Sex differences in chest electrical impedance tomography findings.

Objective.Electrical impedance tomography (EIT) has been used to determine regional lung ventilation distribution in humans for decades, however, the effect of biological sex on the findings has hardly ever been examined. The aim of our study was to determine if the spatial distribution of ventilation assessed by EIT during quiet breathing was influenced by biological sex.Approach.219 adults with no known acute or chronic lung disease were examined in sitting position with the EIT electrodes placed around the lower chest (6th intercostal space). EIT data were recorded at 33 images/s during quiet breathing for 60 s. Regional tidal impedance variation was calculated in all EIT image pixels and the spatial distribution of the values was determined using the established EIT measures of centre of ventilation in ventrodorsal (CoVvd) and right-to-left direction (CoVrl), the dorsal and right fraction of ventilation, and ventilation defect score.Main results.After exclusion of one subject due to insufficient electrode contact, 218 data sets were analysed (120 men, 98 women) (age: 53 ± 18 vs 50 ± 16 yr (p= 0.2607), body mass index: 26.4 ± 4.0 vs 26.4 ± 6.6 kg m-2(p= 0.9158), mean ± SD). Highly significant differences in ventilation distribution were identified between men and women between the right and left chest sides (CoVrl: 47.0 ± 2.9 vs 48.8 ± 3.3% of chest diameter (p< 0.0001), right fraction of ventilation: 0.573 ± 0.067 vs 0.539 ± 0.071 (p= 0.0004)) and less significant in the ventrodorsal direction (CoVvd: 55.6 ± 4.2 vs 54.5 ± 3.6% of chest diameter (p= 0.0364), dorsal fraction of ventilation: 0.650 ± 0.121 vs 0.625 ± 0.104 (p= 0.1155)). Ventilation defect score higher than one was found in 42.5% of men but only in 16.6% of women.Significance.Biological sex needs to be considered when EIT findings acquired in upright subjects in a rather caudal examination plane are interpreted. Sex differences in chest anatomy and thoracoabdominal mechanics may explain the results.

Distribution of regional lung function in upright healthy subjects determined by electrical impedance tomography in two chest examination planes.

Objective. The variation in pulmonary gas content induced by ventilation is not uniformly distributed in the lungs. The aim of our study was to characterize the differences in spatial distribution of ventilation in two transverse sections of the chest using electrical impedance tomography (EIT).Approach. Twenty adult never-smokers, 10 women and 10 men (mean age ± SD, 31 ± 9 years), were examined in a sitting position with the EIT electrodes placed consecutively in a caudal (6th intercostal space) and a cranial (4th intercostal space) chest location. EIT data were acquired during quiet breathing, slow and forced full expiration manoeuvres. Impedance variations representing tidal volume (VT), vital capacity (VC), forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC) were calculated at the level of individual image pixels and their spatial distribution was determined using the following EIT measures: the centres of ventilation in ventrodorsal (CoVvd) and right-to-left direction (CoVrl), the dorsal and right fractions of ventilation, the coefficient of variation (CV) and the global inhomogeneity (GI) index.Main results. The sums of pixel ventilation-related impedance variations reproduced reliably the volumetric dissimilarities amongVT, VC, FEV1and FVC, with no significant differences noted between the two examination planes. Significant differences in ventilation distribution were found between the planes during tidal breathing and slow full expiration, mainly regarding the ventrodorsal direction, with higher values of CoVvdand dorsal fraction of ventilation in the caudal plane (p< 0.01). No significant differences in the spatial distribution of FEV1and FVC were detected between the examination planes.Significance. The spatial distribution of ventilation differed between the two examination planes only during the relaxed (quiet breathing and slow VC manoeuvre) but not during the forced ventilation. This effect is attributable to the differences in thoracoabdominal mechanics between these types of ventilation.

Dynamic membrane structure induces temporal pattern formation.

The understanding of temporal pattern formation in biological systems is essential for insights into regulatory processes of cells. Concerning this problem, the present work introduces a model to explain the attachment/detachment cycle of MARCKS and PKC at the cell membrane, which is crucial for signal transduction processes. Our model is novel with regard to its driving mechanism: Structural changes within the membrane fuel an activator-inhibitor based global density oscillation of membrane related proteins. Based on simulated results of our model, phase diagrams were generated to illustrate the interplay of MARCKS and PKC. They predict the oscillatory behavior in the form of the number of peaks, the periodic time, and the damping constant depending on the amounts of MARCKS and PKC, respectively. The investigation of the phase space also revealed an unexpected intermediate state prior to the oscillations for high amounts of MARCKS in the system. The validation of the obtained results was carried out by stability analysis, which also accounts for further enhanced understanding of the studied system. It was shown, that the occurrence of the oscillating behavior is independent of the diffusion and the consumption of the reactants. The diffusion terms in the used reaction-diffusion equations only act as modulating terms and are not required for the oscillation. The hypothesis of our work suggests a new mechanism of temporal pattern formation in biological systems. This mechanism includes a classical activator-inhibitor system, but is based on the modifications of the membrane structure, rather than a reaction-diffusion system.

Macroscopic, histologic, and ultrastructural lesions associated with avian keratin disorder in black-capped chickadees (Poecile atricapillus).

An epizootic of beak abnormalities (avian keratin disorder) was recently detected among wild birds in Alaska. Here we describe the gross, histologic, and ultrastructural features of the disease in 30 affected adult black-capped chickadees (Poecile atricapillus). Grossly, there was elongation of the rhamphotheca, with varying degrees of lateral deviation, crossing, and gapping between the upper and lower beak. Not uncommonly, the claws were overgrown, and there was alopecia, scaling, and crusting of the skin. The most prominent histopathologic features in the beak included epidermal hyperplasia, hyperkeratosis, and core-like intrusions of necrotic debris. In affected birds, particularly those with moderate to severe beak overgrowth, there was remodeling of premaxillary and mandibular bones and various dermal lesions. Lesions analogous to those found in beaks were present in affected claws, indicating that this disorder may target both of these similar tissues. Mild to moderate hyperkeratosis occurred in other keratinized tissues, including skin, feather follicles, and, occasionally, sinus epithelium, but typically only in the presence of microbes. We did not find consistent evidence of a bacterial, fungal, or viral etiology for the beak lesions. The changes observed in affected birds did not correspond with any known avian diseases, suggesting a potentially novel hyperkeratotic disorder in wild birds.

Subdural hematomas due to ruptured cerebral aneurysms: angiographic diagnosis and potential pitfall for CT.

Two patients with subdural hematoma secondary to rupture of intracranial aneurysms are described. Computed tomography and plain skull films are generally the examination of choice for the patient with significant head trauma. In selected patients, however, cerebral angiography in place of, or along with, computed tomography may be necessary to demonstrate an underlying cause for the subdural hematoma.

Case report of uterine rupture after an automobile accident.

The pregnant woman who is involved in an automobile accident carries the risk of injury to her uterus and fetus. The following is a case report of a woman in her third trimester of pregnancy who had extensive lacerations of the uterus that almost completely severed the fundus from the lower uterine segment. The fetus was stillborn as a result of complete separation from the placenta.