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Biomedical subjects

M D Goldman

Publications and source records attributed to M D Goldman.

At least 55 records · Page 3Linked to original sources
PubMed1985

Differential costal and crural diaphragm compensation for posture changes.

The electromyographic (EMG) activities of the costal and crural diaphragm were recorded from bipolar fine-wire electrodes placed in the costal fibers adjacent to the central tendon and in the anterior portions of the crural fibers in 12 anesthetized cats. The EMG activities of costal and crural recordings were compared during posture changes from supine to head up and during progressive hyperoxic hypercapnia in both positions. The activity of both portions of the diaphragm was greater in the head up compared with supine posture at all levels of CO2; and increases in crural activity were greater than those in costal activity both as a result of changes in posture and with increasing CO2 stimuli. These results are consistent with the concept that diaphragm activation is modulated in response to changes in resting muscle length, and further, that neural control mechanisms allow separate regulation of costal and crural diaphragm activation.

Adaptation, Physiological↗
PubMed1985

Helium-oxygen breathing in severe chronic obstructive pulmonary disease.

The effect of breathing helium-oxygen (He-O2) mixtures was evaluated in 15 patients with severe chronic obstructive pulmonary disease (COPD). Gas exchange was assessed during quiet breathing at rest before and after 15 minutes of breathing 80 percent He-20 percent O2 mixtures in all patients. Functional residual capacity (FRC) determined during argon (Ar) washing studies fell significantly while breathing He-O2, but we did not find significant changes in minute ventilation, tidal volume, respiratory frequency, or inspiratory or expiratory timing. Eleven patients showed decreases in arterial PCO2 and CO2 excretion during resting breathing on He-O2. Expiratory flows were increased at a given lung volume during He-O2 breathing as expected. Apparently, mechanical work of breathing was decreased in patients with severe COPD while breathing He-O2, leading to a reduction in VCO2 and improvement in overall alveolar ventilation. These findings lend support to the therapeutic use of He-O2 under some conditions in patients with severe COPD.

Aged↗
PubMed1983

High-frequency oscillations in human respiratory electromyograms during voluntary breathing.

Electromyograms (EMGs) from respiratory muscles were obtained from human subjects during voluntarily controlled breathing. In 10 studies on 6 subjects EMGs were recorded from the right and left lower ventrolateral surface of the rib cage while the subject emphasized the use of his diaphragm for breathing. Simultaneous samples of the 2 EMG signals of 256-ms duration were obtained once per inspiration (in either the first of second half of inspiration) from each of 30 consecutive breaths using a laboratory minicomputer. Individual power spectra for the 2 EMG signals, and the squared coherence spectrum between them, were calculated. From the coherence spectrum common high-frequency oscillations could be identified within two frequency ranges: 70-100 Hz and 20-50 Hz. Peaks at similar frequencies were identified in both early-inspiratory and late-inspiratory EMG signals. Similar experiments were done on 3 subjects from whom an esophageal diaphragm EMG was obtained as well. The coherence spectrum between the esophageal EMG and the right rib cage surface EMG again demonstrated the presence of common high-frequency oscillations in the same frequency ranges as above. Evidence of these oscillations was not usually apparent in the power spectra. When ECG signal components were allowed to contaminate some of the EMG data samples, the coherence spectrum could be altered considerably, leading to inappropriate conclusions regarding the presence or absence of high-frequency oscillations. It is hypothesized that these high-frequency oscillations are similar to those described in nerve recordings from previous studies on anesthetized and decerebrate cats and dogs and a mechanism for their expression in EMG signals is proposed. The coherence spectrum is a very sensitive method for detecting related signal components in two signals. That high-frequency oscillations can be detected using the less sensitive techniques of autocorrelation and power spectral analysis in some animal preparations may reflect an enhancement of these oscillations in those preparations.

Decerebrate State↗
PubMed1983

Aspirin and dipyridamole reduce platelet deposition on prosthetic femoro-popliteal grafts in man.

Platelet inhibitory drugs may be used in an attempt to reduce high failure rates in small artery bypass using prosthetic grafts. We evaluated in patients the effects of aspirin and dipyridamole (ASA/DPM) on radiolabelled platelet accumulation on femoro-popliteal grafts of Dacron, polytetrafluorethylene and saphenous vein. Forty-seven patients awaiting femoro-popliteal bypass received, at random and double blind, either ASA/DPM or placebo capsules. On the seventh postoperative day, the 42 remaining patients with patent grafts were injected with autologous 111-Indium labelled platelets. Graft platelet accumulation was expressed as the Thrombogenicity Index (TI), which was defined as the mean daily rise in the ratio of radioactivity over the graft to that over the contralateral thigh. ASA/DPM reduced mean (+/- s.e. mean) TI in Dacron grafts from 0.25 +/- 0.09 on placebo to 0.16 +/- 0.05 (p less than 0.05). Mean TI in polytetrafluorethylene grafts was also significantly lower at 0.06 +/- 0.01 on ASA/DPM compared to 0.16 +/- 0.03 on placebo. Vein grafts, however, accumulated few, if any, labelled platelets and ASA/DPM had no further influence. ASA/DPM reduces platelet accumulation in prosthetic femoro-popliteal grafts in man.

