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Biomedical subjects

G Miserocchi

Publications and source records attributed to G Miserocchi.

At least 55 records · Page 3Linked to original sources

Transperitoneal fluid dynamics in rabbit liver.

The peritoneal cavity of 18 anesthetized spontaneously breathing supine rabbits was opened through a midline section. One or two hollow capsules (surface area 0.8 cm2) were glued to the exposed liver surface, filled with whole or 25% diluted plasma, and connected to a transducer and a graduated pipette. Various hydraulic pressures (Pcap) were set in the capsule; at each Pcap the liquid flow per unit surface area (V/S) between the Disse's interstitial space and the capsule was measured from the rate of liquid displacement in the pipette. The slope of the V/S vs. Pcap linear regression was utilized to estimate the hydraulic conductivity of the Glissonian-peritoneal membrane and averaged 5.1 x 10(-3) +/- 4.7 x 10(-3) (SD) ml.h-1.cmH2O-1.cm-2 (n = 25). Hydraulic pressure in the Disse's space (Pd) was measured by closing the capsule against the transducer disconnected from the pipette. At portal and hepatic venous pressures of 7.6 +/- 2.9 and 2.6 +/- 1 cmH2O, respectively, Pd was 2.05 +/- 2 cmH2O. Physiologically, Starling pressure gradients cause fluid transfer from the sinusoids to the Disse's space; transperitoneal fluid filtration only occurs through the liver surface that faces the diaphragm, which corresponds to one-fifth of the total hepatic surface.

Animals↗

Direct measurement of interstitial pulmonary pressure in in situ lung with intact pleural space.

We developed an experimental approach to measure the pulmonary interstitial pressure with the micropuncture technique in in situ lungs with an intact pleural space. Experiments were done in anesthetized paralyzed rabbits that were oxygenated via an endotracheal tube with 50% humidified oxygen and kept in either the supine or the lateral position. A small area of an intercostal space was cleared of the intercostal muscles down to the endothoracic fascia. Subsequently a "pleural window" was opened by stripping the endothoracic fascia over a 0.2-cm2 surface and leaving the parietal pleura (approximately 10 microns thick). Direct micropuncture through the pleural window was performed with 2- to 3-microns-tip pipettes connected to a servo-null pressure-measuring system. We recorded pleural liquid pressure and, after inserting the pipette tip into the lung, we recorded interstitial pressure from subpleural lung tissue. Depth of recording for interstitial pressure averaged 263 +/- 122 (SD) microns. We report data gathered at 26, 53, and 84% lung height (relative to the most dependent portion of the lung). For the three heights, interstitial pressure was -9.8 +/- 3, -10.1 +/- 1.6, and -12.5 +/- 3.7 cmH2O, respectively, whereas the corresponding pleural liquid pressure was -3.4 +/- 0.5, -4.4 +/- 1, and -5.2 +/- 0.3 cmH2O, respectively.

Animals↗

Liquid drainage through the peritoneal diaphragmatic surface.

In 14 spontaneously breathing anesthetized rabbits, we used cyanoacrylate to glue a hollow capsule, at end expiration or at end inspiration, to the peritoneal surface of the tendinous portion of the diaphragm. The capsule was connected to a pressure transducer and a pipette calibrated in microliters. We filled the system with fluid and measured flow into the diaphragmatic surface facing the capsule (Fcap, microliter/cm2), from liquid displacement in the pipette at different hydraulic pressures in the system (Pcap). Pleural liquid pressure was simultaneously measured in the supraphrenic region (Psup). Fcap was positively correlated to transdiaphragmatic pressure gradient (Psup-Pcap) and breathing frequency but was unaffected by protein concentration of capsular fluid. For a breathing frequency of 30 cycles/min and a Psup - Pcap = -2 cmH2O, Fcap was 0.54 microliter.min-1.cm-2 for capsules applied at end expiration and 10-fold greater for capsules applied at end inspiration. Data indicate that the diaphragmatic tendinous portion in rabbits is a draining site for peritoneal fluid and that the conductance of the draining pathways (lymphatic stomata) is related to diaphragmatic tension. In the intact rabbit the average peritoneal fluid drainage through the tendinous portion of the diaphragm (approximately 16 cm2) was estimated at 43 microliters/min.

