Reciprocal changes in airflow resistance between nasal cavities are induced by lateral recumbency, and also by unilateral pressures to body surfaces in postures which avoid hydrostatic differences between sides. The reciprocating spontaneous nasal cycle in erect subjects and these nasal responses to lateral posture and pressure maintain total nasal resistance in the range of 2-3 cmH2O (0.2-0.3 KPa)/l/sec. In the resting subject, erect or recumbent, the centrally mediated autonomic tone of capacitance vessels of nasal erectile mucosa maintains an adequately patent nasal airway despite marked differences in airflow resistance between the nasal cavities which accompany lateral recumbency, asymmetrical body surface pressures or the spontaneous nasal cycle. In addition to passive hydrostatic influences on nasal mucosal blood content, activity of the vasomotor centre modified by impulses from pressure sensors of the body surfaces reciprocally alters the tone of the nasal capacitance vessels. Nasal disorders hamper these stabilizing reciprocal adjustments in airflow resistance and adversely affect breathing mechanics in recumbent subjects.

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Verrucous carcinoma is a rare variant of well-differentiated squamous cell carcinoma. It usually occurs in the oral cavity, genital area, and sole. Verrucous carcinoma of the sole, also called epithelioma cuniculatum, often presents a diagnostic challenge both clinically and histopathologically. The authors report such a case that mimics infected epidermal cyst and gout clinically.

Many patients hospitalized with coronavirus disease 2019 are treated with venovenous extracorporeal membrane oxygenation and prone positioning to optimize oxygenation. However, this combination can result in lower extremity tissue necrosis, especially without adequate offloading. We report the case of a 31-year-old man who required mechanical ventilation and venovenous extracorporeal membrane oxygenation secondary to complications from coronavirus disease 2019, and subsequently developed pedal dry gangrene. The patient was discharged and healed without requiring an amputation. Our institution has since revised the prone positioning protocol to address offloading the lower extremities and feet.