Diaphragm thickening during inspiration

Cohn, David, Joshua O. Benditt, Scott Eveloff, and F. DennisMcCool. Diaphragm thickening during inspiration.J. Appl. Physiol. 83(1): 291-296, 1997.Ultrasound has been used to measure diaphragm thickness(T_di) in thearea where the diaphragm abuts the rib cage (zone of apposition).However, the degree of diaphragm thickening during inspiration reportedas obtained by one-dimensional M-mode ultrasound was greater than thatpredicted by using other radiographic techniques. Becausetwo-dimensional (2-D) ultrasound provides greater anatomic definitionof the diaphragm and neighboring structures, we used this technique toreevaluate the relationship between lung volume andT_di. We firstestablished the accuracy and reproducibility of 2-D ultrasound bymeasuring T_diwith a 7.5-MHz transducer in 26 cadavers. We found thatT_di measured byultrasound correlated significantly with that measured by ruler (R² = 0.89), withthe slope of this relationship approximating a line of identity(y = 0.89x + 0.04 mm). The relationship between lung volume andT_di was thenstudied in nine subjects by obtaining diaphragm images at the fivetarget lung volumes [25% increments from residual volume (RV) tototal lung capacity (TLC)]. Plots ofT_di vs. lungvolume demonstrated that the diaphragm thickened as lung volumeincreased, with a more rapid rate of thickening at the higher lungvolumes[T_di = 1.74 vital capacity (VC)² + 0.26 VC + 2.7 mm] (R² = 0.99; P < 0.001) where lung volumeis expressed as a fraction of VC. The mean increase inT_di between RVand TLC for the group was 54% (range 42-78%). We conclude that2-D ultrasound can accurately measureT_di and that theaverage thickening of the diaphragm when a subject is inhaling from RVto TLC using this technique is in the range of what would be predictedfrom a 35% shortening of the diaphragm.

     

Cervical magnetic stimulation as a method to discriminate between diaphragm and rib cage muscle fatigue

Inspiratory muscle fatigue can probablydetermine hypercapnic respiratory failure. Diaphragm fatigue isdetected by electrical phrenic stimulation (ELS), but there is nosimple tool to assess rib cage muscle (RCM) fatigue. Cervical magneticstimulation (CMS) costimulates the phrenic nerves and RCM. We reasonedthat changes in transdiaphragmatic pressure twitch (Pdi,tw) with CMSand ELS should be different after selective diaphragm vs. RCM fatigue. Five volunteers performed inspiratory resistive tasks while voluntarily uncoupling diaphragm and RCM. BaselinePdi,tw_ELS andPdi,tw_CMS were 28.57 ± 1.68 and 32.83 ± 2.92 cmH₂O. Afterselective diaphragm loading,Pdi,tw_ELS andPdi,tw_CMS were reduced by 39 and26%, with comparable decreases in gastric pressure twitch (Pga,tw).Esophageal pressure twitch (Pes,tw) was better preserved with CMS.Therefore Pes,tw/Pga,tw was lower with ELS than CMS (1.24 ± 0.16 vs. 1.73 ± 0.11, P = 0.05). After selectiveRCM loading, there was no diaphragm fatigue, butPes,tw_CMS was significantlyreduced (30%). These findings support the role of rib cagestiffening by CMS-related RCM contraction in the ELS-CMSdifferences and suggest that CMS can be used to assess RCM fatigue.

     

Conservation of bronchiolar wall area during constriction and dilation of human airways

