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Biomedical subjects

L Zocchi

Publications and source records attributed to L Zocchi.

At least 37 records · Page 2Linked to original sources
PubMed1991

Electrolyte transport across the pleura of rabbits.

The amounts of Na+ and Cl- in the right pleural space of anesthetized rabbits were determined 10 and 60 min after a 2 ml hydrothorax with the following solutions: Ringer, Ringer with an inhibitor of the Na(+)-Cl- coupled transport or of the Na+/K+ pump, Ringer with gluconate instead of Cl- or with methylglucamine instead of Na+. During the 10-60 min period: (a) with Ringer Na+ and Cl- decreased (P less than 0.01) along with an iso-osmotic liquid absorption, (b) with disulfonic-stilbene (0.1 mM), amiloride (0.7 mM), acetazolamide (0.1 mM), or ouabain (0.5 mM) Na+ did not change and Cl- decreased less (P less than 0.01) than with Ringer. With gluconate-Ringer or methylglucamine-Ringer the liquid flow reversed: in the former case Cl- and, to a smaller extent, Na+ increased (P less than 0.01); in the latter only Na+ increased (P less than 0.01). These findings suggest: (1) the occurrence of a Na+/H+ and Cl-/HCO3- double exchange on the serosal side and of a Na+/K+ pump on the interstitial side of the pleural mesothelium; (2) a slow efflux from the pleural space of gluconate or methylglucamine relative to the corresponding influx of Cl- or Na+, respectively; this drags liquid into the space by osmotic gradient.

Acetazolamide↗
PubMed1991

Starling forces and lymphatic drainage in pleural liquid and protein exchanges.

Pleural liquid volume and protein concentration (C) were determined in rabbits 60 min after a 2 ml hydrothorax with various albumin concentrations in Ringer, homologous serum or plasma. The absorption rate of the hydrothorax decreased with the increase in colloid osmotic pressure of the pleural liquid (pi), being 0.56 +/- 0.03, 0.32 +/- 0.02 and 0.17 +/- 0.05 ml/h with Ringer, 1.1 and 3 g% albumin, respectively, and nil with 5% albumin, serum or plasma. C increased with Ringer and 1.1% albumin, did not change with 3% albumin, and decreased with 5% albumin, serum or plasma. The protein content in the pleural liquid increased with Ringer, did not change with 1.1% albumin, and decreased with the other hydrothoraces. These findings indicate that with hydrothoraces of this size: (1) the Starling forces plus the solute-coupled liquid absorption [Agostoni and Zocchi (1990) Respir. Physiol. 81: 19-28] provide most of the pleural liquid absorption when pi is less than or equal to physiological; (2) the lymphatic drainage increases with pi, providing most of the liquid outflow when pi is similar to that of plasma. This increase in lymphatic drainage, however, does not compensate for the effects of the changes in Starling forces produced by the increased pi.

Absorption↗
PubMed1991

[Primary "small-cell" lymphoma of the lung. A clinical case report].

Primary lymphoma of the lung is a rare pathological condition arising from mucosa-associated lymphoid tissue (MALT). The lack of specific symptoms and the related diagnostic problems induced the authors to report a clinical case recently observed. Therefore, some histopathologic characteristics useful for a correct differential diagnosis with the pseudolymphoma of the lung and the interstitial lymphocyte pneumonia are analysed.

Aged↗
PubMed1990

Solute-coupled liquid absorption from the pleural space.

