Interhemispheric distribution of Alzheimer disease and vascular pathology in brain aging

BACKGROUND AND PURPOSE: Most of the neuropathological studies in brain aging were based on the assumption of a symmetrical right-left hemisphere distribution of both Alzheimer disease and vascular pathology. To explore the impact of asymmetrical lesion formation on cognition, we performed a clinicopathological analysis of 153 cases with mixed pathology except macroinfarcts. METHODS: Cognitive status was assessed prospectively using the Clinical Dementia Rating scale; neuropathological evaluation included assessment of Braak neurofibrillary tangle and Ass deposition staging, microvascular pathology, and lacunes. The right-left hemisphere differences in neuropathological scores were evaluated using the Wilcoxon signed rank test. The relationship between the interhemispheric distribution of lesions and Clinical Dementia Rating scores was assessed using ordered logistic regression. RESULTS: Unlike Braak neurofibrillary tangle and Ass deposition staging, vascular scores were significantly higher in the left hemisphere for all Clinical Dementia Rating scores. A negative relationship was found between Braak neurofibrillary tangle, but not Ass staging, and vascular scores in cases with moderate to severe dementia. In both hemispheres, Braak neurofibrillary tangle staging was the main determinant of cognitive decline followed by vascular scores and Ass deposition staging. The concomitant predominance of Alzheimer disease and vascular pathology in the right hemisphere was associated with significantly higher Clinical Dementia Rating scores. CONCLUSIONS: Our data show that the cognitive impact of Alzheimer disease and vascular lesions in mixed cases may be assessed unilaterally without major information loss. However, interhemispheric differences and, in particular, increased vascular and Alzheimer disease burden in the right hemisphere may increase the risk for dementia in this group.

Distribution of artifactual gas on post-mortem multidetector computed tomography (MDCT)

L'imagerie est de plus en plus utilisée en médecine forensique. Actuellement, les connaissances nécessaires pour interpréter les images post mortem sont faibles et surtout celles concernant les artéfacts post mortem. Le moyen radiologique le plus utilisé en médecine légale est la tomodensitométrie multi-coupes (TDMC). Un de ses avantages est la détection de gaz dans le corps. Cette technique est utile au diagnostic d'embolie gazeuse mais sa très grande sensibilité rend visible du gaz présent même en petite quantité. Les premières expériences montrent que presque tous les corps scannés présentent du gaz surtout dans le système vasculaire. Pour cette raison, le médecin légiste est confronté à un nouveau problème : la distinction entre du gaz d'origine post-mortem et une embolie gazeuse vraie. Pour parvenir à cette distinction, il est essentiel d'étudier la distribution de ces gaz en post mortem. Aucune étude systématique n'a encore été réalisée à ce jour sur ce sujet.¦Nous avons étudié l'incidence et la distribution des gaz présents en post mortem dans les vaisseaux, dans les os, dans les tissus sous-cutanés, dans l'espace sous-dural ainsi que dans les cavités crânienne, thoracique et abdominale (82 sites au total) de manière à identifier les facteurs qui pourraient distinguer le gaz post-mortem artéfactuel d'une embolie gazeuse¦Les données TDMC de 119 cadavres ont été étudiées rétrospectivement. Les critères d'inclusion des sujets sont l'absence de lésion corporelle permettant la contamination avec l'air extérieur, et, la documentation du délai entre le moment du décès et celui du CT-scan (p.ex. rapport de police, protocole de réanimation ou témoin). La présence de gaz a été évaluée semi-quantitativement par deux radiologues et codifiée. La codification est la suivante : grade 0 = pas de gaz, grade 1 = une à quelques bulles d'air, grade 2 = structure partiellement remplie d'air, grade 3 = structure complètement remplie d'air.¦Soixante-quatre des 119 cadavres présentent du gaz (62,2%), et 56 (75,7%) ont montré du gaz dans le coeur. Du gaz a été détecté le plus fréquemment dans le parenchyme hépatique (40%); le coeur droit (ventricule 38%, atrium 35%), la veine cave inférieure (infra-rénale 30%, supra-rénale 26%), les veines sus-hépatiques (gauche 26%, moyenne 29%, droite 22 %), et les espaces du porte (29%). Nous avons constaté qu'une grande quantité de gaz liée à la putréfaction présente dans le coeur droit (grade 3) est associée à des collections de gaz dans le parenchyme hépatique (sensibilité = 100%, spécificité = 89,7%). Pour décrire nos résultats, nous avons construit une séquence d'animation qui illustre le processus de putréfaction et l'apparition des gaz à la TDMC post-mortem.¦Cette étude est la première à montrer que l'apparition post-mortem des gaz suit un modèle de distribution spécifique. L'association entre la présence de gaz intracardiaque et dans le parenchyme hépatique pourrait permettre de distinguer du gaz artéfactuel d'origine post-mortem d'une embolie gazeuse vraie. Cette étude fournit une clé pour le diagnostic de la mort due à une embolie gazeuse cardiaque sur la base d'une TDMC post-mortem.¦Abstract¦Purpose: We investigated the incidence and distribution of post-mortem gas detected with multidetector computed tomography (MDCT) to identify factors that could distinguish artifactual gas from cardiac air embolism.¦Material and Methods: MDCT data of 119 cadavers were retrospectively examined. Gas was semiquantitatively assessed in selected blood vessels, organs and body spaces (82 total sites).¦Results: Seventy-four of the 119 cadavers displayed gas (62.2%; CI 95% 52.8 to 70.9), and 56 (75.7%) displayed gas in the heart. Most gas was detected in the hepatic parenchyma (40%); right heart (38% ventricle, 35% atrium), inferior vena cava (30% infrarenally, 26% suprarenally), hepatic veins (26% left, 29% middle, 22% right), and portal spaces (29%). Male cadavers displayed gas more frequently than female cadavers. Gas was detected 5-84 h after death; therefore, the post-mortem interval could not reliably predict gas distribution (rho=0.719, p<0.0001). We found that a large amount of putrefaction-generated gas in the right heart was associated with aggregated gas bubbles in the hepatic parenchyma (sensitivity = 100%, specificity = 89.7%). In contrast, gas in the left heart (sensitivity = 41.7%, specificity = 100%) or in peri-umbilical subcutaneous tissues (sensitivity = 50%, specificity = 96.3%) could not predict gas due to putrefaction.¦Conclusion: This study is the first to show that the appearance of post-mortem gas follows a specific distribution pattern. An association between intracardiac gas and hepatic parenchymal gas could distinguish between post- mortem-generated gas and vital air embolism. We propose that this finding provides a key for diagnosing death due to cardiac air embolism.

