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Biomedical subjects

J Mead

Publications and source records attributed to J Mead.

At least 55 records · Page 3Linked to original sources

Thoracoabdominal blood volume change and its effect on lung and chest wall volumes.

The effects of changing blood volume within the thoracoabdominal cavity (Vtab) have been studied in four male subjects trained in respiratory maneuvers. Subjects were studied lying supine in a pressure plethysmograph with inflatable fracture splints placed around both arms and legs. Changes in Vtab were produced by inflating the splints to 30 cmH2O. Thoracic gas volume (Vtg) measured by Boyle's law, and the change in chest wall volume (delta Vw), measured by anteroposterior magnetometers on rib cage and abdomen, were measured almost simultaneously and at two respiratory system volumes. The quantity of blood moved by splint inflation was estimated for each subject at both respiratory system volumes and varied between 215 and 752 ml. The chest wall increased 64 +/- 11.8% (mean +/- SD) of the increase in Vtab. Thus increases in thoracoabdominal blood volume increase Vw about twice the decrease in Vtg.

Abdomen↗

Effect of posture on vital capacity.

The influence of some extreme body postures on vital capacity (VC) was examined in young adult humans. Two postures required full support of body weight by the arms: arms up, hanging from a bar, and arms down with hands gripping parallel bars. Three involved muscles that flex and extend the trunk: a partial sit-up position while supine and nearly maximal spinal extension and flexion while standing. Changes at the inspiratory and expiratory volume extremes were recognized by having the subjects do two VC efforts: the first standing and the second in the posture in question while continuing to breathe on the spirometer. Control observations in which the second of a VC pair was performed in an unstressed posture allowed correction for the influence of rebreathing. The changes in corrected VC were small, the greatest being an average reduction of approximately 8% in the partial sit-up position. During full support of body weight by the arms, the VC was slightly increased due to a significant increase in the inspiratory extreme and no change in the expiratory extreme. Spinal extension produced small increases in lung volume at both extremes with no significant change in VC, whereas spinal flexion did not influence the upper extreme but did increase lung volume at the lower extreme. The changes are discussed in terms of trunk muscle action.

Adolescent↗

Changes in flow-volume curve configuration with bronchoconstriction and bronchodilation.

Changes in the configuration of maximum expiratory flow-volume (MEFV) curves following mild degrees of bronchodilation or bronchoconstriction were studied in five normal and five asthmatic subjects. In a volume-displacement plethysmograph, MEFV curves were performed before and after inhalation of aerosolized isoproterenol (I) or histamine (H). Five filtered MEFV curves were averaged, and slope ratio vs. volume (SR-V) plots were obtained from averaged curves. Following I, maximal flows at 75% of the vital capacity (VC) were decreased in asthmatics but not in normal subjects. Flows at 50 and 25% of the VC increased in normal subjects and asthmatics, whereas VC's were unchanged. In asthmatics, sudden large decreases in flow (bumps) occurred at lower lung volumes following I. H reduced flows over the entire VC, with greater reductions occurring in asthmatics than in normals, particularly at low lung volumes. In asthmatics, VC was slightly reduced, and bumps in MEFV curve configuration occurred at higher lung volumes or were abolished entirely following H. A reduction in the amount of configurational detail appreciable in MEFV curves following histamine in asthmatics was best seen in SR-V plots. Following H, SR's decreased regularly with decreasing lung volume in all the asthmatics but in none of the normals. This was the single most striking finding of this study. Mild I- and H-induced perturbations of airway bronchomotor tone produced small but consistent changes in MEFV curve configuration.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Reflex compensation of spontaneous breathing when immersion changes diaphragm length.

We measured tidal volume (VT), chest wall dimensions, end-tidal PCO2, and respiratory muscle electromyograms as seated subjects were immersed in water. We studied nine spontaneously breathing subjects; five were uninformed. Raising the water to xiphoid level pushed the abdomen in and expanded the rib cage at end expiration. This increased the diaphragm's operating length, giving it a contractile advantage, and shortened the inspiratory intercostals, giving them a contractile disadvantage. Peak inspiratory activities of both muscle groups decreased; inspiratory time (TI), respiratory frequency (f), and VT were unchanged. The experiments thus demonstrated operational length compensation during immersion and further showed that inspiratory muscle activation is not adjusted locally, according to changes in each muscle's length, but rather that the response is global. Xiphoid-to-shoulder immersion was less easily interpreted, since both rib cage and abdomen were compressed, lengthening both inspiratory muscles. Our subjects continued to maintain VT, f, and TI. Peak inspiratory activities of both muscles were further reduced. We do not attribute the change in inspiratory muscle activation to altered chemical drive or to voluntary response. Rather, the response appears to be a mechanoreceptive reflex that employs afferent information from the lungs or diaphragm to adjust all inspiratory muscle activities.