Mitchell, R. W., E. Rühlmann, H. Magnussen, N. M. Muñoz, A. R. Leff, and K. F. Rabe. Conservation ofbronchiolar wall area during constriction and dilation of humanairways. J. Appl. Physiol. 82(3):954-958, 1997.We assessed the effect of smooth musclecontraction and relaxation on airway lumen subtended by the internalperimeter(A_i)and total cross-sectional area (A_o)of human bronchial explants in the absence of the potential lungtethering forces of alveolar tissue to test the hypothesis thatbronchoconstriction results in a comparable change ofA_i andA_o.Luminal area (i.e.,A_i) andA_owere measured by using computerized videomicrometry, and bronchial wallarea was calculated accordingly. Images on videotape were captured;areas were outlined, and data were expressed as internal pixel numberby using imaging software. Bronchial rings were dissected in 1.0- to1.5-mm sections from macroscopically unaffected areas of lungs frompatients undergoing resection for carcinoma, placed in microplate wellscontaining buffered saline, and allowed to equilibrate for 1 h.Baseline, A_o[5.21 ± 0.354 (SE)mm²], andA_i(0.604 ± 0.057 mm²) weremeasured before contraction of the airway smooth muscle (ASM) withcarbachol. MeanA_inarrowed by 0.257 ± 0.052 mm²in response to 10 µM carbachol (P = 0.001 vs. baseline). Similarly, A_onarrowed by 0.272 ± 0.110 mm²in response to carbachol (P = 0.038 vs. baseline; P = 0.849 vs. change inA_i).Similar parallel changes in cross-sectional area forA_iandA_owere observed for relaxation of ASM from inherent tone of otherbronchial rings in response to 10 µM isoproterenol. We demonstrate aunique characteristic of human ASM; i.e., both luminal and totalcross-sectional area of human airways change similarly on contractionand relaxation in vitro, resulting in a conservation of bronchiolarwall area with bronchoconstriction and dilation.

     

Ultrasound evaluation of piglet diaphragm function before and after fatigue

Kocis, Keith C., Peter J. Radell, Wayne I. Sternberger, JaneE. Benson, Richard J. Traystman, and David G. Nichols. Ultrasound evaluation of piglet diaphragm function before and after fatigue. J. Appl. Physiol. 83(5):1654-1659, 1997.Clinically, a noninvasive measure of diaphragmfunction is needed. The purpose of this study is to determine whetherultrasonography can be used to 1)quantify diaphragm function and 2)identify fatigue in a piglet model. Five piglets were anesthetized withpentobarbital sodium and halothane and studied during the followingconditions: 1) baseline (spontaneous breathing); 2) baseline + CO₂ [inhaledCO₂ to increase arterial PCO₂ to 50-60 Torr (6.6-8kPa)]; 3) fatigue + CO₂ (fatigue induced with 30 minof phrenic nerve pacing); and 4)recovery + CO₂ (recovery after 1 hof mechanical ventilation). Ultrasound measurements of the posteriordiaphragm were made (inspiratory mean velocity) in the transverseplane. Images were obtained from the midline, just inferior to thexiphoid process, and perpendicular to the abdomen. M-mode measures weremade of the right posterior hemidiaphragm in the plane just lateral tothe inferior vena cava. Abdominal and esophageal pressures weremeasured and transdiaphragmatic pressure (Pdi) was calculated duringspontaneous (Sp) and paced (Pace) breaths. Arterial blood gases werealso measured. Pdi(Sp) and Pdi(Pace)during baseline + CO₂ were 8 ± 0.7 and 49 ± 11 cmH₂O, respectively, anddecreased to 6 ± 1.0 and 27 ± 7 cmH₂O,respectively, during fatigue + CO₂. Mean inspiratory velocityalso decreased from 13 ± 2 to 8 ± 1 cm/s during theseconditions. All variables returned to baseline during recovery + CO₂. Ultrasonography can beused to quantify diaphragm function and identify piglet diaphragm fatigue.

     

Effects of lung volume on diaphragm EMG signal strength during voluntary contractions

