Numerical and experimental study of expiratory flow in the case of major upper airway obstructions with fluid structure interaction

Science.gov (United States)

Chouly, F.; van Hirtum, A.; Lagrée, P.-Y.; Pelorson, X.; Payan, Y.

2008-02-01

This study deals with the numerical prediction and experimental description of the flow-induced deformation in a rapidly convergent divergent geometry which stands for a simplified tongue, in interaction with an expiratory airflow. An original in vitro experimental model is proposed, which allows measurement of the deformation of the artificial tongue, in condition of major initial airway obstruction. The experimental model accounts for asymmetries in geometry and tissue properties which are two major physiological upper airway characteristics. The numerical method for prediction of the fluid structure interaction is described. The theory of linear elasticity in small deformations has been chosen to compute the mechanical behaviour of the tongue. The main features of the flow are taken into account using a boundary layer theory. The overall numerical method entails finite element solving of the solid problem and finite differences solving of the fluid problem. First, the numerical method predicts the deformation of the tongue with an overall error of the order of 20%, which can be seen as a preliminary successful validation of the theory and simulations. Moreover, expiratory flow limitation is predicted in this configuration. As a result, both the physical and numerical models could be useful to understand this phenomenon reported in heavy snorers and apneic patients during sleep.

Respiratory mechanics by least squares fitting in mechanically ventilated patients: application on flow-limited COPD patients.

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Volta, Carlo A; Marangoni, Elisabetta; Alvisi, Valentina; Capuzzo, Maurizia; Ragazzi, Riccardo; Pavanelli, Lina; Alvisi, Raffaele

2002-01-01

Although computerized methods of analyzing respiratory system mechanics such as the least squares fitting method have been used in various patient populations, no conclusive data are available in patients with chronic obstructive pulmonary disease (COPD), probably because they may develop expiratory flow limitation (EFL). This suggests that respiratory mechanics be determined only during inspiration. Eight-bed multidisciplinary ICU of a teaching hospital. Eight non-flow-limited postvascular surgery patients and eight flow-limited COPD patients. Patients were sedated, paralyzed for diagnostic purposes, and ventilated in volume control ventilation with constant inspiratory flow rate. Data on resistance, compliance, and dynamic intrinsic positive end-expiratory pressure (PEEPi,dyn) obtained by applying the least squares fitting method during inspiration, expiration, and the overall breathing cycle were compared with those obtained by the traditional method (constant flow, end-inspiratory occlusion method). Our results indicate that (a) the presence of EFL markedly decreases the precision of resistance and compliance values measured by the LSF method, (b) the determination of respiratory variables during inspiration allows the calculation of respiratory mechanics in flow limited COPD patients, and (c) the LSF method is able to detect the presence of PEEPi,dyn if only inspiratory data are used.

Use of tidal breathing curves for evaluating expiratory airway obstruction in infants.

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Hevroni, Avigdor; Goldman, Aliza; Blank-Brachfeld, Miriam; Abu Ahmad, Wiessam; Ben-Dov, Lior; Springer, Chaim

2018-01-15

To evaluate tidal breathing (TB) flow-volume and flow-time curves for identification of expiratory airway obstruction in infants. Pulmonary function tests were analyzed retrospectively in 156 infants aged 3-24 months with persistent or recurrent respiratory complaints. Parameters derived from TB curves were compared to maximal expiratory flow at functional residual capacity ([Formula: see text]maxFRC) measured by rapid thoracoabdominal compression technique. Analyzed parameters were: inspiratory time (t I ), expiratory time (t E ), tidal volume, peak tidal expiratory flow (PTEF), time to peak tidal expiratory flow (t PTEF ), expiratory flow when 50% and 25% of tidal volume remains in the lungs (FEF 50 , FEF 25 , respectively), and the ratios t PTEF /t E , t I /t E , FEF 50 /PTEF, and FEF 25 /PTEF. Statistical comparisons between flow indices and TB parameters were performed using mean squared error and Pearson's sample correlation coefficient. The study population was also divided into two groups based on severity of expiratory obstruction (above or below z-score for [Formula: see text]maxFRC of -2) to generate receiver operating characteristic (ROC) curves and calculate discriminatory values between the groups. TB parameters that were best correlated to [Formula: see text]maxFRC were: t PTEF /t E , FEF 50 /PTEF, and FEF 25 /PTEF, with r = 0.61, 0.67, 0.65, respectively (p < 0.0001 for all). ROC curves for FEF 50 /PTEF, FEF 25 /PTEF and t PTEF /t E showed areas under the curve of 0.813, 0.797, and 0.796, respectively. Cutoff value z-scores of -0.35, -0.34, and -0.43 for these three parameters, respectively, showed an 86% negative predictive value for severe airway obstructions. TB curves can assist in ruling out severe expiratory airway obstruction in infants.