Diaphragm↗

Effects of paralysis with pancuronium on chest wall statics in awake humans.

The influence of tonic inspiratory muscle activity on the relaxation characteristics of the chest wall, rib cage (RC), and abdominal wall (ABW) has been investigated in four highly trained subjects. Chest wall shape and volume were estimated with magnetometers. Pleural pressure (Pes) and abdominal pressure were measured with esophageal and gastric balloons, respectively. Subjects were seated reclining 30 degrees from upright, and respiratory muscle weakness was produced by pancuronium bromide until RC inspiratory capacity was decreased to 60% of control. Only minor changes were observed for Konno-Mead relaxation characteristics (RC vs. ABW) between control and paralysis. Similarly, although RC relaxation curves (RC vs. Pes) during paralysis were significantly different from control (P less than 0.05), the changes were small and not consistent. The differences between paralysis-induced changes in resting end-expiratory position of the chest wall and helium-dilution functional residual capacity (FRC) suggested changes in volume of blood within the chest wall. We conclude that 1) although tonic inspiratory activity of chest wall muscles exists, it does not significantly affect the chest wall relaxation characteristics in trained subjects; 2) submaximal paralysis produced by pancuronium bromide is likely to modify either spinal attitude or the distribution of blood between extremities and the thorax; these effects may account for the changes in FRC in other studies.

Blood Volume↗

Chest wall distortion during resistive inspiratory loading.

We studied six (1 naive and 5 experienced) subjects breathing with added inspiratory resistive loads while we recorded chest wall motion (anteroposterior rib cage, anteroposterior abdomen, and lateral rib cage) and tidal volumes. In the five experienced subjects, transdiaphragmatic and pleural pressures, and electromyographs of the sternocleidomastoid and abdominal muscles were also measured. Subjects inspired against the resistor spontaneously and then with specific instructions to reach a target pleural or transdiaphragmatic pressure or to maximize selected electromyographic activities. Depending on the instructions, a wide variety of patterns of inspiratory motion resulted. Although the forces leading to a more elliptical or circular configuration of the chest wall can be identified, it is difficult to analyze or predict the configurational results based on insertional and pressure-related contributions of a few individual respiratory muscles. Although overall chest wall respiratory motion cannot be readily inferred from the electromyographic and pressure data we recorded, it is clear that responses to loading can vary substantially within and between individuals. Undoubtedly, the underlying mechanism for the distortional changes with loading are complex and perhaps many are behavioral rather than automatic and/or compensatory.

Abdominal Muscles↗

Rib cage distortion during voluntary and involuntary breathing acts.

We examined chest wall and rib cage configuration in seven normal subjects during a variety of breathing maneuvers. Magnetometers were used to measure lower rib cage anteroposterior, lower rib cage transverse, upper rib cage anteroposterior, and abdomen anteroposterior diameters. Changes of these diameters were recorded during voluntary maneuvers, rebreathing, reading, and "natural" breathing. Relative motion of the rib cage and abdomen was displayed with the rib cage represented by the product of its lower anteroposterior and transverse diameters. During spontaneous breathing the rib cage and chest wall are near their relaxation configuration. During chemically driven ventilation the chest wall and rib cage progressively depart from this configuration. Much greater distortions of the chest wall and rib cage occurred during some voluntary maneuvers. Additionally, esophageal pressure and gastric pressure were measured during voluntary distortion of the rib cage. Substantial changes in lower rib cage shape occurred during voluntary maneuvers when compared with spontaneous breaths at the same transmural pressure. We conclude that the unitary behavior of the rib cage in normal subjects requires muscle coordination.

Abdominal Muscles↗

Respiratory mechanical effects of abdominal distension.

We develop a theory to predict the partitioning of a change in volume of the abdominal contents into the end-expiratory volume changes of the lung, rib cage, and anterior abdominal wall. First, we calculate the distribution of such a volume change using the relative compliances of the three compartments. We then consider the inspiratory influence of abdominal pressure on the rib cage and its effect on the distribution of this volume. We test our theory by inducing gastric distension in three experienced laboratory personnel. We instilled and subsequently withdrew 1 liter of water from a gastric balloon and examined the effects of this change in gastric volume on the relaxation characteristics of the respiratory system. The distribution of the volume change that would be expected from the observed relative compliances of the three compartments would be approximately 66% into change in lung volume, 25% into change in rib cage volume, and 9% into change in abdominal volume. Instead, in line with our predictions for acute gastric distension, approximately 33% went into decrease in lung volume, 40% into increase in rib cage volume, and 26% into increase in abdominal volume. These results suggest that the interactions among the rib cage, abdomen, and diaphragm are such as to defend against large changes in end-expiratory lung volume in the face of abdominal distension.