Absorption↗

Size-related differences in parietal extrapleural and pleural liquid pressure distribution.

The hydraulic pressure in the extrapleural parietal interstitium (Pepl) and in the pleural space over the costal side (Pliq) was measured in anesthetized spontaneously breathing supine adult mammals of increasing size (rats, dogs, and sheep) using saline-filled catheters and cannulas, respectively. From the Pliq and Pepl vs. lung height regressions it appears that in all species Pliq was significantly more subatmospheric than Pepl simultaneously measured at the same lung height. The vertical pleural liquid pressure gradient increased with size, amounting to -1, -0.69, and -0.44 cmH2O/cm in rats, dogs, and sheep, respectively. The vertical extrapleural liquid pressure gradient also increased with size, being -0.6, -0.52, and -0.33 cmH2O/cm in rats, dogs, and sheep, respectively. With increasing body size, the transpleural hydraulic pressure gradient (Ptp = Pepl - Pliq) at the level of the right atrium increased from 1.45 to 5.6 cmH2O going from rats to sheep. In all species Ptp increased, with lung height being greatest in the less dependent part of the pleural space.

Animals↗

Intrapleural liquid flow down a gravity-dependent hydraulic pressure gradient.

We studied the vertical movement of 2 mg technetium-labeled albumin injected intrapleurally in 0.5 ml saline (15% of pleural liquid volume) in eight spontaneously breathing anesthetized dogs subject to a sudden change in posture (prone to supine or vice versa). The albumin movements were evaluated through a large field gamma camera placed laterally to the animal and detecting total (AT) and regional activities from two superimposed equal areas (At and Ab, top and bottom, respectively). The At/Ab ratio decreased from 2.1 to 1.3 in four animals up to 20 min from the change in posture and from 0.9 to 0.5 in four more animals studied from 50 to 90 min from turning maneuver. The rate of change in At and Ab was similar in the two groups of animals and unaffected by the acquisition posture. AT decreased by 7.7 and 3.5% for the two groups, respectively, reflecting albumin clearance from the pleural space. The opposite time course of regional activities and the independence of their rate of change of the At/Ab ratio and of the animal posture suggest a top-to-bottom albumin transfer occurring through a bulk flow of liquid estimated at 0.006 ml.kg-1.h-1. The data are consistent with a measured vertical pleural liquid pressure gradient that does not reflect a hydrostatic condition.

Animals↗

Pleural and extrapleural interstitial liquid pressure measured by cannulas and micropipettes.

In 15 anesthetized apneic, oxygenated rabbits we simultaneously measured pleural liquid and interstitial extrapleural parietal pressures by using catheters and/or cannulas and micropipettes connected to a servonull system. With the animal in lateral posture, at an average recording height of 4.4 +/- 0.9 (SD) cm from the most dependent part of the cavity, the extrapleural catheter and the pleural cannula yielded -2.5 +/- 0.6 and -5.5 +/- 0.2 cmH2O; the corresponding values for micropipette readings in the two compartments were -2.4 +/- 0.6 and -5.4 +/- 0.4 cmH2O, respectively (not significantly different from those measured with catheters and cannulas). In the supine animal, interstitial extrapleural catheter pressure data obtained at recording heights ranging from 15 to 80% of pleural cavity lay on the identity line when plotted vs. the micropipette pressure values simultaneously gathered from the same tissues. We conclude that 1) micropipettes and catheters-cannulas yield similar results when recording from the same compartment and 2) the hydraulic pressure in the parietal extrapleural interstitium is less negative than that in the pleural space.

Animals↗

Hypoxia and monosynaptic reflexes in humans.