The occurrence of a solute-coupled absorption of liquid from the pleural space was studied by measuring in anesthetized rabbits the volume of liquid of the right pleural space 1 h after injecting into it 2 ml of Ringer solution or of Ringer with an inhibitor of a Na(+)-Cl- coupled transport or of the Na+/K+ pump. Volume collected after Ringer was 1.56 +/- 0.08 ml. Initial volume being 2.2 ml, net absorption rate was 0.64 ml/h. Volume collected after disulfonic stilbene (0.1 mM) or bumetanide (0.1 mM) was 2.01 +/- 0.06 and 2.01 +/- 0.05 ml, respectively; net absorption rate was reduced to 0.19 ml/h. This suggests the occurrence of Na(+)-Cl- coupled transports. Volume collected after ouabain (0.5 mM) was 2.08 +/- 0.08 ml; net absorption rate was reduced to 0.12 ml/h. This suggests the occurrence of the Na+/K+ pump. The marked reduction in the hydrothorax absorption produced by the inhibitors shows the occurrence of a solute-coupled liquid absorption from the pleural space. Liquid absorbed through the visceral pleura by the solute-coupled transport should be removed by the Starling forces of pulmonary capillaries. Solute-coupled absorption of liquid through the parietal pleura should oppose the filtration caused by the Starling forces.

4-Acetamido-4'-isothiocyanatostilbene-2,2'-disulfo↗
PubMed1990

Chest wall motion and expiratory muscle use during phonation in normal humans.

The pattern of rib cage (RC) and abdomen (AB) motion and the electromyograms of the triangularis sterni (TS) and abdominal external oblique (EO) muscles were studied during speech and reading in six normal uninformed subjects in the sitting posture. Most phrases were started from within the tidal breathing range and extended below RC and AB spontaneous end-expiratory volumes. On the average, 75% of the change in chest wall volume occurred below the resting end-expiratory level. The expired volume resulted from a large predominance of RC displacement, and this was accompanied by marked recruitment of the TS. The EO was also generally activated, but the pattern of activation was less consistent. We conclude that 1) speech occurs primarily below the spontaneous end-expiratory level; 2) most of the volume change is caused by active emptying of the RC produced, at least in part, by contraction of the TS; 3) concomitant activation of the abdominal muscles serves to optimize the inspiratory function of the diaphragm, which has to contract rapidly between phrases to refill the respiratory system.

Adult↗
PubMed1990

Respiratory muscle incoordination in stuttering speech.

We investigated the role of respiratory muscle incoordination during stuttering by measuring esophageal, gastric, and transdiaphragmatic pressures to obtain subglottic pressure (Psg) and indices of diaphragmatic, rib cage, and abdominal muscle contraction during speech in normal volunteers and in severe stutterers. We found in contrast to the relatively constant subglottic pressure during normal conversational speech that speech in stutterers was characterized by failure to control Psg because of contraction of the diaphragm, rib cage, and abdominal muscles singly or in various combinations. As a result, Psg varied substantially and sometimes chaotically from too high to too low, rendering normal speech impossible. During periods of fluency, Psg was much better controlled. We conclude that incoordination of the respiratory muscles is a major problem in stuttering, resulting in failure to control the pressure difference across the vocal cords. It is unclear if this is a primary abnormality or is a secondary response to a primary abnormality elsewhere.

Adolescent↗
PubMed1990

Diaphragmatic rest during negative pressure ventilation by pneumowrap. Assessment in normal and COPD patients.

In the present study, we assessed the occurrence of respiratory muscle rest during long lasting INPV runs using a pneumowrap ventilator at different pressure levels. We measured two indices of diaphragmatic activity: transdiaphragmatic pressure and the electrical activity of the diaphragm. Five healthy volunteers and six COPD patients were studied during spontaneous breathing and during 30-minute runs of INPV at a pressure of -2, -15 and -30 cmH2O. Ventilation, rib cage and abdomen motion were measured by inductive plethysmography; Pdi was obtained as the difference between gastric and esophageal pressures; Edi was recorded with surface electrodes. About 10 minutes of INPV (adaptation phase) were needed to obtain stable values in all the variables recorded. Ventilation increased in both groups up to threefold by increasing the negative pressure applied, this being due to changes in tidal volume. Changes in Pga swings mainly accounted for the reduction in Pdi that became negative during the run at -30 cmH2O. In both groups, Edi, after adaptation, showed no change during INPV at -2 cmH2O but a progressive reduction from control, during INPV at -15 and -30 cmH2O. We conclude that INPV by a pneumowrap ventilator can induce partial respiratory muscle rest in normal subjects and COPD patients.