Abdomen↗

Dependence of diaphragmatic length on lung volume and thoracoabdominal configuration.

Changes in lung volume can be partitioned into volume displacements of the rib cage and abdomen. Abdominal displacements are often used as estimates of diaphragmatic displacements and changes in lengthening of diaphragmatic muscle. We used X-rays, ultrasound, and linear measurements of thoracic and abdominal diameters to estimate relationships among lung volume, thoracoabdominal configuration and diaphragmatic length, and we found that diaphragmatic length was strongly dependent on rib cage as well as abdominal displacement. In three subjects, the diaphragm shortened 57-85% as much during a breath made without abdominal displacement as during a normal breath in which the abdominal wall moved outward with the rib cage. We conclude that changes in diaphragmatic length can be estimated from surface measurements without radiation and that the length of the diaphragm cannot be estimated from displacements of the abdominal wall alone.

Abdomen↗

Rib cage mobility in pectus excavatum.

Pectus excavatum is generally regarded as a cosmetic deformity; however, some children with pectus excavatum complain of chest pain and exercise limitation. Physiologic studies sometimes show mild restrictive changes and suggest an increased oxygen cost of breathing. Limitation of rib cage mobility related to the deformity may explain these findings. If rib cage mobility is limited, the ability of the actively inspiring rib cage to lower abdominal pressure would be decreased. If this were so, increased swings in abdominal pressure would be seen during the respiratory cycle, especially at times of stress such as during exercise. To test the hypothesis that pectus excavatum is associated with decreased rib cage mobility, we studied 11 patients with pectus excavatum and 11 control subjects. Four control subjects were also studied with rib cage mobility restricted by chest wall strapping sufficient to decrease vital capacity by 5, 10, and 40%. Gastric pressure was measured using balloon catheters and was used as an index of abdominal pressure. Flow at the mouth was recorded and integrated to give volume. Measurements were made at rest, immediately after exercise, and during graded voluntary inspiration to total lung capacity. Gastric pressure was related to tidal volume, and pressure-volume loops were constructed. There were no differences in abdominal pressure swings during respiration between the patients with pectus excavatum and the control subjects. Both groups showed moderate increase in gastric pressure during inspiration at rest and smaller increases or even decreases in abdominal pressure at end inspiration after exercise and at total lung capacity.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

Effect of posture on upper and lower rib cage motion and tidal volume during diaphragm pacing.

We monitored changes in upper and lower rib cage dimensions and tidal volume during bilateral phrenic nerve pacing in a quadraplegic subject with a flaccid chest wall paralysis. Both upper and lower rib cage showed inward (paradoxical) motion during paced breaths in supine (horizontal) and upright positions on a tilt table. In both postures, abdominal compression changed only the lower rib cage to orthodox motion. Abdominal compression in the supine posture decreased tidal volume 10 to 20%, while end-inspiratory diaphragm length, assessed from end-expiratory volume, did not change. Abdominal compression in the upright posture caused end-expiratory volume to fall and increased tidal volume 200%. These observations suggest that isolated diaphragm contraction can move the lower ribs independently from the upper ribs and that tidal volume is determined both by the resting length of the diaphragm and by diaphragmatic load.

Adult↗

Abdominal muscle use during quiet breathing and hyperpnea in uninformed subjects.

Although there is electromyographic evidence for abdominal muscle activity during quiet breathing in standing subjects, several studies have shown, or assumed, that subjects normally breathe on their relaxation characteristics. This latter observation would by itself suggest that abdominal muscles do not contract during quiet breathing. To test this assumption we observed abdominal and rib cage displacements with magnetometers in 17 uninformed subjects. During quiet breathing most subjects showed evidence of tonic or phasic abdominal muscle contraction while standing and sitting but not supine. Subjects studied during hyperpnea immediately following exercise-showed evidence of greater abdominal muscle contraction than at rest. We conclude that most subjects standing at rest normally contract their abdominal muscles.

Abdominal Muscles↗

Analysis of volume displacement and length changes of the diaphragm during breathing.