PROGRESSIVE MUSCLE RELAXATION INCREASE PEAK EXPIRATORY FLOW RATE ON CHRONIC OBSTRUCTIVE PULMONARY DISEASE PATIENTS

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Tintin Sukartini

2017-07-01

Full Text Available Introduction: Limited progressive air flow in Chronic Obstructive Pulmonary Disease (COPD can caused by small airway disease (bronchiolitis obstructive and loss of elasticity of the lung (emphysema. Further it can be decreasing the quality of life in COPD patients because dyspnea and uncomfortable in activity. Progressive muscle relaxation (PMR is one of the relaxation technique that can repair pulmonary ventilation by decreasing chronic constriction of the respiratory muscles. The objective of this study was to analyze the effect of progressive muscle relaxation on raised peak expiratory flow rate (PEFR. Method: A pre-experimental one group pre-post test design was used in this study. Population was all of the COPD patients at Pulmonary Specialist Polyclinic Dr Mohamad Soewandhie Surabaya. There were 8 respondents taken by using purposive sampling. PEFR was counted by using peak flow meter every six day. Data were analyzed by using Paired t-Test with significance level  p≤0.05. Result: The result showed that PMR had significance level on increasing of PEFR (p=0.012. Discussion: It can be concluded that PMR has an effect on raise PEFR. Further studies are recommended to measure the effect of PMR on respiratory rate (RR, heart rate (HR subjective dyspnoe symptoms, forced expiration volume on the first minute (FEV1 and mid maximum flow rate (MMFR in COPD patients.

The Concave Shape of the Forced Expiratory Flow-Volume Curve in 3 Seconds Is a Practical Surrogate of FEV1/FVC for the Diagnosis of Airway Limitation in Inadequate Spirometry.

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Li, Hao; Liu, Chunhong; Zhang, Yi; Xiao, Wei

2017-03-01

Spirometry is important for the differential diagnosis of dyspnea. However, some patients cannot exhale for ≥6 s to achieve the American Thoracic Society/European Respiratory Society criteria. The aim of this study was to demonstrate the reliability of a new parameter that quantifies the degree of concavity in the first 3 s to define airway limitation as a surrogate for the FEV 1 /FVC. Four hundred spirometry test results were selected through complete random sampling. The new parameter, termed the AUC 3 /AT 3 , was calculated as the area under the descending limb of the expiratory flow-volume curve before the end of the first 3 s (AUC 3 ) divided by the area of the triangle before the end of the first 3 s (AT 3 ). The AUC 3 /AT 3 was compared with the FEV 1 /FVC using Pearson's correlation analysis. The level of agreement between the AUC 3 /AT 3 and the FEV 1 /FVC in the detection of airway obstruction was analyzed using the kappa statistic. We also compared the diagnostic accuracy of the new index with that of the FEV 1 /forced expiratory volume in the first 3 s (FEV 3 ). There was a strong correlation (r = 0.88, P < .001) between the AUC 3 /AT 3 and the FEV 1 /FVC. There was also strong agreement between the AUC 3 /AT 3 and the FEV 1 /FVC in the detection of obstruction with kappa indices of 0.72 (Global Initiative for Chronic Obstructive Lung Disease [GOLD] criterion) and 0.67 (lower limit of normal criterion), and these values were greater than those obtained for the FEV 1 /FEV 3 . The AUC 3 /AT 3 also exhibited acceptable sensitivity, specificity, positive predictive value, and negative predictive value. The diagnostic accuracies of the AUC 3 /AT 3 were 86.3% (GOLD criterion) and 83.8% (lower limit of normal criterion), which were greater than the 76.0 and 74.0% obtained for the FEV 1 /FEV 3 , respectively. The AUC 3 /AT 3 can be utilized as a surrogate parameter for the FEV 1 /FVC when patients cannot complete a 6-s expiratory effort. Additionally, the