The Ciliogenic Transcription Factor RFX3 Regulates Early Midline Distribution of Guidepost Neurons Required for Corpus Callosum Development.

The corpus callosum (CC) is the major commissure that bridges the cerebral hemispheres. Agenesis of the CC is associated with human ciliopathies, but the origin of this default is unclear. Regulatory Factor X3 (RFX3) is a transcription factor involved in the control of ciliogenesis, and Rfx3-deficient mice show several hallmarks of ciliopathies including left-right asymmetry defects and hydrocephalus. Here we show that Rfx3-deficient mice suffer from CC agenesis associated with a marked disorganisation of guidepost neurons required for axon pathfinding across the midline. Using transplantation assays, we demonstrate that abnormalities of the mutant midline region are primarily responsible for the CC malformation. Conditional genetic inactivation shows that RFX3 is not required in guidepost cells for proper CC formation, but is required before E12.5 for proper patterning of the cortical septal boundary and hence accurate distribution of guidepost neurons at later stages. We observe focused but consistent ectopic expression of Fibroblast growth factor 8 (Fgf8) at the rostro commissural plate associated with a reduced ratio of GLIoma-associated oncogene family zinc finger 3 (GLI3) repressor to activator forms. We demonstrate on brain explant cultures that ectopic FGF8 reproduces the guidepost neuronal defects observed in Rfx3 mutants. This study unravels a crucial role of RFX3 during early brain development by indirectly regulating GLI3 activity, which leads to FGF8 upregulation and ultimately to disturbed distribution of guidepost neurons required for CC morphogenesis. Hence, the RFX3 mutant mouse model brings novel understandings of the mechanisms that underlie CC agenesis in ciliopathies.