The recruitment curves of the monosynaptic Hoffmann (H) reflex and of the direct motor (M) excitation of alpha-motor fibers of the posterior popliteal nerve were studied in seven human subjects in normoxic and hypoxic conditions at sea level. The amplitude of the H and M responses were determined from the computerized full-wave rectified and integrated surface electromyographic (EMG) signal derived from bipolar surface electrodes placed over the soleus muscle. Hypoxic exposure [end-tidal O2 fraction (FETO2) = 0.066 +/- 0.003 and end-tidal CO2 fraction (FETCO2) = 0.0504 +/- 0.001 (SE)] did not affect the maximal M (Mmax) response but decreased significantly (7%) the maximal H (Hmax) response. The Hmax/Mmax ratio decreased from 0.60 to 0.53. Furthermore, by fitting the rising phase of the recruitment curves of the H and M responses vs. stimulus intensity with linear regressions, hypoxia was found to produce a significant decrease of similar magnitude (6%) in the threshold of both the H and M responses with no change in slope. Using a constant stimulus strength eliciting an H response of half the maximum (H50%) of the control conditions, hypoxia resulted in a 50% increase in the amplitude of the H response within 12 min. These results suggest that the effects of hypoxia on the nervous system consist of a direct depolarizing action on the peripheral alpha-fibers and 1A sensory fibers and of a central effect on supraspinal structures affecting the spinal alpha-motoneurons.

Adult↗

Gravity-dependent distribution of parietal subpleural interstitial pressure.

Using liquid-filled catheters, we recorded, in 30 anesthetized, spontaneously breathing supine rabbits, the hydraulic pressure from the parietal subpleural interstitial space (Pspl). Through a small exposed area of parietal pleura a plastic catheter (1 mm ED), with a closed and smooth tip and several holes on the last centimeter, was carefully advanced between the muscular layer and the parietal pleura, tangentially to the pleural surface to reach the submesothelial layer. Simultaneous measurements of pleural liquid pressure (Pliq) were obtained from intrapleurally placed cannulas. End-expiratory Pspl decreased (became more negative) with increasing height (LH) according to the following: Pspl (cmH2O) = -1 - 0.4 LH (cm), the corresponding equation for Pliq being Pliq (cmH2O) = -1.5 - 0.7 LH (cm). Thus at end expiration a transpleural hydraulic pressure difference (Pliq-Pspl) developed at any height, increasing from the bottom to the top of the cavity as Pliq - Pspl (cmH2O) = -0.5 - 0.3 LH (cm). The Pliq-Pspl difference increased during inspiration due to the much smaller tidal change in Pspl than in Pliq. By considering the gravity-dependent distribution of the functional hydrostatic pressure in the systemic capillaries of the pleura (Pc) and the Pspl and Pliq values integrated over the respiratory cycle we estimated that on the average, the Pc-Pspl difference is sevenfold larger than the Pspl-Pliq difference.

Animals↗

Kinetics of the intrapleural distribution of a radioactive bolus.

Through the use of a gamma-camera placed horizontally over the chest of 5 supine, anesthetized and spontaneously breathing dogs we studied the kinetics of the intrapleural spreading of 1 ml saline containing 2 mg of 99mTc labelled albumin (250 microCi/kg) injected at various points on the costal side. From the postinjection sequence of gamma-camera images, we defined, along the intrapleural spreading pathways, some regions of interest (ROI) displaying a preferential label accumulation. In all the animals the ROI roughly corresponded to the apical, mediastinal and latero-diaphragmatic regions. The kinetics of the intrapleural label distribution, estimated from the time course of the activity under the ROI, displayed an initial rapid phase, lasting a few minutes, followed by a marked slowing down of the exchange processes. At 30 min regional counts reached an apparent steady state, the activity values greatly varying (even by 10 fold) among the animals, for the ROI corresponding to the same anatomical region, independently on the site of injection. The mathematical modelling of the regional activity curves required the assumption of a progressive decrease in the exchange coefficients to account for a marked slowing down of the exchange processes with increasing time.

Animals↗

Contribution of Starling and lymphatic flows to pleural liquid exchanges in anesthetized rabbits.

