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Biomedical subjects

B R Celli

Publications and source records attributed to B R Celli.

80 records · Page 5Linked to original sources
PubMed1978

Maximum expiratory flow and transpulmonary pressure in the hamster.

Maximum expiratory flow was measured in 19 normal, anesthetized, tracheostomized, supine hamsters from records of forced deflation produced by the application of varying degrees of negative pressure to the tracheostomies of animals whose lungs had been previously inflated to a transpulmonary pressure (PL) of 25 cmH2O. Flow was measured with a pneumotachograph, volume with a constant-volume pressure plethysmograph and pleural surface pressure (Ppl) with a water-filled esophageal catheter. The esophageal pressure measurement overestimated Ppl and a simple technique was based on an estimate of the resting volume of the chest wall. This volume, at which the Ppl is zero, was calculated for anesthetized supine hamsters from the measurement of respiratory-system pressure and PL made independently of esophageal pressure and was found to be about 30% of vital capacity (VC). Flow limitation was present below 70% of VC with a tracheal deflation pressure of -30cmH2O. Negative effort dependence of flow was seen in small segments of the flow-volume curves. Mean +/- SD maximum expiratory flow at 50% VC was 52 +/- 9.5 ml/s or 9.1 VC/s. Upstream resistance was 0.09 +/- 0.03 cmH2O/ml per s.

Airway Resistance↗
PubMed1978

Localized amyloidosis of the lower respiratory tract.

Amyloidosis limited to the lower respiratory tract is a relatively rare condition. Three new patients are reported, and the pertinent literature is reviewed. The available information is discussed with regard to clinical forms, diagnostic methods, therapy, and clinical course. Tracheobronchial deposition is the most frequent form of localized amyloidosis; it affects relatively younger persons and often gives rise to symptoms of airway obstruction. Bronchoscopy, although carrying a risk of bleeding, is the procedure of choice diagnostically and therapeutically. Single or multiple pulmonary nodules are usually discovered as an incidental roentgenographic finding, and surgical resection (for suspected malignancy) has resulted in cure in all cases. On rare occasions, amyloid may be deposited diffusely in the pulmonary parenchyma, leading to death from respiratory insufficiency.

Adrenal Cortex Hormones↗
PubMed1978

Patterns of pulmonary involvement in systemic amyloidosis.

The clinical and histopathologic features of pulmonary amyloidosis were reviewed in 22 patients with systemic amyloidosis who came to autopsy. Eleven of 12 patients (92 percent) with primary amyloidosis had prominent interalveolar amyloid deposits. Symptoms attributable to these deposits were found in four cases (33 percent), while severe lung involvement was the apparent cause of death in one. Extensive deposition was noted in all three cases of amyloidosis associated with multiple myeloma or Waldenstrom's macroglobulinemia. Five of seven patients (71 percent) with secondary amyloidosis showed histologic lung involvement, which was perivascular or tracheobronchial in location, but not associated with symptoms. Histologic lung involvement is frequent in all forms of amyloidosis and lung tissue obtained from any patient with unexplained interstitial or reticular-alveolar pulmonary disease should be stained with Congo-red and viewed for green birefringence under polarizing microscopy for the presence of amyloid.

Adult↗
PubMedDate not supplied

Arm training reduces the VO2 and VE cost of unsupported arm exercise and elevation in chronic obstructive pulmonary disease.

BACKGROUND: Patients with severe chronic obstructive pulmonary disease (COPD) may develop dyspnea with minimal arm activity, thoracoabdominal dyssynchrony with unsupported arm exercise (UAEX) and increased oxygen uptake (VO2), and minute ventilation (VE) with simple unsupported arm elevation (UAE) and UAEX. We investigated whether unsupported arm training, as the only form of exercise, could decrease the VO2 and VE cost (percentage increase from resting baseline) associated with unsupported arm elevation and exercise, respectively. METHODS: Twenty-six patients with severe COPD were randomized to 21-24 sessions of unsupported arm (ARMT) or low-intensity resistive breathing (RBT) training as the only form of exercise. Patients were studied before and after training using a metabolic cart and esophageal and gastric pressures to evaluate metabolic and respiratory muscle function. RESULTS: After ARMT, the VO2 (58% vs 38% increase, P < 0.05) and VE (41% v. 21% increase, P < 0.05) cost for UAEX at exercise isotime decreased and endurance time increased. Similarly the VO2 (25% vs 18% increase, P < 0.05) cost decreased and VE no longer increased in response to 2 minutes of UAE after ARMT. The RBT group showed no such change. No improvement in ventilatory load or respiratory muscle function could be identified to explain the physiologic changes observed. After ARMT, mean inspiratory flow (VT/TL), a measure of central respiratory drive, was reduced during UAEX and the expected increase during UAE did not occur. CONCLUSION: We conclude that arm training reduces the VO2 and VE cost of UAE and UAEX, possibly through improved synchronization and coordination of accessory muscle action during unsupported arm activity.

Aged↗
PubMedDate not supplied

Cardiopulmonary exercise testing in patients with chronic obstructive pulmonary disease.

Severe chronic obstructive pulmonary disease is characterized by limited exercise capacity as a result of changes in pulmonary mechanics, abnormal gas exchange, altered cardiac function, respiratory muscle dysfunction, nutritional factors, and dyspnea. Cardiopulmonary exercise testing is a safe, effective method for objectively studying exercise performance and may be carried out using simple walk tests or more complicated treadmill or cycle-ergometry testing. Indications in patients with chronic obstructive pulmonary disease include defining the etiology of dyspnea, evaluating work disability or impairment, and assessing the response to therapy or the need for supplemental oxygen. It is also indicated in preoperative evaluation and as part of a pulmonary rehabilitation program.

Exercise Test↗