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Journal of Arrhythmia Jun 2024Hemidiaphragm paralysis, a complication of catheter ablation for atrial fibrillation, can severely affect respiratory function and can lead to paradoxical breathing and...
Improvement in respiratory function and exercise tolerance following video-assisted thoracoscopic diaphragm plication for symptomatic iatrogenic persistent diaphragm paralysis after radiofrequency catheter ablation.
Hemidiaphragm paralysis, a complication of catheter ablation for atrial fibrillation, can severely affect respiratory function and can lead to paradoxical breathing and dyspnea on exertion. A 75-year-old woman with iatrogenic diaphragm paralysis showed improved symptoms, respiratory function, and exercise tolerance after video-assisted thoracoscopic diaphragm plication.
PubMed: 38939779
DOI: 10.1002/joa3.13039 -
Journal of Arrhythmia Jun 2024
Editorial to "Improvement in respiratory function and exercise tolerance following video-assisted thoracoscopic diaphragm plication for symptomatic iatrogenic persistent diaphragm paralysis after radiofrequency catheter ablation"-An essential respiratory physiology every electrophysiologist should...
PubMed: 38939772
DOI: 10.1002/joa3.13064 -
Oncology Letters Aug 2024Liver cancer near the deep diaphragm can be difficult to visualize due to the effects of lung gas, which presents a challenge for microwave ablation (MWA). The present...
Liver cancer near the deep diaphragm can be difficult to visualize due to the effects of lung gas, which presents a challenge for microwave ablation (MWA). The present study aimed to investigate the feasibility and efficacy of artificial ascites-assisted MWA for treating liver cancer near the deep diaphragm, as well as the significance of perioperative nursing. A retrospective analysis was conducted on patients who underwent artificial ascites-assisted MWA for liver cancer located near the deep diaphragm between January 2016 and December 2022. Normal saline was utilized as artificial ascites to safeguard the deep diaphragm during MWA. The study recorded the procedural success rate, incidence of major complications, technical efficacy of ablation and local tumor progression (LTP). A total of 62 lesions in 54 patients were included, with 44 men and 10 women, and a mean (± SD) age of 55.64±10.33 years. The ultrasound image quality scores for liver cancer before and after ascites were 3.57±0.79 and 4.89±0.33, respectively, showing a statistically significant difference between the two groups (t=16.324; P<0.05). No diaphragm injury, skin burns at the puncture site or abdominal hemorrhage occurred during the procedure. A single patient developed right-sided pleural effusion, which did not require drainage. The complete ablation rate was 94.4% (51/54) at 1 month post-ablation, with 3 patients experiencing recurrence and receiving additional MWA treatment. The median follow-up time for the patients in this study was 21 months (range, 12-45 months), with a LTP rate of 5.6% (3/54). In conclusion, MWA assisted by artificial ascites is a safe and effective treatment for liver cancer near the deep diaphragm. Furthermore, perioperative treatment and rehabilitation of the patients with high-quality nursing is beneficial.
PubMed: 38939625
DOI: 10.3892/ol.2024.14515 -
JACC. Advances Nov 2023There is limited data regarding the interplay of anatomic and physiologic parameters with exercise capacity in adults with native or recurrent nonsevere coarctation of...
BACKGROUND
There is limited data regarding the interplay of anatomic and physiologic parameters with exercise capacity in adults with native or recurrent nonsevere coarctation of the aorta (CoA).
OBJECTIVES
The objective of this study was to use exercise stress echocardiography and cardiac magnetic resonance imaging to identify anatomic and physiologic correlates of exercise capacity in these patients.
METHODS
We conducted a single-center retrospective analysis of 54 adults with nonsevere CoA (repaired or unrepaired) followed at our institution between 2015 and 2020. Resting coarctation gradients were obtained using echocardiography. Exercise gradients and functional capacity were assessed using exercise stress echocardiography. Aorta anatomy was obtained using magnetic resonance imaging.