The use ofesophageal recordings of the diaphragm electromyogram (EMG) signalstrength to evaluate diaphragm activation during voluntary contractionsin humans has recently been criticized because of a possible artifactcreated by changes in lung volume. Therefore, the first aim of thisstudy was to evaluate whether there is an artifactual influence of lungvolume on the strength of the diaphragm EMG during voluntarycontractions. The second aim was to measure the required changes inactivation for changes in lung volume at a given tension, i.e., thevolume-activation relationship of the diaphragm. Healthy subjects(n = 6) performed contractions of thediaphragm at different transdiaphragmatic pressure (Pdi) targets (range20-160 cmH₂O) whilemaintaining chest wall configuration constant at different lungvolumes. The diaphragm EMG was recorded with a multiple-arrayesophageal electrode, with control of signal contamination andelectrode positioning. The effects of lung volume on the EMG werestudied by comparing the crural diaphragm EMG root mean square (RMS),an index of crural diaphragm activation, with an index of globaldiaphragm activation obtained by normalizing Pdi to the maximum Pdi atthe given muscle length(Pdi/Pdi_max@L) at thedifferent lung volumes. We observed a direct relationship between RMSand Pdi/Pdi_max@L independent of diaphragm length. The volume-activation relationship ofthe diaphragm was equally affected by changes in lung volume as thevolume-Pdi relationship (60% change from functional residual capacityto total lung capacity). We conclude that the RMS of the diaphragm EMGis not artifactually influenced by lung volume and can be used as areliable index of diaphragm activation. The volume-activationrelationship can be used to infer changes in the length-tensionrelationship of the diaphragm at submaximal activation/contractionlevels.

     

Patterns of shortening and thickening of the human diaphragm

Wait, J. L., and R. L. Johnson. Patterns of shorteningand thickening of the human diaphragm. J. Appl.Physiol. 83(4): 1123-1132, 1997.To study how the human diaphragm changesconfiguration during inspiration, we simultaneously measured diaphragmthickening using ultrasound and inspired volumes using apneumotachograph. Diaphragm length was assessed by chest radiography.We found that thickening and shortening were greatest during a breathtaken primarily with the abdomen. However, the degree of thickening wasgreater than expected for fiber shortening, assuming parallel musclefibers and no shear. So, to clarify this unexpected finding, weconsidered geometric models of the diaphragm. How a muscle thickens asits fibers shorten is critically dependent on geometry. Thus, if a flatrectangular sheet of muscle shortens along one dimension, surfacearea-to-length ratio along this dimension should remain constant, andthickness would be inversely proportional to length during shortening.The simplest model of the diaphragm, however, is a cylindrical sheet ofmuscle in the zone of apposition capped by a dome; the ratio of surfacearea to radial fiber length in the dome is substantially less than theratio of area to length of the cylindrical zone of apposition; hence,as the zone of apposition shortens while the dome radius remainsconstant, the ratio of total surface area to combined length (i.e.,dome + zone of apposition) must decrease and thickening of the musclecorrespondingly must increase more than expected for a simplerectangular strip. A similar relationship can be derived betweenthickening and length in a muscle sheet with a wedge-shaped insertioninto a thin flat tendon. Comparison of calculations with these types ofmodels to data from human subjects indicates that the unexpectedthickening in the zone of apposition is explained by the peculiargeometry of the diaphragm. The greater thickening of the diaphragm inthe zone of apposition suggests that more of the muscle mass and more sarcomeres are retained in the zone of apposition as the dome descends.Physiologically, this greater thickening may have importance byreducing wall stress in the zone of apposition and reducing the work orenergy requirements per sarcomere.

     