Arterial Occlusive Diseases↗
PubMed1983

Parameter estimation in linear functional relationships.

We present the application of a weighted least-squares technique to extract parameter estimates in linear models when all variables are subject to error and the goal of the investigation is the value of the parameters themselves. We assume that the relative variances of the variables are known and that the errors between variables are independent. The method of parameter estimation for linear functional relationships is presented, and we describe its differences from linear regression. We discuss how to obtain confidence intervals for the parameter estimates with an emphasis on computer Monte Carlo simulations. An explicit example related to measurements of lung volume changes is presented. An eigenvalue analysis of the data pertaining to the number of independent variables and a physical interpretation of the data space are also discussed.

Abdomen↗
PubMed1983

Postural changes in rib cage and abdominal volume-motion coefficients and their effect on the calibration of a respiratory inductance plethysmograph.

Volume-motion coefficients were determined for the rib cage and abdomen in normal human subjects in upright, supine, and semirecumbent postures by the isovolume calibration technique of Konno and Mead (J Appl Physiol 1967; 22:407-422, using the respiratory inductive plethysmograph (RIP) to measure displacements of rib cage and abdominal walls. Volume motion coefficients changed systematically with posture; those for the rib cage were smallest in the upright posture, and for the abdomen, greatest in the upright posture. These volume motion coefficients were then used to estimate tidal volume during resting breathing in the different postures, and compared with estimates of tidal volume derived from calibration by the change in posture technique reported by Sackner and coworkers (American Review of Respiratory Disease 1980; 122:867-871). Estimates of tidal volume derived from RIP signals using both calibration techniques were compared with independently measured spirometric volume changes. Errors in tidal volume averaged 6% with the isovolume technique and 9 to 23% with the change in posture technique (depending upon whether the calibrating postures were upright, supine or semirecumbent supine). The larger errors with the change in posture calibration method are attributable to both the change in volume motion coefficients with posture and the change in distribution of tidal volume between rib cage and abdomen compartments with change in posture.

Abdomen↗
PubMed1982

Sleep apnea considered as a control system instability.

In the present study a mathematical model of the chemical control of respiration is described which attempts to simulate periodic breathing during sleep. The model is an extension of an earlier model which has been shown to successfully reproduce the transient effects of CO2 inhalation on breathing, controlled changes in ventilation on arterial gas tension, and Cheyne-Stokes breathing. Included in the extended model are the effects of chemical stimuli during sleep on both chest wall and upper airway muscle activity. Data is presented indicating that simulations from the model reproduce reasonably well the essential features of the results obtained in eight subjects with periodic respiration during sleep when breathing room air, O2, or low concentrations of CO2. Simulations from the model and the experimental data suggest that periodic breathing during sleep results from unstable operation in the respiratory control system analogous to that seen during instabilities in physical control systems. The model indicates that obstructive as well as central apneas can be produced by control system instability. Furthermore, central apneas increase the likelihood of obstructive apneas while obstructive apneas tend to aggravate the control instability. The model results predict that the characteristics of the periodic breathing seen during sleep, such as apnea length, will depend on circulation time and the sensitivity of both upper airway and chest wall muscles to hypercapnia and hypoxia.

Air↗
PubMed1982

Effect of progressive hypoxia on breathing during sleep.

We examined the effects of progressive hypoxia on breathing during wakefulness and quiet (NREM) sleep in 17 healthy young adults (11 males and 6 females). Ventilation was determined from quantitative measurements of abdominal and rib cage excursions using magnetometers or inductive plethysmography. Hypoxia was induced by blending N2 into the inspiratory line of a loose-fitting mask while O2 saturation was monitored with an ear oximeter. No attempt was made to maintain isocapnia. Ventilatory responses to hypoxia were depressed in 2 male subjects by sleep, but were unchanged or increased in the others. Thus on the average, sleep produced no change in ventilatory responses to hypoxia. There was no consistent difference in the frequencies or tidal volumes attained at a given level of ventilation during hypoxia awake and asleep. During sleep there was relatively more rib cage than abdominal movement. Relief of hypoxia was followed by periodic breathing during sleep in 12 subjects but in only 2 subjects when awake. In two thirds of the trials, hypoxia failed to produce arousal even though arterial O2 saturation was allowed to fall below 75%. The results suggest that (1) sleep potentiates apnea producing effects of O2 changes but has inconsistent effects on ventilatory responses to hypoxia, and (2) hypocapnic hypoxia is not an invariably potent stimulus for arousal.

Abdomen↗
PubMed1981

Effect of quiet sleep on resting and CO2-stimulated breathing in humans.

