotics at the time of intubation, four (20%) had streptococcal bacteremia compared with 2/47 (4.2%) patients receiving antibiotics (P=0.06). Conclusions: Urgent intubation can cause transient bacteremia with streptococci in a significant proportion of intensive care patients. The observed frequency of bacteremia is higher than previously reported after elective intubation. The difficulty of intubation is probably a predisposing factor. Author Affiliation: (1) Interne Geneeskunde, Universitaire Ziekenhuizen Leuven, Herestraat 49, 3000 Leuven, Belgium Article History: Received Date: 31/07/2000 Accepted Date: 16/11/2000 Article note: Final revision received: 6 November 2000 Electronic Publication more...
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- 2001
35. Abnormalities of the tracheal cartilage in the rat fetus with tracheo-oesophageal fistula or tracheal agenesis
- Author
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Pole, R. J., Qi, B. Q., and Beasley, S. W.
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Esophagus -- Surgery ,Esophagus -- Patient outcomes ,Esophagus -- Atresia ,Trachea -- Diseases ,Trachea -- Patient outcomes ,Trachea -- Research ,Health - Abstract
Byline: R. J. Pole (1), B. Q. Qi (1), S. W. Beasley (1) Keywords: KeywordsaAdriamycin; Oesophageal atresia; Tracheo-oesophageal fistula; Tracheal agenesis; Tracheomalacia Abstract: aMany infants with oesophageal atresia and tracheo-oesophageal fistula (OA/TOF) have associated tracheomalacia (TM), which is one of the reasons for respiratory complications after surgical correction of the atresia. OA/TOF was induced in the offspring of pregnant rats by intraperitoneal injection of adriamycin. Fetuses were harvested by caesarean section. The trachea, oesophagus, lungs, and stomach were removed en bloc and stained for cartilage using Alcian blue. The tracheas were examined, photographed, and relevant parameters pertaining to the tracheal cartilage were measured. Exposure to adriamycin resulted in a range of anatomical defects including OA/TOF (47%) and tracheal agenesis (TA) (41%). Adriamycin-treated fetuses were smaller (P< 0.01), yet had longer tracheas (P< 0.001) than control fetuses. The OA/TOF fetuses had more tracheal cartilage rings than controls (P< 0.01), whereas TA fetuses had fewer (P< 0.001). Both OA/TOF and TA fetuses had more malformed tracheal cartilage rings than controls (P< 0.001 and P< 0.05, respectively). Cartilage in the proximal part of the trachea was most frequently and severely affected (P< 0.05). These observations clarify the structural abnormalities of tracheal cartilage that occur in rat fetuses with OA/TOF or TA induced by adriamycin, and may explain the functional disturbances of TM seen in OA/TOF. Author Affiliation: (1) Department of Paediatric Surgery, Christchurch Hospital, Private Bag 4710, Christchurch, New Zealand, NZ Article note: Accepted: 4 November 1999 more...
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- 2001
36. Changing patterns of airway accidents in intubated ICU patients
- Author
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Kapadia, F.N., Bajan, K.B., Singh, S., Mathew, B., Nath, A., and Wadkar, S.