RESULTS
Coarctation-to-diaphragm ratio correlated with minutes of exercise (r = 0.56, < 0.01) and metabolic equivalents (r = 0.49, < 0.01). These relationships remained significant after controlling for use of beta-blockers, valvular disease, and type of coarctation repair. Minutes of exercise correlated with mean resting gradients (r = -0.39, < 0.05). Coarctation-to-diaphragm ratio correlated with peak and mean resting gradients (r = -0.34, < 0.05; r = -0.48, < 0.01). Patients with coarctation-to-diaphragm ratio ≤0.7 achieved fewer metabolic equivalents (11.1 ± 1.9 vs 12.8 ± 2.2, < 0.05) and minutes of exercise (10.3 ± 2.0 vs 12.6 ± 2.7, < 0.05).
CONCLUSIONS
In patients with nonsevere native or recurrent CoA, reduced exercise capacity is correlated with coarctation severity by anatomic size and gradients. Those with a coarctation-to-diaphragm ratio ≤0.7 may represent a subset of patients with nonsevere CoA whose clinical symptoms are only elicited with exercise stress testing. Exercise stress testing and cross-sectional imaging may help identify those who could be considered for earlier coarctation intervention.
PubMed: 38938731
DOI: 10.1016/j.jacadv.2023.100672 -
Journal of Medical Case Reports Jun 2024We present a unique case of rhinolalia as the first recognizable sign of spontaneous pneumomediastinum and surgical emphysema following drug use.
BACKGROUND
We present a unique case of rhinolalia as the first recognizable sign of spontaneous pneumomediastinum and surgical emphysema following drug use.
CASE PRESENTATION
This case presents a 17-year-old white male experiencing rhinolalia following ecstasy ingestion at a rave. Subsequent chest X-ray revealed extensive surgical emphysema, along with a continuous diaphragm sign indicative of pneumomediastinum. Computed tomography confirmed the diagnosis. The patient was managed conservatively with strict monitoring and 6 hourly electrocardiograms. Follow-up computed tomography on day 3 showed resolution of pneumomediastinum and surgical emphysema, and the patient was safely discharged. Notably, the patient experienced a temporary rhinolalia during the acute phase, which resolved spontaneously as his condition improved.
CONCLUSIONS
This case underscores the importance of considering spontaneous pneumomediastinum and surgical emphysema in the differential diagnosis of young individuals presenting with acute symptoms after drug use.
Topics: Humans; Male; Mediastinal Emphysema; N-Methyl-3,4-methylenedioxyamphetamine; Adolescent; Tomography, X-Ray Computed; Subcutaneous Emphysema; Diagnosis, Differential
PubMed: 38937843
DOI: 10.1186/s13256-024-04618-9 -
Materials (Basel, Switzerland) Jun 2024A combined stamping-bulging forming process was proposed to achieve high-precision forming of large-diameter, ultra-thin-walled, superalloy welded S-type corrugated...
A combined stamping-bulging forming process was proposed to achieve high-precision forming of large-diameter, ultra-thin-walled, superalloy welded S-type corrugated diaphragms. The underlying principle is to enhance the diaphragm's forming accuracy by increasing the plastic deformation region and reducing springback. Using the ABAQUS version 6.14 finite element analysis software, finite element models were constructed for the stamping, hydraulic bulging, and combined stamping-bulging forming processes of the welded S-type metal corrugated diaphragms. A comparative analysis was conducted on the forming processes of the welded S-type metal corrugated diaphragms under the three forming methods, focusing on equivalent stress, distribution of wall thickness, and forming accuracy. This analysis determined the optimal forming process and the corresponding process parameters for superalloy welded S-type metal corrugated diaphragms. The results show that under a constant drawing force, as the bulging pressure increases, the plastic deformation of the straight sections of the diaphragm becomes more pronounced, resulting in improved shape accuracy. The combined stamping-bulging forming process guarantees the highest degree of shape accuracy for the diaphragm. The optimal process parameters were identified as a 30 t force and a 5 MPa pressure, with a maximum shape error of 0.02 mm. Concerning a plate thickness of 0.3 mm, the maximum deviation rate was found to be 6.7%, which represents a 30% improvement over traditional stamping processes. The maximum wall thinning rate was found to be 3.3%, a 1% reduction compared to traditional stamping processes, confirming the process's feasibility.