Adult↗
PubMed1990

Short term effect of intermittent negative pressure ventilation in COPD patients with respiratory failure.

Ten patients with stable chronic obstructive pulmonary disease (COPD) and hypercapnic respiratory failure were randomly submitted to intermittent negative pressure ventilation (INPV) 6 h per day for 5 consecutive days by either a cuirass or pneumo wrap ventilator. The effects were assessed by measurements of spirometry, blood gases, maximal inspiratory (MIP) and expiratory (MEP) pressures, 12 minutes walking distance test (12 mwd), sensation of dyspnoea by a visual analogue scale (VAS) and diaphragmatic electromyographic activity (Edi). Edi was recorded during INPV sessions in only 7 patients. The same measurements apart from Edi were also performed in 8 matched control patients randomly submitted to conventional physiotherapy. During INPV, Edi activity was reduced, at least temporarily down to 50% of baseline values. Comparison of baseline with post INPV values showed no changes in thoracic gas volume (TGV), forced expiratory volume in one second (FEV1), FEV1/forced vital capacity (FVC), arterial oxygen partial pressure (Pao2) and MEP; significant improvements were seen in MIP, vital capacity (VC), VAS, and 12 mwd only in patients submitted to INPV. A significant improvement in PaCO2 was observed in both groups of patients. We conclude that INPV may be effective in improving the functional reserve of the inspiratory muscles in selected COPD patients with hypercapnic respiratory failure and signs of inspiratory muscle dysfunction.

Breathing Exercises↗
PubMed1989

Pleural liquid pressure in the zone of apposition and in the lung zone.

Pleural liquid pressure in zone of apposition (Pliq,ap) and in lung zone (Pliq,L) was measured simultaneously through liquid filled cannulas in anesthetized dogs in lateral posture. At top Pliq,ap and Pliq,L at iso-height were -9.7 +/- 0.4 and -11.9 +/- 0.3 cm H2O, respectively, at end expiration (eE; P of delta less than 0.01; 11 dogs); -9.6 +/- 0.7 and -19.8 +/- 0.7 cm H2O at end inspiration (eI). At bottom they were -0.6 +/- 0.2 and -2.4 +/- 0.4 cm H2O, respectively, at eE (P of delta less than 0.05; 4 dogs); -1.5 +/- 0.3 and -8.5 +/- 1.0 cm H2O at eI. Vertical gradient of Pliq,ap was -0.97 +/- 0.02 cm H2O/cm. A 132% increase in ventilation (after 10 min dead space breathing) did not change eE and eI Pliq,ap, and eE Pliq,L, but decreased eI Pliq,L. These results imply: (1) no transmission to zone of apposition of tidal changes in Pliq,L; (2) a liquid flow from zone of apposition to lung zone; (3) a net filtration into zone of apposition. They suggest that absorption pressure of capillaries of visceral pleura is greater than that of lymphatics of zone of apposition. Lymphatic role in setting Pliq,L is discussed.

Animals↗
PubMed1989

Pleural pressure from abdominal to pulmonary rib cage: sweep of the lung border.

Pleural pressure was measured by a capsule placed in the superior part of right 8th or 9th intercostal space of dogs in left lateral posture. Transit of lung border was observed through endothoracic fascia at sides of the capsule. During inspiration the capsule membrane faced sequentially: diaphragm, lung border, lung; vice versa during expiration. Pressure on the diaphragm at end expiration was -5.3 +/- 0.5 cm H2O, reflecting outward recoil of the rib cage. At transit of lung border during inspiration (bor. I) a marked negative pressure spike occurred; a smaller spike occurred at expiratory transit (bor. E). These spikes should reflect pleural liquid pressure at lung border. At bor. I lung volume and radial displacement of rib 9 or 10 were greater during active than passive ventilation, whereas at bor. E they were similar under both conditions. Hence, during spontaneous inspiration displacement of lung border lags behind lung and rib expansion. Speed of lung border (assessed from duration of negative spike) ranged from 0.8 to 2.3 cm/sec during spontaneous breathing. On average it was similar at bor. I and bor. E, while air flow was greater at bor. I.