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Tracheotomy -- Accidents ,Tracheotomy -- Methods ,Trachea -- Intubation ,Trachea -- Physiological aspects ,Trachea -- Research ,Health care industry - Abstract
Byline: F.N. Kapadia (1), K.B. Bajan (1), S. Singh (1), B. Mathew (1), A. Nath (1), S. Wadkar (1) Keywords: Endotracheal tube Tracheostomy Airway accidents Unplanned extubation Intubated patients Mechanical ventilation Abstract: Objective: To document the changes in patterns of airway accidents in intubated patients. Design: Prospective recording of all airway accidents over two periods:1994--1997 and 1998--1999. Patients: Ventilated patients (5,046) intubated for 9,289 days over 4 years (1994--1997) and 2,932 ventilated patients intubated for 6,339 days over 2 years (1998--1999). Measurements: The incidence and pattern of airway accidents over a 2-year period were compared to an earlier similar analysis done in the previous 4 years. Results: The total accident rate in the 1994--1997 period was 36 in 5,046 patients over 9,289 intubated-patient days. The total accident rate in the period 1998--1999 was 20 in 2,932 patients over 6,339 intubated-patient days. The frequency of blocked tracheal tube increased to equal that of unplanned extubation (UE) of endotracheal tube (ETT) as the commonest airway accident. There were nine episodes of blocked tracheal tube in the two current years compared to four in the previous 4 years and there were nine episodes of UE in the two current years compared to 15 in the previous 4 years. There were a total of 18 ETT accidents in 2,930 patients over 5,309 ETT days compared to a total of two tracheostomy accidents in 67 patients over 1,030 tracheostomy days. Conclusions: We noted a change of the pattern of airway accidents. We noted an increasing trend in the incidence of blocked tracheal tubes, associated with an increased duration of heat and moisture exchanger-filters use. We also noted that the incidence of tracheostomy tube accidents was similar to that of ETT accidents in the current study, unlike the earlier study where tracheostomy tube accidents were more frequent than ETT accidents. This was due to the elimination of tracheostomy tube displacements during the later study period. We associated this with the use of adjustable tracheostomy length tubes. Author Affiliation: (1) Department of Intensive Care, Hinduja National Hospital & Medical Research Center, Veer Savarkar Marg, Mahim, Mumbai 400016, India Article History: Received Date: 03/05/2000 Accepted Date: 16/10/2000 Article note: Final revision received: 26 September 2000 Electronic Publication more...
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- 2001
37. Early translaryngeal tracheostomy in patients with severe brain damage
- Author
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Stocchetti, N., Parma, A., Songa, V., Colombo, A., Lamperti, M., and Tognini, L.
- Subjects
Brain damage -- Care and treatment ,Tracheotomy -- Methods ,Tracheotomy -- Research ,Trachea -- Physiological aspects ,Trachea -- Research ,Intracranial pressure -- Physiological aspects ,Intracranial pressure -- Research ,Health care industry - Abstract
Byline: N. Stocchetti (1), A. Parma (1), V. Songa (1), A. Colombo (1), M. Lamperti (1), L. Tognini (2) Keywords: Key words Brain damage; Cerebral extraction of oxygen; Cerebral perfusion pressure; Intracranial pressure; Tracheostomy Abstract: Objectives: To describe the effects of early translaryngeal tracheostomy on intracranial pressure (ICP), cerebral perfusion pressure (CPP), and jugular bulb saturation (SjO.sub.2) to identify the main mechanisms affecting ICP during tracheostomy and to evaluate the long-term effects of tracheostomy on tracheal anatomy and function. Design: Prospective, observational, clinical study. Setting: Neurosurgical intensive care unit in a teaching hospital. Patients: 20 patients admitted to the ICU because of head injury, subarachnoid hemorrhage, or brain tumor with a Glasgow Coma Scale less than 8. Interventions: Patients underwent translaryngeal tracheostomy under strict neuromonitoring. Measurements and results: ICP rose significantly (p < 0.05) at the critical time of cannula placement while all other parameters remained stable. At this time five patients suffered intracranial hypertension (ICP > 20 mmHg). In one of them CPP dropped below 60 mmHg. Arterial CO.sub.2 tension (PaCO.sub.2) did not rise significantly. No other major complications were recorded during the procedures. Three months after tracheostomy normal findings were detected by tracheoscopy in all cases (11 patients could be examined). Conclusions: Translaryngeal tracheostomy, performed in selected patients when the risk of intracranial hypertension was reduced to the minimum, was well tolerated in the majority of cases and did not induce persistent intracranial disorders. However, ICP is affected by tracheostomy, and careful monitoring and patient selection is necessary. At follow-up no severe anatomical or functional damage was detected. Author Affiliation: (1) Department Anesthesia and Intensive Care, Neuroscience Intensive Care, Policlinico Hospital IRCCS, Via Francesco Sforza 35, 20 122 Milan, Italy e-mail: stocchet@polic.cilea.it Tel.: + 39-02-55 03 55 17 Fax: + 39-02-59 90 22 39, FR (2) Department of Emergency Surgery, Policlinico Hospital IRCCS, Via Francesco Sforza 35, 20 122 Milan, Italy, FR Article note: Received: 24 November 1999 Final revision received: 20 April 2000 Accepted: 30 May 2000 more...