Comparison of plantar pressure distribution in adolescent runners at low vs. high running velocity

This study aimed to compare foot plantar pressure distribution while jogging and running in highly trained adolescent runners. Eleven participants performed two constant-velocity running trials either at jogging (11.2 ± 0.9 km/h) or running (17.8 ± 1.4 km/h) pace on a treadmill. Contact area (CA in cm(2)), maximum force (F(max) in N), peak pressure (PP in kPa), contact time (CT in ms), and relative load (force time integral in each individual region divided by the force time integral for the total plantar foot surface, in %) were measured in nine regions of the right foot using an in-shoe plantar pressure device. Under the whole foot, CA, F(max) and PP were lower in jogging than in running (-1.2% [p<0.05], -12.3% [p<0.001] and -15.1% [p<0.01] respectively) whereas CT was higher (+20.1%; p<0.001). Interestingly, we found an increase in relative load under the medial and central forefoot regions while jogging (+6.7% and +3.7%, respectively; [p<0.05]), while the relative load under the lesser toes (-8.4%; p<0.05) was reduced. In order to prevent overloading of the metatarsals in adolescent runners, excessive mileage at jogging pace should be avoided.

Integrating the export distribution channels after an acquisition

This thesis is based on studying integration synergies in a merger or acquisition situation with the interest in distribution channel integration. M&As seem to be forever popular and nowadays companies often use them as a certain kind of strategy to develop their business. M&As have attracted research for decades and also distribution in M&As has been found interesting. Moreover, research often concentrates to the horizontal M&A´s potential synergies that emerge in the integration process and so is the case also in this study as the core issue is to study the integration of the distribution channels and its potential synergies. This study concentrates on a single case, an acquisition which took place in 2011. The case consists of two Finnish companies operating in the same business field. Both of the companies are very export orientated, which gives this study its export view. As the companies operate in the same field this acquisition falls into the categorization of horizontal acquisition. The objective of the thesis is to study how the export channels could be integrated after an acquisition? This research question is divided again to three sub-questions asking how the distribution channels of the acquirer and acquired company are organized, what is pursued by the post-acquisition distribution channel integration and what are the integration challenges especially from the logistics point-of-view. The framework was built from the basis of the literature used in this thesis. The framework combines M&A process and distribution channels to a one united model which presents the progress of this thesis. The study was carried out as a qualitative research and as a holistic single case study. The data used in the research includes two interviews, other material from the case companies and also material of the companies collected by the author independently from different sources. There were many motives for the acquisition as usual. From the research results one can find that the integration process is still very ongoing and the synergies have not yet been fully discovered but also they are there to be found. The concentration of the research was in the export distribution which proved to be meaningful since the exports markets of the case companies were found to be quite complementary. The research results brought up also other issues concerning the post-acquisition integration process rather than the distribution channels and export. M&As are always a risky business. The final result can never be predicted. No matter how good the merging companies look on paper the practice is not the same. The acquisition process of this case has not ended yet and there lies potential synergy benefits to be discovered if enough effort is used to go through the process right.

The distribution of presumptive thoracic paraganglionic tissue in the common marmoset (Callithrix jacchus)

The aortic-pulmonary regions (APR) of seven adult marmosets (Callithrix jacchus) and the region of the right subclavian artery of a further three marmosets were diffusion-fixed with 10% buffered formol-saline solution. In both regions serial 5-µm sections were cut and stained by the Martius yellow, brilliant crystal scarlet and soluble blue method. Presumptive thoracic paraganglionic (PTP) tissue was only observed in the APR. PTP tissue was composed of small groups of cells that varied in size and number. The distribution of the groups of cells was extremely variable, so much so that it would be misleading to attempt to classify their position; they were not circumscribed by a connective tissue capsule, but were always related to the thoracic branches of the left vagus nerve. The cells lay in loose areolar tissue characteristic of this part of the mediastinum and received their blood supply from small adjacent connective tissue arterioles. Unlike the paraganglionic tissue found in the carotid body the cells in the thorax did not appear to have a profuse capillary blood supply. There was, however, a close cellular-neural relationship. The cells, 10-15 µm in diameter, were oval or rounded in appearance and possessed a central nucleus and clear cytoplasm. No evidence was found that these cells possessed a 'companion' cell reminiscent of the arrangement of type 1 and type 2 cells in the carotid body. In conclusion, we found evidence of presumed paraganglionic tissue in the APR of the marmoset which, however, did not show the characteristic histological features of the aortic body chemoreceptors that have been described in some non-primate mammals. A survey of the mediastina of other non-human primates is required to establish whether this finding is atypical for these animals.