Animals↗
PubMed1989

Pleural liquid pressure at the caudal border of the lung.

Model simulation indicates that pressure recorded through a capsule, when lung border is under it, is essentially equal to pressure of pleural liquid (Pliq) surrounding lung border, though only a strip of capsule membrane is exposed to this liquid (the rest is facing diaphragm and lung). At the top of the right 8th or 9th intercostal space of dogs in left lateral posture Pliq recorded through a capsule at transit of lung border during inspiration (bor. I) or expiration (bor. E) was -19.7 +/- 1.1 and -11.2 +/- 0.3 cm H2O, respectively. Pliq recorded simultaneously through a cannula on the flat surface of lung in 5th or 6th intercostal space (corrected for 1 cm lower height) was -18.7 +/- 1.4 and -12.4 +/- 0.8 cm H2O. Similar values of Pliq on lung border and on flat surface of lung, despite different kinds of deformation and different measuring devices, provide further evidence that Pliq is more subatmospheric than pleural surface pressure. Seventy percent of difference in Pliq between bor. I and bor. E was accounted for by: (a) corresponding difference in pleural surface pressure, and (b) greater tidal change of liquid than surface pressure. Possible factors accounting for the remaining 30% are discussed.

Animals↗
PubMed1989

Lung border sweep upon phrenic stimulation: dynamic fall in pleural liquid pressure.

Pleural pressure was measured by a capsule in 9th or 10th intercostal space (ics) of dogs during tetanic stimulation of phrenic nerves (PS). When lung border passed under capsule (bor.I) a marked negative spike occurred, reflecting pleural liquid pressure (Pliq). In 9th ics spike was briefer than during spontaneous breathing (SB), speed of lung border being 4.6 times greater. During PS spike was greater and longer in 10th than in 9th ics, lung volume at bor.I being 228 ml greater. Lung volume at bor.I was smaller during PS than passive inflation because of chest wall deformation. Dynamic fall in Pliq at bor.I has been estimated about 4 cm H2O during SB, and at least 12 and 16 cm H2O (in 9th and 10th ics, respectively) during PS. Dynamic fall in Pliq seems essentially a viscous loss: it increased with thinning of pleural liquid (increase in lung volume), and with speed and displacement of lung border. Results suggest that at ordinary lung volume viscous loss of pleural liquid in this region is about 2 cm H2O per cm displacement at a speed of 1 cm/sec.

Animals↗
PubMed1989

Early detection of pulmonary congestion and edema in dogs by using lung sounds.

Five mongrel dogs (2 interstitial and 3 alveolar edema) were studied. Lung mechanics were measured by recording the flow, volume, and esophageal pressure according to the standard technique. Edema was produced by infusion of Ringer lactate solution. Lung sounds were recorded on tape from the dependent part of the chest wall. Lung sound signals were high-pass filtered at 100 Hz and subjected to fast Fourier transform. Samples of lung sounds were analyzed before (control) and at 5, 10, 20, 30, and 40 min after the infusion. The mean, median, and mode frequencies of sound power spectra at the control time were, respectively, 169.6 +/- 29.19, 129.6 +/- 29.81, and 136.0 +/- 29.87 (SD) Hz. These values increased significantly at 5 min after infusion to 194.0 +/- 26.08 (P less than 0.0037), 150.2 +/- 23.48 (P less than 0.0085), and 164.6 +/- 28.74 Hz (P less than 0.02), respectively. These values stayed significantly elevated at 10, 20, 30, and 40 min. The pulmonary wedge pressure, lung dynamic compliance, and pulmonary resistance were measured also at the same times. The mean, median, and mode frequencies correlated with pulmonary wedge pressure (P less than 0.00001, P less than 0.0001, P less than 0.0001), lung dynamic compliance (P less than 0.001, P less than 0.0001, P less than 0.0001), and pulmonary resistance (P less than 0.00001, P less than 0.00001, P less than 0.0001), respectively. There were no significant adventitious sounds up to 40 and 50 min after infusion. We concluded that pulmonary congestion and early edema alter the frequency characteristics of lung sounds early, before the occurrence of adventitious sounds. These altered lung sounds may be used as an index of pulmonary congestion and impending edema.