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- 2000
38. Delay of extubation in neonates and children after cardiac surgery: impact of ventilator-associated pneumonia
- Author
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Fischer, J. E., Allen, P., and Fanconi, S.
- Subjects
Pediatric intensive care -- Research ,Artificial respiration -- Complications and side effects ,Bacterial pneumonia -- Development and progression ,Pneumonia -- Development and progression ,Trachea -- Intubation ,Trachea -- Complications and side effects ,Trachea -- Research ,Health care industry - Abstract
Byline: J. E. Fischer (1), P. Allen (2), S. Fanconi (1) Keywords: Key words Ventilator-associated pneumonia; Cardiac surgery; Children; Pediatric intensive care; Complications; Extubation Abstract: Objective: This study was undertaken to determine the delay of extubation attributable to ventilator-associated pneumonia (VAP) in comparison to other complications and complexity of surgery after repair of congenital heart lesions in neonates and children.APMethods: Cohort study in a pediatric intensive care unit of a tertiary referral center. All patients who had cardiac operations during a 22-month period and who survived surgery were eligible (n = 272, median age 1.3 years). Primary outcome was time to successful extubation. Primary variable of interest was VAP. Surgical procedures were classified according to complexity. Cox proportional hazards models were calculated to adjust for confounding. Potential confounders comprised other known risk factors for delayed extubation.APResults: Median time to extubation was 3 days. VAP occurred in 26 patients (9.6 %). The rate of VAP was not associated with complexity of surgery (P = 0.22), or cardiopulmonary bypass (P = 0.23). The adjusted analysis revealed as further factors associated with delayed extubation: other respiratory complications (n = 28, chylothorax, airway stenosis, diaphragm paresis), prolonged inotropic support (n = 48, 17.6 %), and the need for secondary surgery (n = 51, 18.8 % e. g., re-operation, secondary closure of thorax). Older age promoted early extubation. The median delay of extubation attributable to VAP was 3.7 days (hazards ratio HR = 0.29, 95 % CI 0.18--0.49), exceeding the effect size of secondary surgery (HR = 0.48) and other respiratory complications (HR = 0.50).APConclusion: VAP accounts for a major delay of extubation in pediatric cardiac surgery. Author Affiliation: (1) Department of Neonatology and Pediatric Intensive Care, University Children's Hospital, University of Zurich, Steinwiesstrasse 75, Zurich 8032, Switzerland, CH (2) Harvard Medical School, The Cambridge Health Alliance, Cambridge, Massachusetts, USA e-mail: joachim.fischer@kispi.unizh.ch Tel.: + 41-1-2 66 71 11 Fax: + 41-1-2 66 71 71, US Article note: Received: 29 October 1999/Final revision received: 4 April 2000/Accepted: 10 April 2000 more...
- Published
- 2000
39. Study of the Posterior Spiracles of Drosophila as a Model to Understand the Genetic and Cellular Mechanisms Controlling Morphogenesis
- Author
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Hu, Nan and Castelli-Gair, James
- Subjects
Morphogenesis -- Research ,Drosophila -- Research ,Trachea -- Research ,Biological sciences - Abstract
We have studied the posterior spiracles of Drosophila as a model to link patterning genes and morphogenesis. A genetic cascade of transcription factors downstream of the Hox gene Abdominal-B subdivides the primordia of the posterior spiracles into two cell populations that develop using two different morphogenetic mechanisms. The inner cells that give rise to the spiracular chamber invaginate by elongating into 'bottle-shaped' cells. The surrounding cells give rise to a protruding stigmatophore by changing their relative positions in a process similar to convergent extension. The genetic cascades regulating spiracular chamber, stigmatophore, and trachea morphogenesis are different but coordinated to form a functional tracheal system. In the posterior spiracle, this coordination involves the control of the initiation of cell invagination that starts in the cells closer to the trachea primordium and spreads posteriorly. As a result, the opening of the tracheal system shifts back from the spiracular branch of the trachea into the posterior spiracle cells. We analyze the contribution of the ems gene to this coordination. In eros mutants, invagination of the spiracle cells adjacent to the trachea does not occur, but more posterior cells of the spiracle invaginate normally. This results in a spiracle without a lumen and with the tracheal opening located outside it. more...