Topographic distribution of the tibial somatosensory evoked potential using coherence

The objective of the present study was to determine the adequate cortical regions based on the signal-to-noise ratio (SNR) for somatosensory evoked potential (SEP) recording. This investigation was carried out using magnitude-squared coherence (MSC), a frequency domain objective response detection technique. Electroencephalographic signals were collected (International 10-20 System) from 38 volunteers, without history of neurological pathology, during somatosensory stimulation. Stimuli were applied to the right posterior tibial nerve at the rate of 5 Hz and intensity slightly above the motor threshold. Response detection was based on rejecting the null hypothesis of response absence (significance level α= 0.05 and M = 500 epochs). The best detection rates (maximum percentage of volunteers for whom the response was detected for the frequencies between 4.8 and 72 Hz) were obtained for the parietal and central leads mid-sagittal and ipsilateral to the stimulated leg: C4 (87%), P4 (82%), Cz (89%), and Pz (89%). The P37-N45 time-components of the SEP can also be observed in these leads. The other leads, including the central and parietal contralateral and the frontal and fronto-polar leads, presented low detection capacity. If only contralateral leads were considered, the centro-parietal region (C3 and P3) was among the best regions for response detection, presenting a correspondent well-defined N37; however, this was not observed in some volunteers. The results of the present study showed that the central and parietal regions, especially sagittal and ipsilateral to the stimuli, presented the best SNR in the gamma range. Furthermore, these findings suggest that the MSC can be a useful tool for monitoring purposes.

Méthodes de génération et de validation de champs de déformation pour la recombinaison de distribution de dose à l’aide d’images 4DCT dans le cadre d’une planification de traitement de cancers pulmonaires

Des efforts de recherche considérables ont été déployés afin d'améliorer les résultats de traitement de cancers pulmonaires. L'étude de la déformation de l'anatomie du patient causée par la ventilation pulmonaire est au coeur du processus de planification de traitement radio-oncologique. À l'aide d'images de tomodensitométrie quadridimensionnelles (4DCT), une simulation dosimétrique peut être calculée sur les 10 ensembles d'images du 4DCT. Une méthode doit être employée afin de recombiner la dose de radiation calculée sur les 10 anatomies représentant une phase du cycle respiratoire. L'utilisation de recalage déformable d'images (DIR), une méthode de traitement d'images numériques, génère neuf champs vectoriels de déformation permettant de rapporter neuf ensembles d'images sur un ensemble de référence correspondant habituellement à la phase d'expiration profonde du cycle respiratoire. L'objectif de ce projet est d'établir une méthode de génération de champs de déformation à l'aide de la DIR conjointement à une méthode de validation de leur précision. Pour y parvenir, une méthode de segmentation automatique basée sur la déformation surfacique de surface à été créée. Cet algorithme permet d'obtenir un champ de déformation surfacique qui décrit le mouvement de l'enveloppe pulmonaire. Une interpolation volumétrique est ensuite appliquée dans le volume pulmonaire afin d'approximer la déformation interne des poumons. Finalement, une représentation en graphe de la vascularisation interne du poumon a été développée afin de permettre la validation du champ de déformation. Chez 15 patients, une erreur de recouvrement volumique de 7.6 ± 2.5[%] / 6.8 ± 2.1[%] et une différence relative des volumes de 6.8 ± 2.4 [%] / 5.9 ± 1.9 [%] ont été calculées pour le poumon gauche et droit respectivement. Une distance symétrique moyenne 0.8 ± 0.2 [mm] / 0.8 ± 0.2 [mm], une distance symétrique moyenne quadratique de 1.2 ± 0.2 [mm] / 1.3 ± 0.3 [mm] et une distance symétrique maximale 7.7 ± 2.4 [mm] / 10.2 ± 5.2 [mm] ont aussi été calculées pour le poumon gauche et droit respectivement. Finalement, 320 ± 51 bifurcations ont été détectées dans le poumons droit d'un patient, soit 92 ± 10 et 228 ± 45 bifurcations dans la portion supérieure et inférieure respectivement. Nous avons été en mesure d'obtenir des champs de déformation nécessaires pour la recombinaison de dose lors de la planification de traitement radio-oncologique à l'aide de la méthode de déformation hiérarchique des surfaces. Nous avons été en mesure de détecter les bifurcations de la vascularisation pour la validation de ces champs de déformation.

Dénombrement dans les empilements apolloniens généralisés et distribution angulaire dans les extensions quadratiques imaginaires.