PubMed: 38930198
DOI: 10.3390/ma17122829 -
Antioxidants (Basel, Switzerland) May 2024Duchenne muscular dystrophy (DMD) is one of the most frequent and severe childhood muscle diseases. Its pathophysiology is multifaceted and still incompletely...
Duchenne muscular dystrophy (DMD) is one of the most frequent and severe childhood muscle diseases. Its pathophysiology is multifaceted and still incompletely understood, but we and others have previously shown that oxidative stress plays an important role. In particular, we have demonstrated that inhibition of mitochondrial monoamine oxidases could improve some functional and biohumoral markers of the pathology. In the present study we report the use of dystrophic mice to evaluate the efficacy of a dual monoamine oxidase B (MAO-B)/semicarbazide-sensitive amine oxidase (SSAO) inhibitor, PXS-5131, in reducing inflammation and fibrosis and improving muscle function. We found that a one-month treatment starting at three months of age was able to decrease reactive oxygen species (ROS) production, fibrosis, and inflammatory infiltrate in the tibialis anterior (TA) and diaphragm muscles. Importantly, we also observed a marked improvement in the capacity of the gastrocnemius muscle to maintain its force when challenged with eccentric contractions. Upon performing a bulk RNA-seq analysis, PXS-5131 treatment affected the expression of genes involved in inflammatory processes and tissue remodeling. We also studied the effect of prolonged treatment in older dystrophic mice, and found that a three-month administration of PXS-5131 was able to greatly reduce the progression of fibrosis not only in the diaphragm but also in the heart. Taken together, these results suggest that PXS-5131 is an effective inhibitor of fibrosis and inflammation in dystrophic muscles, a finding that could open a new therapeutic avenue for DMD patients.
PubMed: 38929061
DOI: 10.3390/antiox13060622 -
Foods (Basel, Switzerland) Jun 2024This study aims to improve press equipment for safflower oil production by using a mechanism that optimizes pressure distribution within screw turns. A detailed analysis...
This study aims to improve press equipment for safflower oil production by using a mechanism that optimizes pressure distribution within screw turns. A detailed analysis of the main components of the produced safflower oil was performed, encompassing both quantitative and qualitative assessments. Through the exploration of dependencies governing the safflower oil pressing process on the screw press, the optimal parameters were determined. As a result of the research, the optimal diaphragm gap between the gape cylinder and the pressing screw was determined, with the optimal oil yield percentage achieved at ω = 6.2 rad/s and δ = 5 mm. The study also compared the performance of the existing Dream Modern ODM-01 screw press and its upgraded version by analyzing the extracted oil. The results reveal changes in the quantitative and qualitative composition of the main oil components following the operation of the existing and the modernized screw presses. For instance, the amount of unsaturated fatty acids, such as oleic acid (7.7 ± 0.566%), linoleic acid (85.3 ± 1.185%), and linolenic acid (1.2 ± 0.223%), increased. There was an increase in the presence of inorganic substances in safflower oil: iron (0.023 ± 0.031 mg/kg), phosphorus (0.086 ± 0.059 mg/kg), silicium (0.136 ± 0.075 mg/kg), and others. The findings of this study hold significant commercial value and offer promising prospects for global market implementation.
PubMed: 38928850
DOI: 10.3390/foods13121909 -
International Journal of Molecular... Jun 2024Heart failure with preserved ejection fraction (HFpEF) is characterized by biomechanically dysfunctional cardiomyocytes. Underlying cellular changes include perturbed...