Animals↗
PubMed1988

Pleural pressure between diaphragm and rib cage during inspiratory muscle activity.

We measured the changes in pleural surface pressure (delta Ppl) in the area of apposition of the rib cage to the diaphragm (Aap) in anesthetized dogs during spontaneous breathing, inspiratory efforts after airway occlusion at functional residual capacity, and phrenic stimulation. Intact dogs were in supine or lateral posture; partially eviscerated dogs were in lateral posture. delta Ppl,ap often differed significantly from changes in abdominal pressure (delta Pab); sometimes they differed in sign (except during phrenic stimulation). Changes in transdiaphragmatic pressure in Aap (delta Pdi,ap) could be positive or negative and were less in eviscerated than in intact dogs. delta Pdi,ap could differ in sign among respiratory maneuvers and over different parts of Aap. Hence average delta Pdi,ap should be closer to zero than delta Pdi,ap at a given site. Since delta Ppl,ap = delta Prc,ap, where Prc,ap represents rib cage pressure in Aap, delta Pdi,ap = delta Pab - delta Prc,ap. Hence, considering that delta Pab and delta Prc depend on different factors, delta Pdi,ap may differ from zero. This pressure difference seems related to the interaction between two semisolid structures (contracted diaphragm and rib cage in Aap) constrained to the same shape and position.

Animals↗
PubMed1988

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.

Animals↗
PubMed1987

Epidemiological diagnosis of asthma: methodological considerations of prevalence evaluation.

Within an epidemiological survey on Chronic Obstructive Pulmonary Disease, before reporting data on the prevalence of bronchial asthma we checked the group of subjects defined as "pathological" by means of a suitable questionnaire and a group of "normals" as a control. We evaluated the sensitivity and specificity of the questionnaire, in comparison with a clinical evaluation made by two physicians and controlled the relationship among their results, non-specific bronchial hyperreactivity and skin tests. In particular the correspondence between diagnosis made by physicians from a clinical evaluation and that obtained by questionnaire was not satisfactory. We suggest the importance of employing physicians for an epidemiological approach to asthma, in absence of a valid objective criterion.

Adolescent↗
PubMed1987

Postinspiratory-ramp activity of diaphragm under inspiratory resistive load.

Inspiratory ramp activity, postramp activity (PRA) of diaphragm and respiratory flow were studied in anesthetized rabbits and conscious humans under inspiratory resistive load. Under load with chloralose-urethane anesthesia neural inspiration lasted 124 +/- 12 msec more than under control conditions and end of mechanical inspiration lagged behind that of neural inspiration by 114 +/- 4 msec. With pentobarbital-urethane anesthesia corresponding changes under load were 67 +/- 18 msec and 44 +/- 6 msec; after SO2 block of slowly adapting stretch receptors in bronchi corresponding changes under load were nil and 65 +/- 7 msec. In humans corresponding changes under load were about 192 and 127 msec. Both in rabbits and humans time course of PRA under load was essentially unchanged. Hence, under load a considerable part of PRA (or all of it under pentobarbital-urethane anesthesia without SO2 block) occurred during inspiration and that occurring during expiration was smaller than under control conditions. Consequently, under load braking of expiratory flow was smaller and peak expiratory flow occurred earlier than under control conditions.

Adult↗