Cette thèse traite de deux thèmes principaux. Le premier concerne l'étude des empilements apolloniens généralisés de cercles et de sphères. Généralisations des classiques empilements apolloniens, dont l'étude remonte à la Grèce antique, ces objets s'imposent comme particulièrement attractifs en théorie des nombres. Dans cette thèse sera étudié l'ensemble des courbures (les inverses des rayons) des cercles ou sphères de tels empilements. Sous de bonnes conditions, ces courbures s'avèrent être toutes entières. Nous montrerons qu'elles vérifient un principe local-global partiel, nous compterons le nombre de cercles de courbures plus petites qu'une quantité donnée et nous nous intéresserons également à l'étude des courbures premières. Le second thème a trait à la distribution angulaire des idéaux (ou plutôt ici des nombres idéaux) des corps de nombres quadratiques imaginaires (que l'on peut voir comme la distribution des points à coordonnées entières sur des ellipses). Nous montrerons que la discrépance de l'ensemble des angles des nombres idéaux entiers de norme donnée est faible et nous nous intéresserons également au problème des écarts bornés entre les premiers d'extensions quadratiques imaginaires dans des secteurs.

Replacing fat and sugar with inulin in cakes: bubble size distribution, physical and sensory properties

The replacement of fat and sugar in cakes is a challenge as they have an important effect on the structural and sensory properties. Moreover, there is the possibility to incorporate an additional value using novel replacers. In this work, inulin and oligofructose were used as fat and sugar replacers, respectively. Different combinations of replacement levels were investigated: fat replacement (0 and 50 %) and sugar replacement (0, 20, 30, 40 and 50 %). Simulated microbaking was carried out to study bubble size distribution during baking. Batter viscosity and weight loss during baking were also analysed. Cake characteristics were studied in terms of cell crumb structure, height, texture and sensory properties. Fat and sugar replacement gave place to batters with low apparent viscosity values. During heating, bubbles underwent a marked expansion in replaced cakes if compared to the control cake. The low batter stability in fat-replaced samples increased bubble movement, giving place to cakes with bigger cells and less height than the control. Sugar-replaced samples had smaller and fewer cells and lower height than the control. Moreover, sugar replacement decreased hardness and cohesiveness and in- creased springiness, which could be related with a denser crumb and an easily crumbled product. Regarding the sensory analysis, a replacement up to 50 % of fat and 30 % of sugar, separately and simultaneously, did not change remarkably the overall acceptability of the cakes. However, the sponginess and the sweetness could be improved in all the replaced cakes, according to the Just About Right scales.

Expression Profile and Distribution of Efhc1 Gene Transcript During Rodent Brain Development

One of the putative causative genes for juvenile myoclonic epilepsy (JME) is EFHC1. We report here the expression profile and distribution of Efhc1 messenger RNA (mRNA) during mouse and rat brain development. Real-time polymerase chain reaction revealed that there is no difference in the expression of Efhc1 mRNA between right and left hemispheres in both species. In addition, the highest levels of Efhc1 mRNA were found at intra-uterine stages in mouse and in adulthood in rat. In common, there was a progressive decrease in Efhc1 expression from 1-day-old neonates to 14-day-old animals in both species. In situ hybridization studies showed that rat and mouse Efhc1 mRNAs are expressed in ependymal cells of ventricle walls. Our findings suggest that Efhc1 expression is more important during initial phases of brain development and that at this stage it could be involved in key developmental mechanisms underlying JME.

Testing hypotheses in the Birnbaum-Saunders distribution under type-II censored samples

The two-parameter Birnbaum-Saunders distribution has been used successfully to model fatigue failure times. Although censoring is typical in reliability and survival studies, little work has been published on the analysis of censored data for this distribution. In this paper, we address the issue of performing testing inference on the two parameters of the Birnbaum-Saunders distribution under type-II right censored samples. The likelihood ratio statistic and a recently proposed statistic, the gradient statistic, provide a convenient framework for statistical inference in such a case, since they do not require to obtain, estimate or invert an information matrix, which is an advantage in problems involving censored data. An extensive Monte Carlo simulation study is carried out in order to investigate and compare the finite sample performance of the likelihood ratio and the gradient tests. Our numerical results show evidence that the gradient test should be preferred. Further, we also consider the generalized Birnbaum-Saunders distribution under type-II right censored samples and present some Monte Carlo simulations for testing the parameters in this class of models using the likelihood ratio and gradient tests. Three empirical applications are presented. (C) 2011 Elsevier B.V. All rights reserved.