Mechanical advantage of the canine triangularis sterni

De Troyer, André, and Alexandre Legrand.Mechanical advantage of the canine triangularis sterni.J. Appl. Physiol. 84(2): 562-568, 1998.Recent studies on the canine parasternal intercostal,sternomastoid, and scalene muscles have shown that the maximal changesin airway opening pressure (Pao) obtained per unit muscle mass(Pao/m) during isolatedcontraction are closely related to the fractional changes in musclelength per unit volume increase of the relaxed chest wall. In thepresent study, we have examined the validity of this relationship for the triangularis sterni, an important expiratory muscle of the rib cagein dogs. Passive inflation above functional residual capacity (FRC)induced a virtually linear increase in muscle length, such that, with a1.0-liter inflation, the muscle lengthened by 17.9 ± 1.6 (SE) % of its FRC length. When the muscle in one interspace wasmaximally stimulated at FRC, Pao increased by 0.84 ± 0.11 cmH₂O. However, in agreement withthe length-tension characteristics of the muscle, when lung volume wasincreased by 1.0 liter before stimulation, the rise in Pao amounted to1.75 ± 0.12 cmH₂O. At thehigher volume, Pao/m thereforeaveraged + 0.53 ± 0.05 cmH₂O/g, such that the coefficientof proportionality between the change in triangularis sterni lengthduring passive inflation and Pao/m was the same as that previously obtained for the parasternalintercostal and neck inspiratory muscles. These observations,therefore, confirm that there is a unique relationship between thefractional changes in length of the respiratory muscles, bothinspiratory and expiratory, during passive inflation and theirPao/m. Consequently, the maximal effect of a particular muscle on the lung can be predicted on the basisof its change in length during passive inflation and its mass. Ageometric analysis of the rib cage also established that thelengthening of the canine triangularis sterni during passive inflationis much greater than the shortening of the parasternal intercostalsbecause, in dogs, the costal cartilages slope downward from thesternum.

     

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.     

Relationship between T-wave amplitude and oxygen pulse in guinea pigs in hyperbaric helium and hydrogen

Diving isknown to induce a change in the amplitude of the T wave(A_Tw) ofelectrocardiograms, but it is unknown whether this is linked to achange in cardiovascular performance. We analyzed A_Tw in guinea pigs at 10-60atm and 25-36°C, breathing 2%O₂ in either helium (heliox;n = 10) or hydrogen (hydrox;n = 9) for 1 h at each pressure. Coretemperature and electrocardiograms were detected by using implantedradiotelemeters. O₂ consumption rate was measured by using gas chromatography. In a previous study (S. R. Kayar and E. C. Parker. J. Appl.Physiol. 82: 988-997, 1997), we analyzed theO₂ pulse, i.e., theO₂ consumption rate per heartbeat, in the same animals. By multivariate regression analysis, weidentified variables that were significant toO₂ pulse: body surface area,chamber temperature, core temperature, and pressure. In this study,inclusion of A_Tw made asignificantly better model with fewer variables. After normalizing forchamber temperature and pressure, theO₂ pulse increased with increasing A_Tw in heliox(P = 0.001) but with decreasingA_Tw in hydrox(P < 0.001). ThusA_Tw is associated with thedifferences in O₂ pulse foranimals breathing heliox vs. hydrox.

     

The diaphragm of the newborn infant: anatomical and ultrasonographic studies.

In the newborn infant, the diaphragm seems badly adapted to perform the burden of respiratory work. Indeed, due to the large angle of insertion on the rib cage and the small area of apposition, the flat diaphragm of the newborn infant seems better designed to suck in the rib cage rather than air. To better understand this paradox, and get insight in the structure-function relationship, the anatomical connections between the diaphragm and the rib cage were studied in 16 infants of various postmenstrual and postnatal ages. It was concluded (1) that the diaphragm inserts on the rib cage border only in the anterior costo-diaphragmatic triangle. From antero-laterally to posteriorly it inserts at increasingly greater distance from the rib cage border; (2) that the dorsal diaphragm ends its free course at the 11th rib and continues caudally as a spur ending between the 12th rib and the crista iliaca. From echographic studies of the right diaphragm with simultaneous measurement of the caudad displacement of the diaphragm and abdominal circumference change, the dynamics of the diaphragmatic movements could be better understood. It was concluded that, in contrast with the adult diaphragm, acting as a piston within the rib cage, the diaphragm of the newborn infant acts as a below moving mainly in the posterior part.(ABSTRACT TRUNCATED AT 250 WORDS)     

Three-dimensional reconstruction of human diaphragm with the use of spiral computed tomography