Diaphragmatic volume displacements cause equal displacements of abdominal contents. Since the rib cage forms a variable part of the abdominal container (the variable part being its area of apposition with the diaphragm) the rib cage and ventral abdominal wall share in abdominal displacements. The fraction of total rib cage volume displacement (delta Vrc) contributing to abdominal displacement is predicted from anatomic considerations and measurements. During quiet inspirations it is estimated that more than half of delta Vrc goes into abdominal expansion. This displacement plus the outward displacement of the anterolateral abdominal wall constitute the diaphragmatic displacement. In a typical inspiration in which delta Vrc accounts for 3/4 of the lung volume change, the diaphragm displaces nearly the same volume. Associated changes in diaphragm length are estimated with a model. Diaphragm shortening during an inspiration in which only the rib cage expands is estimated to be only 11% less than during a normal inspiration. We conclude that the direct rib cage contribution to lung volume change is much less, and that diaphragmatic contribution is much more than was previously thought.

Abdominal Muscles↗

Action of the diaphragm on the rib cage inferred from a force-balance analysis.

Displacements of the rib cage are determined by the intrinsic passive properties of the rib cage, rib cage musculature, pleural and abdominal pressures, and the diaphragm. The diaphragm's mechanical actions on the rib cage are inferred from a force-balance analysis in which the diaphragm is seen to cause expansion of the rib cage by pulling cephalad at its insertions on the lower ribs (insertional component) and by raising intra-abdominal pressure, which pushes outward on the diaphragm's zone of apposition to the rib cage (appositional component). Goldman and Mead suggested that the diaphragm, acting alone, could drive both the rib cage and abdomen on their passive characteristics. The force-balance analysis shows that the diaphragm's inspiratory action on the rib cage is less than predicted by Goldman and Mead, but that in the special circumstances of their experiment (low lung volumes), the appositional component is large and the rib cage can be driven close to its passive characteristics. The force-balance analysis is consistent with recent observations by other investigations and is incompatible with the model proposed by Macklem and colleagues and with the Goldman-Mead hypothesis. Experiments on three subjects produced data consistent with the force-balance analysis, showing that the inspiratory action of the diaphragm on the rib cage is greatest at low lung volumes.

Abdominal Muscles↗

Effects of posture on flow-volume curve configuration in normal humans.

Tien et al. (J. Appl. Physiol.: Respirat. Environ. Exercise Physiol. 46: 565-570, 1979) found reproducible details in the configuration of averaged maximal expiratory flow-volume curves and suggested that these details may correspond to sudden relocations of airway choke points. The occurrence of choke points depends on factors affecting local airway pressure-diameter behavior. We postulated that changes in posture as they affect the distribution of lung recoil on airways might change the locations of choke points and thereby alter flow-volume configuration. Twenty normal adults performed five flow-volume curves in each of four postures (standing, supine, right, and left lateral recumbent). Volume was measured with a Krogh spirometer and airflow with a Fleisch No. 4 pneumotachometer. Curves were digitally filtered and plotted relative to upright total lung capacity. Five curves in each posture were averaged at increments of 0.1 l/s of flow and average volumes at given flows were compared using the Student's t test. Significant differences (P less than 0.01) in mean volumes at given flows occurred in all subjects from standing to supine and/or right to left lateral postures. Large changes in configuration were apparent in one of the two postural pairs in eight subjects. We conclude that changes in posture result in significant changes in flow-volume configuration in most normal adults. These findings are consistent with the wave-speed theory of flow limitation and suggest that small changes in local airway stresses can significantly alter the location and motion of airway choke points during forced expiration.

Adult↗

Hepatic contribution to newly made fatty acids in adipose tissue in rats and inhibition of hepatic and extrahepatic lipogenesis from glucose by dietary corn oil.

We have reexamined an earlier rat study in which the authors concluded that 60 min after [U-14C]-glucose injection half of labeled fatty acids found in adipose tissue had been made in liver and then transported to the adipose tissue. We have shown that even under conditions in which the lipogenic role of the liver is optimized (fed-refed rats on a fat-free, high-carbohydrate diet), almost none of the labeled fatty acids found in adipose tissue of rats 60 min after they were fed a labeled glucose test meal was derived from the liver. This conclusion was based experimentally on (a) the use of the blocking agent Triton WR 1339 to measure the total labeled triglyceride fatty acids (TGFA) synthesized and secreted by the liver in 60 min and (b) comparison of plasma TGFA-14C data with radioactivity found in liver and in adipose tissue in 60 min. Without using Triton WR 1339, mathematical, analysis of plasma TFGA-14C following the glucose test-meal leads one to the same conclusion: 97% of 14C-labeled fatty acids found in adipose tissue at 60 min was made in situ. Additional studies in rats established that the source of error in the earlier studies was an incorrect assumption that dietary corn oil could inhibit hepatic lipogenesis from glucose C without inhibiting fatty acid synthesis in adipose tissue. In our studies, 10% corn oil inhibited equally both hepatic and adipose tissue fatty acid synthesis from glucose C under conditions that precluded any significant transport of labeled TGFA-14C from liver to adipose tissue.

Adipose Tissue↗