Heart failure with preserved ejection fraction (HFpEF) is characterized by biomechanically dysfunctional cardiomyocytes. Underlying cellular changes include perturbed myocardial titin expression and titin hypophosphorylation leading to titin filament stiffening. Beside these well-studied alterations at the cardiomyocyte level, exercise intolerance is another hallmark of HFpEF caused by molecular alterations in skeletal muscle (SKM). Currently, there is a lack of data regarding titin modulation in the SKM of HFpEF. Therefore, the aim of the present study was to analyze molecular alterations in limb SKM (tibialis anterior (TA)) and in the diaphragm (Dia), as a more central SKM, with a focus on titin, titin phosphorylation, and contraction-regulating proteins. This study was performed with muscle tissue, obtained from 32-week old female ZSF-1 rats, an established a HFpEF rat model. Our results showed a hyperphosphorylation of titin in limb SKM, based on enhanced phosphorylation at the PEVK region, which is known to lead to titin filament stiffening. This hyperphosphorylation could be reversed by high-intensity interval training (HIIT). Additionally, a negative correlation occurring between the phosphorylation state of titin and the muscle force in the limb SKM was evident. For the Dia, no alterations in the phosphorylation state of titin could be detected. Supported by data of previous studies, this suggests an exercise effect of the Dia in HFpEF. Regarding the expression of contraction regulating proteins, significant differences between Dia and limb SKM could be detected, supporting muscle atrophy and dysfunction in limb SKM, but not in the Dia. Altogether, these data suggest a correlation between titin stiffening and the appearance of exercise intolerance in HFpEF, as well as a differential regulation between different SKM groups.
Topics: Animals; Heart Failure; Rats; Diaphragm; Connectin; Phosphorylation; Disease Models, Animal; Female; Muscle, Skeletal; Stroke Volume; Muscle Contraction; Physical Conditioning, Animal; Muscle Proteins
PubMed: 38928324
DOI: 10.3390/ijms25126618 -
International Journal of Molecular... Jun 2024Mechanical ventilation (MV), used in patients with acute lung injury (ALI), induces diaphragmatic myofiber atrophy and contractile inactivity, termed ventilator-induced...
Mechanical ventilation (MV), used in patients with acute lung injury (ALI), induces diaphragmatic myofiber atrophy and contractile inactivity, termed ventilator-induced diaphragm dysfunction. Phosphoinositide 3-kinase-γ (PI3K-γ) is crucial in modulating fibrogenesis during the reparative phase of ALI; however, the mechanisms regulating the interactions among MV, myofiber fibrosis, and PI3K-γ remain unclear. We hypothesized that MV with or without bleomycin treatment would increase diaphragm muscle fibrosis through the PI3K-γ pathway. Five days after receiving a single bolus of 0.075 units of bleomycin intratracheally, C57BL/6 mice were exposed to 6 or 10 mL/kg of MV for 8 h after receiving 5 mg/kg of AS605240 intraperitoneally. In wild-type mice, bleomycin exposure followed by MV 10 mL/kg prompted significant increases in disruptions of diaphragmatic myofibrillar organization, transforming growth factor-β1, oxidative loads, Masson's trichrome staining, extracellular collagen levels, positive staining of α-smooth muscle actin, PI3K-γ expression, and myonuclear apoptosis ( < 0.05). Decreased diaphragm contractility and peroxisome proliferator-activated receptor-γ coactivator-1α levels were also observed ( < 0.05). MV-augmented bleomycin-induced diaphragm fibrosis and myonuclear apoptosis were attenuated in PI3K-γ-deficient mice and through AS605240-induced inhibition of PI3K-γ activity ( < 0.05). MV-augmented diaphragm fibrosis after bleomycin-induced ALI is partially mediated by PI3K-γ. Therapy targeting PI3K-γ may ameliorate MV-associated diaphragm fibrosis.
Topics: Animals; Bleomycin; Diaphragm; Mice; Fibrosis; Disease Models, Animal; Mice, Inbred C57BL; Acute Lung Injury; Male; Respiration, Artificial; Class Ib Phosphatidylinositol 3-Kinase; Transforming Growth Factor beta1; Apoptosis; Quinoxalines; Thiazolidinediones
PubMed: 38928077
DOI: 10.3390/ijms25126370