Pettiaux, Nicolas, Marie Cassart, Manuel Paiva, and MarcEstenne. Three-dimensional reconstruction of human diaphragm withthe use of spiral computed tomography. J. Appl.Physiol. 82(3): 998-1002, 1997.We developed atechnique of diaphragm imaging by using spiral computed tomography, andwe studied four normal subjects who had been previously investigatedwith magnetic resonance imaging (A. P. Gauthier, S. Verbanck,M. Estenne, C. Segebarth, P. T. Macklem, and M. Paiva.J. Appl. Physiol. 76: 495-506,1994). One acquisition of 15- to 25-s duration was performed atresidual volume, functional residual capacity, functional residualcapacity plus one-half inspiratory capacity, and total lung capacitywith the subject holding his breath and relaxing. From theseacquisitions, 20 coronal and 30 sagittal images were reconstructed ateach lung volume; on each image, diaphragm contour in the zone ofapposition and in the dome was digitized with the software Osiris, andthe digitized silhouettes were used for three-dimensionalreconstruction with Matlab. Values of length and surface area for thediaphragm, the dome, and the zone of apposition were very similar tothose obtained with magnetic resonance imaging. We conclude thatsatisfactory three-dimensional reconstruction of the in vivo diaphragmmay be obtained with spiral computed tomography, allowing accurate measurements of muscle length, surface area, and shape.

     

Chest wall motion during tidal breathing

De Groote, A., M. Wantier, G. Cheron, M. Estenne, and M. Paiva. Chest wall motion during tidal breathing. J. Appl. Physiol. 83(5): 1531-1537, 1997.We have used an automaticmotion analyzer, the ELITE system, to study changes inchest wall configuration during resting breathing in five normal,seated subjects. Two television cameras were used to record thex-y-z displacements of 36 markers positioned circumferentiallyat the level of the third (S₁) and fifth(S₂) costal cartilage, corresponding to the lung-apposedrib cage; midway between the xyphoid process and thecostal margin (S₃), corresponding to the abdomen-apposedrib cage; and at the level of the umbilicus (S₄).Recordings of different subsets of markers were made by submitting thesubject to five successive rotations of 45-90°. Each recordinglasted 30 s, and three-dimensional displacements of markers wereanalyzed with the Matlab software. At spontaneous end expiration,sections S_1-3 were elliptical but S₄ wasmore circular. Tidal changes in chest wall dimensions were consistentamong subjects. For S_1-2, changes during inspirationoccurred primarily in the cranial and ventral directions and averaged3-5 mm; displacements in the lateral direction were smaller(1-2 mm). On the other hand, changes at the level ofS₄ occurred almost exclusively in the ventral direction. Inaddition, both compartments showed a ventral displacement of theirdorsal aspect that was not accounted for by flexion of the spine. Weconclude that, in normal subjects breathing at rest in the seatedposture, displacements of the rib cage during inspiration are in thecranial, lateral outward, and ventral directions but that expansion ofthe abdomen is confined to the ventral direction.

     

Luminal L-alanine stimulates exocytosis at the K+-conductive apical membrane of Aplysia enterocytes

In Aplysia intestine,stimulation of Na⁺ absorption withluminal alanine increases apical membraneK⁺ conductance(G_K,a), whichpresumably regulates enterocyte volume during stimulatedNa⁺ absorption. However, themechanism responsible for the sustained increase in plasma membraneK⁺ conductance is not known forany nutrient-absorbing epithelium. In the present study, we have begunto test the hypothesis that the alanine-induced increase inG_K,a inAplysia enterocytes results fromexocytic insertion of K⁺ channelsinto the apical membrane. We used the fluid-phase marker horseradishperoxidase to assess the effect of alanine on apical membraneexocytosis and conventional microelectrode techniques to assess theeffect of alanine on fractional capacitance of the apical membrane(fC_a). Luminalalanine significantly increased apical membrane exocytosis from 1.04 ± 0.30 to 1.39 ± 0.38 ng · min¹ · cm².To measure fC_a,we modeled the Aplysia enterocyte as adouble resistance-capacitance (RC) electric circuit arranged in series. Several criteria were tested to confirm application of the model to theenterocytes, and all satisfied the model. When added to the luminalsurface, alanine significantly increasedfC_a from 0.27 ± 0.02 to 0.33 ± 0.04 (n = 10)after 4 min. There are two possible explanations for our findings:1) the increase in exocytosis, whichadds membrane to the apical plasma membrane, prevents plasma membranefracture, and 2) the increase inexocytosis delivers K⁺ channels tothe apical membrane by exocytic insertion. After the alanine-induceddepolarization of apical membrane potential (V_a), there isa strong correlation (r = 0.96)between repolarization ofV_a, whichreflects the increase inG_K,a, andincrease in fC_a. This correlation supports the exocytic insertion hypothesis for activation ofG_K,a.