We examined the effects of different levels of inspired CO2 on ventilation and the pattern of breathing in healthy adults during the awake and the stage II quiet-sleep states. During both states, subjects were studied supine with their heads enclosed in a canopy. Tidal volume (VT) was determined from quantitative measurements of abdominal and rib cage excursions with magnetometers. Inspired CO2 was raised by blending CO2-enriched gas into the airflow, which continuously flushed the canopy. During sleep, while room air was breathed, VT decreased significantly from 410 to 360 ml, and respiratory rate also fell from 17 to 16 breaths/min. As a consequence, ventilation was significantly reduced from 6.5 to 5.8 l/min, and end-tidal CO2 partial pressure (PCO2) rose from 39.1 to 42.5 Torr. Ventilatory responses to CO2 were reduced, on the average, during sleep to 79% of waking levels. The change in average inspiratory flow produced by CO2 was also less during sleep. Waking and sleeping ventilatory responses to CO2 correlated inversely with the rise in end-tidal PCO2 when room air was breathed during sleep. At all levels of VT, the rib cage contribution to VT was greater during quiet sleep than during wakefulness. These findings suggest that quiet sleep, in addition to depressing ventilation and the response to CO2 alters the manner in which VT is attained by rib cage and abdominal displacements.

Abdomen↗
PubMed1981

Pattern of diaphragmatic activity during forced expiratory vital capacity.

We measured transdiaphragmatic pressure (Pdi) during forced expiratory vital capacity (FVC) maneuvers in 13 normal subjects and electromyographic activity of the diaphragm (edi) in 8 of these subjects. In all subjects, Pdi increased at the initiation of the FVC. In most, this increase lasted 30--50 ms and reached levels well above the Pdi observed at total lung capacity (TLC). After the initial transient increase, approximately half of the subjects demonstrated a substantial fall in Pdi to values near the relaxation level in the mid-vital capacity (VC) volume range, while half showed a second large increase in Pdi in this volume range. Seven of eight subjects tested showed a rapid decrease in Edi at the onset of the FVC, reaching a minimum in 30--50 ms. After this initial transient decrease, Edi increased in six subjects in the mid-VC volume range, in association with secondary rises in Pdi. In two subjects, Edi remained low throughout the remainder of the FVC, and Pdi in the mid VC range was generally lower. These results are consistent with the conclusion that the diaphragm is neither electromyographically silent nor mechanically unimportant during the FVC. Changes in abdominothoracic configuration, superimposed upon "antagonistic" activity of the diaphragm, result in substantial reductions in pleural (esophageal) pressure that may influence regional lung emptying during the FVC.

Abdominal Muscles↗
PubMed1980

Intercostal muscle reflexes and sleep breathing patterns in the human infant.

Breathing variability and apnea characteristic of rapid eye movement (REM) sleep was investigated in a newborn infant with complete interruption of intercostal to phrenic neural pathways due to intrapartem transection of the cervical spinal cord. Breath-to-breath variability in inspiratory duration (TI), breath duration (Ttot), tidal volume (VT), and ventilation (VI) was significantly greater in REM than in quiet sleep and was similar to the variability in these parameters seen in normal infants. In addition, brief periods of diaphragmeatic apnea were observed during REM sleep. The phenomenon of shortened TI during airway occlusion previously attributed to intercostal-to-phrenic reflexes was examined in the quadriplegic infant and in seven healthy term infants. The frequency of this response was increased when airway occlusion was delayed until after onset of inspiration. Shortening of TI by occlusion occurred no less frequently in the quadriplegic than in the control infants. The constant paradoxical inward movement of the rib cage during inspiration observed in the quadriplegic infant suggests that supraspinal innervation of intercostal muscle limits such paradoxical movements in the normal infant. The quadriplegic infant's end-expiratory volume was consistently above his passive functional residual capacity, as inferred from respiratory volume and pressure measurements.

Birth Injuries↗
PubMed1979

Lung volume changes, occlusion pressure and chest wall configuration in human infants.

UNLABELLED: Measurements of respiration were compared in normal, full term and premature infants before and after application of 5 cm H2O continuous negative pressure (CNEG) around the body below the neck. Mean minute ventilation in the full term infants decreased when CNEG was applied, secondary to a decrease in respiratory rate, with tidal volume relatively unchanged. The premature infants showed no consistent ventilatory response to CNEG. There were variable changes in occlusion pressure at increased lung volume. Observation with rib cage and abdomen anterior-posterior (A-P) magnetometers showed that the increase in end-expiratory lung volume was accounted for largely by expansion of the rib cage so that the configuration of the diaphragm and its mechanical advantage were maintained. These results suggest that the diaphragm is the major determinant of mask occlusion pressure in infants. SPECULATION: The effects of increased lung volume on the configuration of the chest wall may relate to the success of continuous distending pressure in the treatment of respiratory disorders in infants, including apnea of prematurity.

Humans↗