We studied the time course of volume and protein reabsorption of a 2-ml hydrothorax using whole (WP) or diluted (DP) homologous plasma injected into the right pleural cavity in anesthetized spontaneously breathing supine rabbits. Animals were killed at 5 (WP, n = 4; DP, n = 3), 36 (WP, n = 3; DP, n = 4), 55 (WP, n = 4), 90 (WP, n = 8; DP, n = 4), and 150 (WP, n = 4; DP, n = 5) min after the injection. The volume and protein content of the pleural liquid in control conditions (n = 12) amounted to 0.35 +/- 0.015 (SE) ml/kg and 1.8 +/- 0.27 g/100 ml, respectively, which are not significantly different at 90 min (n = 7). Pleural liquid volume decreased at a similar rate during WP or DP reabsorption according to the equation V = 0.84 +/- 0.05 X e-0.02t, with net reabsorptive flow expressed as dV/dt. The globulin quantity (Q) of the pleural liquid for WP and DP, respectively, decreased according to the equations Qwp = 1 + 1.5 X e-0.04t and Qdp = 0.7 + 0.6 X e-0.03t. Assuming a major lymphatic globulin clearance and no filtration into the cavity, we obtained lymph flow using the equation VL = dQ/dt X l/C where dQ/dt is calculated from the equations for Qwp and Qdp and C represents globulin concentration. The Starling flow (Vs) was then calculated by the equation Vs = dV/dt-VL. With increasing time, lymph flow was found to decrease progressively and was not significantly different from net flow with DP, which implied a Starling flow value of zero. During WP reabsorption, lymph flow initially exceeded the net flow, with the difference disappearing at approximately 60 min; accordingly, Starling filtration flow decreased progressively, becoming zero at the same time.

Anesthesia↗

Regional protein absorption rates from the pleural cavity in dogs.

In five supine spontaneously breathing anesthetized dogs we injected into the pleural space 0.5-1 ml of saline solution containing 2 mg/ml albumin labeled with technetium-99m. By use of a gamma camera placed horizontally over the chest, we followed, up to 120 min, the activity over the whole lung and over the preferential accumulation areas of the label (regions of interest, ROI) that corresponded to the apical, mediastinal, and laterodiaphragmatic regions. Activities were corrected for the decay rate of the isotope used. On the average, the activity over the whole lung decreased by 27% up to 120 min. The overall activity over the ROI amounted to 44.3% after the injection and decreased to 24% of total at 120 min, thus accounting for 75% of the total decrease in activity. At 10 min, the activity per unit surface of the gamma camera image (As) was from 2.2- to 5.7-fold higher over the ROI than for the rest of the lung image. The decrease of As at 120 min was 18-, 13-, and 5-fold greater for mediastinal, diaphragmatic, and apical regions, respectively, compared with the rest of the lung image. The time course of the changes in As are discussed in terms of regional albumin egress rate based on the functional interaction between the Starling and the lymphatic mechanisms.

Absorption↗

Pleural liquid pressure gradients and intrapleural distribution of injected bolus.

In supine anesthetized dogs we measured pleural liquid pressure (Pliq) in mediastinal, diaphragmatic, apical, and costal regions at different lung heights during eupneic breathing. At end expiration and at a given height, Pliq was similar in the costal and apical regions, but it was lower in the diaphragmatic and mediastinal compartments. Inspiratory swings toward lower values were progressively greater with increasing height and moving from costal to apical, diaphragmatic and mediastinal compartments. Thus during inspiration, at any height, the costomediastinal and costodiaphragmatic Pliq difference increased while a costoapical difference developed. One minute after injection of 0.5-1 ml of saline at different points within the cavity, end-expiratory liquid pressure became higher on the average by 0.45, 1.55, and 0.55 cmH2O in the apical, mediastinal, and diaphragmatic compartments, respectively, while no change was observed on costal side. These results suggested liquid accumulation in the compartments displaying a lower Pliq. This was confirmed by following, with a gamma camera, on a frontal projection of the lung, the intrapleural distribution of a bolus containing 99mTc-labeled albumin injected at various places.

Animals↗

Comparative features of Starling-lymphatic interaction at the pleural level in mammals.