     

Transdiaphragmatic pressure and rib motion in area of apposition during paralysis

Changes in pleural surface pressure in area of apposition of diaphragm to rib cage (delta Ppl,ap), changes in abdominal pressure (delta Pab), and redial displacement of the 11th rib have been recorded in anesthetized, paralyzed dogs during lung inflation or deflation. Above functional residual capacity (FRC) changes in transdiaphragmatic pressure in area of apposition (delta Pdi,ap) were essentially nil in intact (INT) dogs either in lateral or supine posture, and in partially eviscerated (EVS) dogs in lateral posture, either in the 10th or 11th intercostal space. Below FRC delta Pdi,ap could be positive (INT lateral and EVS), nil (EVS), or negative (INT supine and EVS); it could be different in the 10th and 11th intercostal spaces. Hence, with stretched (like with contracted) diaphragm, delta Ppl,ap measured at one site often differs from delta Pab and is not representative of average pressure acting on area of apposition. With volume increase above FRC, the 11th rib moved slightly in and then out in EVS and linearly out in INT. With volume decrease below FRC it moved out progressively in EVS, and it moved in and eventually reversed in INT. In paralyzed dogs in lateral posture the factor having the greatest influence on displacement of the abdominal rib cage is Pab. Mechanical linkage with pulmonary rib cage becomes relevant at large volume, whereas insertional traction of diaphragm becomes relevant at low volume.     

Task failure with lack of diaphragm fatigue during inspiratory resistive loading in human subjects

McKenzie, D. K., G. M. Allen, J. E. Butler, and S. C. Gandevia. Task failure with lack of diaphragm fatigue during inspiratory resistive loading in human subjects. J. Appl. Physiol. 82(6): 2011-2019, 1997.Taskfailure during inspiratory resistive loading is thought to beaccompanied by substantial peripheral fatigue of the inspiratorymuscles. Six healthy subjects performed eight resistive breathingtrials with loads of 35, 50, 75 and 90% of maximal inspiratorypressure (MIP) with and without supplemental oxygen. MIP measuredbefore, after, and at every minute during the trial increased slightlyduring the trials, even when corrected for lung volume (e.g., for 24 trials breathing air, 12.5% increase, P < 0.05). In some trials, taskfailure occurred before 20 min (end point of trial), and in thesetrials there was an increase in end-tidalPCO₂(P < 0.01), despite the absence of peripheral muscle fatigue. In four subjects (6 trials with task failure), there was no decline in twitch amplitude with bilateral phrenic stimulation or in voluntary activation of the diaphragm, eventhough end-tidal PCO₂ rose by 1.6 ± 0.9%. These results suggest that hypoventilation,CO₂ retention, and ultimate taskfailure during resistive breathing are not simply dependent on impairedforce-generating capacity of the diaphragm or impaired voluntaryactivation of the diaphragm.

     

Regional deformation of the canine diaphragm.

