{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T00:40:58Z","timestamp":1793320858754,"version":"4.5.0"},"reference-count":37,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2001,11,1]],"date-time":"2001-11-01T00:00:00Z","timestamp":1004572800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2001,11,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Injury of the diaphragm may have clinical relevance having been reported in cases of sudden infant death syndrome or fatal asthma. However, examination of diaphragm injury after acute inspiratory loading has not been reported. The purpose of this study was to determine whether an acute inspiratory overload induces injury of the human diaphragm and to determine if diaphragm from chronic obstructive pulmonary disease (COPD) is more susceptible to injury. Eighteen patients with COPD and 11 control patients with normal pulmonary function (62 \u00b1 10 yr) undergoing thoracotomy or laparotomy were studied. A threshold inspiratory loading test was performed prior to surgery in a subset of seven patients with COPD and five control patients. Samples of the costal diaphragm were obtained during surgery and processed for electron microscopy analysis. Signs of sarcomere disruption were found in all diaphragm samples. The range of values of sarcomere disruption was wide (density: 2\u201345 abnormal areas\/100 \u03bc m2; area fractions: 1.3\u201317.3%), significantly higher in diaphragm from patients with COPD (p &amp;lt; 0.05) and with the greatest injury after inspiratory loading. We conclude that sarcomere disruption is common in the human diaphragm, is more evident in patients with COPD, and is higher after inspiratory loading, especially in the diaphragm of those with COPD.<\/jats:p>","DOI":"10.1164\/ajrccm.164.9.2011150","type":"journal-article","created":{"date-parts":[[2013,4,4]],"date-time":"2013-04-04T14:57:23Z","timestamp":1365087443000},"page":"1734-1739","source":"Crossref","is-referenced-by-count":220,"title":["Injury of the Human Diaphragm Associated with Exertion and Chronic Obstructive Pulmonary Disease"],"prefix":"10.1093","volume":"164","author":[{"given":"MAURICIO","family":"OROZCO-LEVI","sequence":"first","affiliation":[{"name":"Servei de Pneumologia, Hospital del Mar and Unitat de Recerca Respirat\u00f2ria i Ambiental, Institut Municipal d'Investigaci\u00f3 M\u00e8dica (IMIM), Barcelona, Spain; Servei de Anatomia Patol\u00f2gica and Servei de Cirurgia, Hospital del Mar, Barcelona (Catalonia), Spain; and CEXS-Universitat Pompeu Fabra and Universitat Aut\u00f2noma de Barcelona, Catalonia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"JOSEP","family":"LLORETA","sequence":"additional","affiliation":[{"name":"Servei de Pneumologia, Hospital del Mar and Unitat de Recerca Respirat\u00f2ria i Ambiental, Institut Municipal d'Investigaci\u00f3 M\u00e8dica (IMIM), Barcelona, Spain; Servei de Anatomia Patol\u00f2gica and Servei de Cirurgia, Hospital del Mar, Barcelona (Catalonia), Spain; and CEXS-Universitat Pompeu Fabra and Universitat Aut\u00f2noma de Barcelona, Catalonia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"JOAN","family":"MINGUELLA","sequence":"additional","affiliation":[{"name":"Servei de Pneumologia, Hospital del Mar and Unitat de Recerca Respirat\u00f2ria i Ambiental, Institut Municipal d'Investigaci\u00f3 M\u00e8dica (IMIM), Barcelona, Spain; Servei de Anatomia Patol\u00f2gica and Servei de Cirurgia, Hospital del Mar, Barcelona (Catalonia), Spain; and CEXS-Universitat Pompeu Fabra and Universitat Aut\u00f2noma de Barcelona, Catalonia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"SERGI","family":"SERRANO","sequence":"additional","affiliation":[{"name":"Servei de Pneumologia, Hospital del Mar and Unitat de Recerca Respirat\u00f2ria i Ambiental, Institut Municipal d'Investigaci\u00f3 M\u00e8dica (IMIM), Barcelona, Spain; Servei de Anatomia Patol\u00f2gica and Servei de Cirurgia, Hospital del Mar, Barcelona (Catalonia), Spain; and CEXS-Universitat Pompeu Fabra and Universitat Aut\u00f2noma de Barcelona, Catalonia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"JOAN M.","family":"BROQUETAS","sequence":"additional","affiliation":[{"name":"Servei de Pneumologia, Hospital del Mar and Unitat de Recerca Respirat\u00f2ria i Ambiental, Institut Municipal d'Investigaci\u00f3 M\u00e8dica (IMIM), Barcelona, Spain; Servei de Anatomia Patol\u00f2gica and Servei de Cirurgia, Hospital del Mar, Barcelona (Catalonia), Spain; and CEXS-Universitat Pompeu Fabra and Universitat Aut\u00f2noma de Barcelona, Catalonia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"JOAQUIM","family":"GEA","sequence":"additional","affiliation":[{"name":"Servei de Pneumologia, Hospital del Mar and Unitat de Recerca Respirat\u00f2ria i Ambiental, Institut Municipal d'Investigaci\u00f3 M\u00e8dica (IMIM), Barcelona, Spain; Servei de Anatomia Patol\u00f2gica and Servei de Cirurgia, Hospital del Mar, Barcelona (Catalonia), Spain; and CEXS-Universitat Pompeu Fabra and Universitat Aut\u00f2noma de Barcelona, Catalonia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2001,11,1]]},"reference":[{"key":"2026032708110523800_B1","doi-asserted-by":"crossref","first-page":"170","DOI":"10.1055\/s-2008-1026030","article-title":"Myofibrillar injury following intense eccentric exercise in humans.","volume":"4","author":"Frid\u00e9n","year":"1983","journal-title":"Int J Sports Med"},{"key":"2026032708110523800_B2","first-page":"429","article-title":"Initial events in exercise-induced muscle injury.","volume":"22","author":"Armstrong","year":"1990","journal-title":"Med Sci Sports Exerc"},{"key":"2026032708110523800_B3","doi-asserted-by":"crossref","first-page":"24","DOI":"10.2165\/00007256-199520010-00003","article-title":"Delayed muscle soreness. The inflammatory response to muscle injury and its clinical implications.","volume":"20","author":"MacIntyre","year":"1995","journal-title":"Sports Med"},{"key":"2026032708110523800_B4","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1023\/A:1006803703128","article-title":"Respiratory muscle injury in animal models and humans.","volume":"179","author":"Reid","year":"1998","journal-title":"Mol Cell Biochem"},{"key":"2026032708110523800_B5","doi-asserted-by":"crossref","first-page":"3710","DOI":"10.1073\/pnas.90.8.3710","article-title":"Dystrophin protects the sarcolemma from stresses developed during muscle contraction.","volume":"90","author":"Petrof","year":"1993","journal-title":"Proc Natl Acad Sci USA"},{"key":"2026032708110523800_B6","doi-asserted-by":"crossref","first-page":"549","DOI":"10.1242\/jcs.96.3.549","article-title":"Molecular traffic through plasma membrane disruptions of cells in vivo.","volume":"96","author":"McNeil","year":"1990","journal-title":"J Cell Sci"},{"key":"2026032708110523800_B7"},{"key":"2026032708110523800_B8","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1016\/S0272-5231(21)00504-9","article-title":"Respiratory muscles in disease. 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