Pleural liquid pressure was measured with saline-filled cannulas in rats, rabbits, cats, pups (4-5 days and 2 mo), small and large dogs, and pigs. On both the costal and mediastinal sides pleural liquid pressure at a level corresponding to the tricuspid valve decreased with increasing body mass; because this behavior was more marked on the mediastinal than on the costal side, a horizontal costomediastinal pleural liquid pressure gradient developed. No differences in liquid pressure were found in animals of different age but of similar size. The protein concentration and the volume-to-body weight ratio of the collected pleural liquid were also found to decrease with increasing body mass. For plasma colloid osmotic pressure, no size-related differences in the Starling balance seem to occur on costal side, whereas such balance shifts toward filtration at mediastinal level with increasing body mass. The lower liquid pressure found with increasing body mass is discussed in terms of lower conductance of the mesothelia and possibly greater lymphatic action. In terms of the Starling-lymphatic interaction we suggest that lymphatics can generate a pressure only slightly lower than that reflecting the equilibrium of the Starling balance of forces.

Aging↗

Reabsorption of a saline- or plasma-induced hydrothorax.

In supine rabbits injection of 2 ml of saline into the lower right diaphragmatic region increased pleural liquid pressure at the injection point and, to a minor extent, on the costal and mediastinal side, indicating a redistribution of liquid among the pleural compartments. Over a period of 120 min end-expiratory liquid pressure on the diaphragmatic and costal surfaces approached the control value as a result of local reabsorption. No difference in the time course of liquid pressure was found on injection of either saline or homologous plasma. This was confirmed by measuring the volume of saline or plasma remaining in the cavity 90 min after injection; the net absorption flow amounted to 0.22 ml . kg-1 . h-1. These results suggest that local absorption mechanisms are relatively independent of the Starling pressure gradients acting across the pulmonary-perfused (-10.2 and 6.6 cmH2O with saline and plasma, respectively, the negative sign indicating a reabsorption gradient) and systemically perfused mesothelium (3.3 and 20.1 cmH2O with saline and plasma, respectively).

Absorption↗

Role of the diaphragm in setting liquid pressure in serous cavities.

Supraphrenic and subphrenic liquid pressures in supine dogs and rabbits were found to be about 2 cm H2O more negative than costal and mediastinal liquid pressures at the same lung height. Peritoneal liquid pressure was negative at all lung heights in dogs and slightly positive below 25% of lung height in rabbits. The vertical gradients of liquid pressure did not differ significantly in either species between the pleural and peritoneal cavities and were lower than 1 cm H2O/cm. From the peritoneal protein concentration (2.3 and 3.5 g/100 ml in dogs and rabbits, respectively) we calculated a filtration pressure for the peritoneal mesothelium and a lymphatic role was hypothesized to explain negative liquid pressures in the peritoneal cavity. The greater negativity of the subphrenic as compared with the peritoneal data could be related to a strong respiratory-dependent lymphatic action. A similar mechanism and/or a low filtration conductance of the diaphragmatic pleura may explain the costo-supraphrenic liquid pressure difference. The present results, extending previously published data on the mediastinal side of the lung, further support the existence of local differences in fluid dynamics in the pleural cavity.

Animals↗

Mechanical properties of the lungs during acclimatization to altitude.

Mechanical properties of the lung were studied in nine healthy lowlanders during a 6-day sojourn at an altitude of 3,457 m. In comparison to sea-level values, it was found at altitude that 1) lung volumes measured by plethysmography including total lung capacity, vital capacity, and functional residual capacity (FRC) presented small changes not exceeding 300 ml; 2) static and dynamic lung compliances were not modified but static pressure-volume curves of lungs were shifted progressively to the left (the decrease in lung elastic recoil averaged about 2 cmH2O on days 4-6); and 3) maximal midexpiratory flow, forced expiratory volume in 1 s, and maximal expiratory and inspiratory flows were increased and, conversely, airways and pulmonary flow resistances were decreased on most days at altitude. The unchanged FRC in the face of a decreased lung recoil may be explained by an increase in thoracic blood volume at altitude, but other possible mechanisms are discussed. The decrease in resistances and increase in maximal flows may be partly explained by the decreased air density at altitude, but another contributing factor such as a bronchodilatation is also suggested. It is proposed that changes in lung mechanics at altitude may account for some of the changes in the pattern of breathing and mouth occlusion pressure (P0.1) observed during acclimatization of lowlanders to altitude.

Acclimatization↗