- Published
- 1999
40. Facilitatory beta-2-adrenoceptors on cholinergic and adrenergic nerve endings of the guinea pig trachea
- Author
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Haas, Jan Roelof A. de, Terpstra, J. Saskia, Zwaag, Monica van der, Kockelbergh, Pieter G.E., Roffel, Ad F., and Zaagsma, Johan
- Subjects
Beta adrenoceptors -- Research ,Acetylcholine -- Receptors ,Guinea pigs -- Research ,Trachea -- Research ,Noradrenaline -- Research ,Biological sciences - Abstract
Research was conducted to examine the presence and the influence of prejunctional beta-2-adrenoceptors using electrical field stimulation of epithelium-denuded intact guinea pig tracheal tube preparations. Evoked endogenous acetylcholine and norepinephrine release were measured directly. Results demonstrate a differential capacity and response time profile of facilitatory prejunctional beta-2-adrenoceptors on adrenergic and cholinergic nerve terminals in the guinea pig trachea which illustrates the susceptibility of the receptors on adrenergic nerves to desensitization. more...
- Published
- 1999
41. CASE REPORTS: Unusual Case of Tracheal Agenesis
- Author
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O'Neill, David, Morecroft, James A., Gibson, Alan T., Bull, Peter D., and Walker, Jenny
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Agenesis -- Research ,Agenesis -- Case studies ,Children -- Diseases ,Children -- Research ,Children -- Case studies ,Trachea -- Diseases ,Trachea -- Case studies ,Trachea -- Research ,Health care industry - Abstract
Byline: David O'Neill (1), James A. Morecroft (2), Alan T. Gibson (3), Peter D. Bull (4), Jenny Walker (2) Keywords: Key words: tracheal agenesis, segmental esophageal agenesis, crossed renal ectopia, multiple abnormalities Abstract: We describe the clinical presentation and pathological features of an unusual case of tracheal agenesis. The axial derivatives of the primitive foregut between the larynx and stomach were represented by a single structure featuring sequential segmentation into regions showing exclusively tracheal or esophageal differentiation in a pattern that is not easily classified by existing nosologic systems nor explained by the conventional hypothesis of dysontogenesis. Author Affiliation: (1) Department of Histopathology, Sheffield Children's Hospital, Western Bank, Sheffield S10 2TH, UK , UK (2) Department of Paediatric Surgery, Sheffield Children's Hospital, Western Bank, Sheffield S10 2TH, UK , UK (3) Department of Otorhinolaryngology, Sheffield Children's Hospital, Western Bank, Sheffield S10 2TH, UK , UK (4) Department of Neonatology, Jessop Hospital for Women, Leavygreave Road, Sheffield S3 7RE, UK , UK Article note: Received January 22, 1998 accepted June 2, 1998. more...
- Published
- 1999
42. Placental transfer and pharmacokinetics of thiopentone in newborn infants
- Author
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Norman, Elisabeth, Westrin, Per, and Fellman, Vineta
- Subjects
Thiopental -- Dosage and administration ,Thiopental -- Research ,Pharmacokinetics -- Research ,Infants (Premature) -- Drug therapy ,Infants (Premature) -- Research ,Prenatal drug exposure -- Research ,Trachea -- Intubation ,Trachea -- Demographic aspects ,Trachea -- Research ,Family and marriage ,Health ,Women's issues/gender studies - Published
- 2010
43. Remifentanil for endotracheal intubation in neonates: a randomised controlled trial
- Author
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Choong, K., AlFaleh, K., Doucette, J., Gray, S., Rich, B., Verhey, L., and Paes, B.
