The purpose of this study was to quantitatively evaluate paradoxical diaphragmatic motion using magnetic resonance (MR) imaging. A total of 27 subjects were examined, including 12 normal young adults, six control individuals, and nine patients with emphysema. With subjects in the supine position, 30 sequential sagittal MR images of the entire right lung were obtained during tidal and deep slow breathing. Diaphragmatic movement between sequential images was estimated as the displacement area and the total diaphragmatic movement in a respiratory cycle was calculated. The paradoxical motion of the diaphragm, representing the inverted movement to increase or decrease lung area, since paradoxical movement ratio (Mpr=(total paradoxical diaphragmatic movement/total diaphragmatic movement)x100), was evaluated. In patients with emphysema, paradoxical diaphragmatic motion was observed on MR images during deep breathing. The mean Mpr in emphysematous patients during deep breathing was 10+/-4%, which was significantly higher than 0.5+/-0.2% in young adults (p<0.05), and 1.2+/-0.6% in aged-matched controls (p<0.05). The present results indicate that magnetic resonance images could be used to detect paradoxical diaphragmatic motion in patients with emphysema.
Pneumothorax in IPF patients is associated with lower VC and rapid deterioration of CT findings. The findings suggest that pneumothorax is a complication of advanced IPF.
Abstract. Axonal transport plays a crucial role in neuronal morphogenesis, survival, and function. Despite its importance, however, the molecular mechanisms of axonal transport remain mostly unknown because a simple and quantitative assay system for axonal transport has been lacking. In order to better characterize the molecular mechanisms involved in axonal transport, we here developed a computer-assisted monitoring system. Using lipophilic fluorochrome chloromethylbenzamido dialkylcarbocyanine (CM-DiI) as a labeling dye, we have successfully labeled membranous organelles in cultured chick dorsal root ganglia neurons. We confirmed that sodium azide, an ATPase inhibitor, and nocodazole, a microtubule-destabilizing agent, markedly suppressed anterograde and retrograde axonal transport of CM-DiI-labeled particles. We further tested the effects of several anti-neoplastic drugs on axonal transport. Paclitaxel, vincristine, cisplatin, and oxaliplatin, all of which are known to be neurotoxic and to cause neurological symptoms, suppressed anterograde and retrograde axonal transport. Another series of anti-neoplastic drugs, including methotrexate and 5-fluorouracil, did not affect the axonal transport. This is the first report of an automated monitoring system for axonal transport. This system will be useful for toxicity assays, characterizing axonal transport, or screening drugs that may modify neuronal functions.
The authors evaluate paradoxical diaphragmatic motion using magnetic resonance (MR) imaging in patients with emphysema. The subjects were 12 healthy volunteers and 10 male patients with moderate to severe air flow obstruction. With subjects in the supine position, 30 sequential sagittal images of the bilateral lungs were obtained during quiet and forced breathing using a 1.5T MR unit with a body coil. The sequence was single shot fast spin echo (SSFSE) with half Fourier transformation. Subtraction images were made from the original images (by subtracting a given image from the preceding image), which visualized the chest wall motion as white or black bands on the edge of the lung fields. The authors evaluated both the original and subtraction images. MR imaging showed abnormal hemidiaphragmatic motion during forced breathing: the ventral portion of the hemidiaphragm moved downward while the dorsal part moved upward like a seesaw in 6 patients. MR images also revealed abnormal ribcage motion; the ventral ribcage moved anteriorly when the hemidiaphragm moved upward in 7 patients. No abnormal motion was observed in healthy volunteers. MR is a noninvasive and useful tool for evaluating the asynchronous respiratory motion in patients with emphysema.
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