Search for right-handed W bosons in top quark decay

We present a measurement of the fraction f(+) of right-handed W bosons produced in top quark decays, based on a candidate sample of t (t) over bar events in the lepton+jets decay mode. These data correspond to an integrated luminosity of 230 pb(-1), collected by the D0 detector at the Fermilab Tevatron p (p) over bar Collider at root s=1.96 TeV. We use a constrained fit to reconstruct the kinematics of the t (t) over bar and decay products, which allows for the measurement of the leptonic decay angle theta(*) for each event. By comparing the cos theta(*) distribution from the data with those for the expected background and signal for various values of f(+), we find f(+)=0.00 +/- 0.13(stat)+/- 0.07(syst). This measurement is consistent with the standard model prediction of f(+)=3.6 x 10(-4).

Spatial and temporal distribution of fishing resources exploited by the Manaus fishing fleet, Amazonas, Brazil

Recursos pesqueiros são importantes fontes de renda e alimento para as populações rurais e urbanas na Amazônia. O presente trabalho avalia a pesca e as variáveis ambientais que determinam a produção de pescarias que desembarcam em Manaus, e avalia também a abundância relativa de recursos pesqueiros em diferentes subsistemas na Amazônia Central. A informação coletada no porto de desembarque de pescado de Manaus foi utilizada para testar um novo índice de captura obtido a partir de um modelo de covariância que apresentou as seguintes variáveis significativas: número de pescadores/dia (dias de pesca vezes número de pescadores por viagem); distância do pesqueiro até Manaus; quantidade de gelo que usou durante a viagem; e nível de rio. Não houve nenhuma diferença significativa entre valores médios de captura entre os subsistemas do Purus, Madeira e de Juruá. Estes resultados sugerem que os tributários da margem direita são similares e mais produtivos em termos comerciais. Concluiu-se que a produção corrente varia de acordo com a magnitude de esforço pesqueiro, por variações ambientais, assim como por aspectos operacionais da pesca, particularmente o consumo de gelo.

Influence of different routes of flush perfusion on the distribution of lung preservation solutions in parenchyma and airways

Objective: The present study was performed to investigate the influence of different routes of perfusion on the distribution of the preservation solutions in the lung parenchyma and upper airways. Methods: Pigs were divided into four groups: control (n = 6), pulmonary artery (PA) (n = 6), simultaneous PA + bronchial artery (BA) (n = 8), and retrograde delivery (n = 6). After preparation and cannulation, cardioplegia solution and Euro- Collins solution (ECS) for lung preservation were given simultaneously. After removal of the heart, the double lung bloc was harvested. Following parameters were assessed: total and regional perfusion (dye-labeled microspheres), tissue water content, PA, aorta, left atrial and left ventricular pressures, cardiac output and lung temperature. Results: Our data show that flow of the ECS in lung parenchyma did not reach control values (9.4 ± 1.0 ml/min per g lung wet weight) regardless of the route of delivery (PA 6.3 ± 1.5, PA + BA 4.8 ± 0.9, retrograde 2.7 ± 0.9 ml/min per g lung wet weight). However, flow in the proximal and distal trachea were significantly increased by PA + BA delivery (0.970 ± 0.4, respectively, 0.380 ± 0.2 ml/min per g) in comparison with PA (0.023 ± 0.007, respectively, 0.024 ± 0.070 ml/min per g), retrograde (0.009 ± 0.003, respectively, 0.021 ± 0.006 ml/min per g) and control experiments (0.125 ± 0.0018, respectively, 0.105 ± 0.012 ml/g per min). Similarly the highest flow rates in the right main bronchus were achieved by PA + BA delivery (1.04 ± 0.4 ml/min per g) in comparison with 0.11 ± 0.03 in control, 0.033 ± 0.008 in PA, and 0.019 ± 0.005 ml/min per g in retrograde group. Flows in the left main bronchus were 0.09 ± 0.02 ml/min per g in control, 0.045 ± 0.012 ml/min per g in PA, and 0.027 ± 0.006 ml/min per g in retrograde group. The flow rates were significantly (P = 0.001) increased by PA + BA delivery of the storage solution (0.97 ± 0.3 ml/min per g). Conclusions: Our data show that the distribution of ECS for lung preservation is significantly improved in airway tissues (trachea and bronchi) if a simultaneous PA + BA delivery is used.