- Subjects
Remifentanil -- Dosage and administration ,Remifentanil -- Research ,Neonatal intensive care units -- Research ,Preanesthetic medication -- Research ,Preoperative care -- Research ,Trachea -- Intubation ,Trachea -- Drug therapy ,Trachea -- Research ,Family and marriage ,Health ,Women's issues/gender studies - Published
- 2010
44. Pediatric primary anterior laryngotracheoplasty: thyroid ala vs costal cartilage grafts
- Author
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Nguyen, Carolyn V., Bent, John P., Shah, Maulik B., and Parikh, Sanjay R.
- Subjects
Laryngeal cartilages -- Usage ,Laryngeal cartilages -- Research ,Trachea -- Stenosis ,Trachea -- Care and treatment ,Trachea -- Demographic aspects ,Trachea -- Research ,Children -- Surgery ,Children -- Patient outcomes ,Children -- Research ,Health - Published
- 2010
45. Single- vs double-stage laryngotracheal reconstruction
- Author
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Smith, Lee P., Zur, Karen B., and Jacobs, Ian N.
- Subjects
Preoperative care -- Research ,Larynx -- Surgery ,Larynx -- Patient outcomes ,Larynx -- Research ,Trachea -- Stenosis ,Trachea -- Care and treatment ,Trachea -- Patient outcomes ,Trachea -- Research ,Health - Published
- 2010
46. Effect of a novel anatomically shaped endotracheal tube on intubation-related injury
- Author
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Gordin, Arie, Chadha, Neil K., Campisi, Paolo, Luginbuehl, Igor, Taylor, Glenn, and Forte, Vito
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Trachea -- Intubation ,Trachea -- Complications and side effects ,Trachea -- Research ,Larynx -- Injuries ,Larynx -- Research ,Animal models in research ,Health - Published
- 2010
47. Comparison of four manikins and fresh frozen cadaver models for direct laryngoscopic orotracheal intubation training
- Author
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Yang, J.H., Kim, Y.-M., Chung, H.S., Cho, J., Lee, H.-M., Kang, G.-H., Kim, E.-C., Lim, T., and Cho, Y.S.
- Subjects
Mannequins (Figures) -- Usage ,Cadavers -- Usage ,Trachea -- Intubation ,Trachea -- Study and teaching ,Trachea -- Research ,Medical personnel -- Training ,Medical personnel -- Research ,Health - Published
- 2010
48. Flexible laser bronchoscopy for subglottic stenosis in the awake patient
- Author
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Leventhal, Douglas D., Krebs, Elizabeth, and Rosen, Marc R.
- Subjects
Bronchoscopy -- Methods ,Bronchoscopy -- Research ,Trachea -- Stenosis ,Trachea -- Care and treatment ,Trachea -- Patient outcomes ,Trachea -- Demographic aspects ,Trachea -- Research ,Health - Published
- 2009
49. Tracheal reconstruction: mucosal survival on porous titanium
- Author
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Janssen, Luuk M., van Osch, Gerjo J.V.M., Li, Jia Ping, Kops, Nicole, de Groot, Klaas, Von den Hoff, Johannes W., Feenstra, Louw, and Hardillo, Jose A.U.
- Subjects
Titanium -- Usage ,Titanium -- Research ,Trachea -- Stenosis ,Trachea -- Care and treatment ,Trachea -- Patient outcomes ,Trachea -- Research ,Health - Published
- 2009
50. Emergency intubation: a prospective multicentre descriptive audit in an Australian helicopter emergency medical service
- Author
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Gunning, M., O'Loughlin, E., Fletcher, M., Crilly, J., Hooper, M., and Ellis, D.Y.
- Subjects
Helicopter ambulances -- Standards ,Helicopter ambulances -- Research ,Emergency medical services -- Research ,Airway obstruction (Medicine) -- Care and treatment ,Airway obstruction (Medicine) -- Research ,Trachea -- Intubation ,Trachea -- Safety and security measures ,Trachea -- Research ,Health - Published
- 2009
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