To follow regional deformation of the diaphragm in dogs, radiopaque markers were implanted under surgical anesthesia into different anatomic regions of the muscle in triangular arrays (approximately 1 cm to a side). After recovery from surgery, changes in area and shape of the triangles were followed with biplane cinefluorography during quiet breathing and during inspiratory efforts against an occluded airway (Mueller maneuvers). From changes in shape of the triangles during contraction, area changes were decomposed into a major direction and magnitude of shortening (Eg1) and a minor length change (Eg2) perpendicular to Eg1, both expressed as a fraction of initial length at end expiration. With the use of these techniques, systematic differences in regional area change were observed in different parts of the diaphragm during inspiratory efforts at different lung volumes. Regional area always decreased during contraction in the crural and midcostal zones of apposition to the rib cage. Area decreased less and often increased during inspiratory efforts in the costal dome near the central tendon and in the costal region near its rib cage insertion. Differences in regional area change were not due to differences in the Eg1 in different parts of the diaphragm but were a consequence of differences in widening of the muscle along Eg2 perpendicular to the direction of Eg1. As lung volume was passively increased above functional residual capacity, regional area decreased in all parts of the diaphragm except in the costal regions near rib cage insertion, where area increased.     

K+ transport and capacitance of the basolateral membrane of the larval frog skin

Skin from larval bullfrogs was mounted in an Ussing-type chamberin which the apical surface was bathed with a Ringer solution containing 115 mM K⁺ and thebasolateral surface was bathed with a Ringer solution containing 115 mMNa⁺. Ion transport was measured asthe short-circuit current(I_sc) with alow-noise voltage clamp, and skin resistance(R_m) wasmeasured by applying a direct current voltage pulse. Membrane impedance was calculated by applying a voltage signal consisting of 53 sine wavesto the command stage of the voltage clamp. From the ratio of theFourier-transformed voltage and current signals, it was possible tocalculate the resistance and capacitance of the apical and basolateralmembranes of the epithelium(R_a andR_b,C_a and C_b,respectively). With as the anion,R_m decreasedrapidly within 5 min following the addition of 150 U/ml nystatin to theapical solution, whereasI_sc increasedfrom 0.66 to 52.03 µA/cm² over a60-min period. These results indicate that nystatin becomes rapidlyincorporated into the apical membrane and that the increase inbasolateral K⁺ permeabilityrequires a more prolonged time course. Intermediate levels ofI_sc were obtainedby adding 50, 100, and 150 U/ml nystatin to the apical solution. Thisproduced a progressive decrease in R_a andR_b whileC_a andC_b remainedconstant. With Cl as theanion, I_sc valuesincreased from 2.03 to 89.57 µA/cm² following treatment with150 U/ml nystatin, whereas with gluconate as the anionI_sc was onlyincreased from 0.63 to 11.64 µA/cm². This suggests that theincrease in basolateral K⁺permeability produced by nystatin treatment, in the presence of morepermeable anions, is due to swelling of the epithelial cells of thetissue rather than the gradient for apicalK⁺ entry. Finally,C_b was notdifferent among skins exposed toCl,, or gluconate, despite the largedifferences inI_sc, nor didinhibition of I_scby treatment with hyperosmotic dextrose cause significant changes inC_b. These resultssupport the hypothesis that increases in cell volume activateK⁺ channels that are alreadypresent in the basolateral membrane of epithelial cells.

     

Isotonic contractile and fatigue properties of developing rat diaphragm muscle

Postnatal transitions in myosin heavy chain (MHC) isoformexpression were found to be associated with changes in both isometric and isotonic contractile properties of rat diaphragm muscle(Dia_m). Expression of MHC_neo predominated inneonatal Dia_m fibers but was usually coexpressed withMHC_slow or MHC_2A isoforms. Expression ofMHC_neo disappeared by day 28. Expression ofMHC_2X and MHC_2B emerged at day 14 andincreased thereafter. Associated with these MHC transitions in theDia_m, maximum isometric tetanic force (P_o), maximum shortening velocity, and maximum power output progressively increased during early postnatal development. Maximum power output ofthe Dia_m occurred at ~40% P_o at days0 and 7 and at ~30% P_o in older animals.Susceptibility to isometric and isotonic fatigue, defined as a declinein force and power output during repetitive activation, respectively,increased with maturation. Isotonic endurance time, defined as the timefor maximum power output to decline to zero, progressively decreasedwith maturation. In contrast, isometric endurance time, defined as thetime for force to decline to 30-40% P_o, remained>300 s until after day 28. We speculate that with thepostnatal transition to MHC_2X and MHC_2Bexpression energy requirements for contraction increase, especiallyduring isotonic shortening, leading to a greater imbalance betweenenergy supply and demand.

     

Letters to the Editor

The following are the abstracts of the articles discussed inthe subsequent letter:

  Huang, Yuh-Chin T., Aneysa C. Sane, Steven G. Simonson, Thomas A. Fawcett, Richard E. Moon,Philip J. Fracica, Margaret G. Menache, Claude A. Piantadosi, andStephen L. Young. Artificial surfactant attenuates hyperoxic lunginjury in primates. I. Physiology and biochemistry. J. Appl.Physiol. 78(5): 1816-1822, 1995.Prolonged exposure toO₂ causes diffuse alveolar damage and surfactantdysfunction that contribute to the pathophysiology of hyperoxic lunginjury. We hypothesized that exogenous surfactant would improve lungfunction during O₂ exposure in primates. Sixteen healthymale baboons (10-15 kg) were anesthetized and mechanically ventilated for 96 h. The animals received either 100% O₂(n = 6) or 100% O₂ plus aerosolized artificialsurfactant (Exosurf; n = 5). A third group of animals(n = 5) was ventilated with an inspired fraction ofO₂ of 0.21 to control for the effects of sedation andmechanical ventilation. Hemodynamic parameters were obtained every 12 h, and ventilation-perfusion distribution(_A/) was measureddaily using a multiple inert-gas elimination technique. Positive end-expiratory pressure was kept at 2.5 cmH₂O andwas intermittently raised to 10 cmH₂O for 30 minto obtain additional measurements of_A/. After theexperiments, lungs were obtained for biochemical and histologicalassessment of injury. O₂ exposures altered hemodynamics,progressively worsened_A/, altered lung phospholipid composition, and produced severe lung edema. Artificial surfactant therapy significantly increased disaturatedphosphatidylcholine in lavage fluid and improved intrapulmonary shunt,arterial PO₂, and lung edema. Surfactant alsoenhanced the shunt-reducing effect of positive end-expiratory pressure.We conclude that an aerosolized protein-free surfactant decreased theprogression of pulmonary O₂ toxicity in baboons.

     

Interaction of cross-sectional area, driving pressure, and airflow of passive velopharynx

Isono, Shiroh, Thom R. Feroah, Eric A. Hajduk, Rollin Brant,William A. Whitelaw, and John E. Remmers. Interaction ofcross-sectional area, driving pressure, and airflow of passive velopharynx. J. Appl. Physiol. 83(3):851-859, 1997.Previous studies have shown that, when thepharyngeal muscles are relaxed, the velopharynx is a highly compliantsegment of the pharynx. Thus, under these circumstances,cross-sectional area of the velopharynx (A_VP), drivingpressure across the velopharynx (P), and inspiratory airflow(I) willbe mutually interdependent variables. The purpose of the presentinvestigation was to describe the interrelation among these threevariables during inspiration. We studied 15 sleeping patients withobstructive sleep apnea/hypopnea when the pharyngeal muscles wererendered hypotonic by applying continuous positive airway pressure tothe nasal airway.A_VP, determined by endoscopic imaging, was significantly greater at onset ofI limitationthan at minimum oropharyngeal pressure(P < 0.01). Snoring was neverobserved duringIlimitation. In a subgroup of six patients, values for P,I, andA_VP were obtainedat 0.1-s intervals at various levels of mask pressure. For these sixpatients, the mathematical expressionI = 0.657(A_VP/A_max) · P^0.332,where A_max ismaximal A_VP,described the relationship among the three variables(R² = 0.962) forflow-limited and non-flow-limited inspirations. The impedance of thepassive velopharynx, defined asP^0.33/,was inversely related toA_VP and increaseddramatically when A_VP was <0.3cm². In summary, we observed aprogressive decrease inA_VP during flow-limited inspiration in patients with obstructive sleep apnea. Thisconstriction of the velopharynx contributes to an increase invelopharyngeal impedance that, in turn, counterbalances the increase inP during flow limitation.