Peak expiratory flow rate in healthy children aged 6-17 years

DEFF Research Database (Denmark)

Høst, A; Høst, A H; Ibsen, T

1994-01-01

Peak expiratory flow rate (PEFR) was measured in a cross-sectional study in 861 healthy Danish schoolchildren aged 6-17 years using a Mini Wright peak flowmeter. We found a strong correlation between PEFR and height, age and sex. The results were comparable with those from previous studies using...... a Wright peak flowmeter. The equation for prediction of PEFR in boys was calculated as (3.8 x height) + (10.6 x age) - 313.2 (p age) - 143.9 (p ... coefficient in this large sample. Among healthy children without previous asthma, earlier episodes of recurrent wheezing were reported in 8.8% and a significantly lower PEFR was found in this group....

Normal expiratory flow rate and lung volumes in patients with combined emphysema and interstitial lung disease: a case series and literature review.

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Heathcote, Karen L; Cockcroft, Donald W; Fladeland, Derek A; Fenton, Mark E

2011-01-01

Pulmonary function tests in patients with idiopathic pulmonary fibrosis characteristically show a restrictive pattern including small lung volumes and increased expiratory flow rates resulting from a reduction in pulmonary compliance due to diffuse fibrosis. Conversely, an obstructive pattern with hyperinflation results in emphysema by loss of elastic recoil, expiratory collapse of the peripheral airways and air trapping. When the diseases coexist, pulmonary volumes are compensated, and a smaller than expected reduction or even normal lung volumes can be found. The present report describes 10 patients with progressive breathlessness, three of whom experienced severe limitation in their quality of life. All patients showed lung interstitial involvement and emphysema on computed tomography scan of the chest. The 10 patients showed normal spirometry and lung volumes with severe compromise of gas exchange. Normal lung volumes do not exclude diagnosis of idiopathic pulmonary fibrosis in patients with concomitant emphysema. The relatively preserved lung volumes may underestimate the severity of idiopathic pulmonary fibrosis and attenuate its effects on lung function parameters.

Static end-expiratory and dynamic forced expiratory tracheal collapse in COPD

International Nuclear Information System (INIS)

O'Donnell, C.R.; Bankier, A.A.; O'Donnell, D.H.; Loring, S.H.; Boiselle, P.M.

2014-01-01

Aim: To determine the range of tracheal collapse at end-expiration among chronic obstructive pulmonary disease (COPD) patients and to compare the extent of tracheal collapse between static end-expiratory and dynamic forced-expiratory multidetector-row computed tomography (MDCT). Materials and methods: After institutional review board approval and obtaining informed consent, 67 patients meeting the National Heart, Lung, and Blood Institute (NHLBI)/World Health Organization (WHO) Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria for COPD were sequentially imaged using a 64-detector-row CT machine at end-inspiration, during forced expiration, and at end-expiration. Standardized respiratory coaching and spirometric monitoring were employed. Mean percentage tracheal collapse at end-expiration and forced expiration were compared using correlation analysis, and the power of end-expiratory cross-sectional area to predict excessive forced-expiratory tracheal collapse was computed following construction of receiver operating characteristic (ROC) curves. Results: Mean percentage expiratory collapse among COPD patients was 17 ± 18% at end-expiration compared to 62 ± 16% during forced expiration. Over the observed range of end-expiratory tracheal collapse (approximately 10–50%), the positive predictive value of end-expiratory collapse to predict excessive (≥80%) forced expiratory tracheal collapse was <0.3. Conclusion: COPD patients demonstrate a wide range of end-expiratory tracheal collapse. The magnitude of static end-expiratory tracheal collapse does not predict excessive dynamic expiratory tracheal collapse

Hand grip strength and maximum peak expiratory flow: determinants of bone mineral density of adolescent students.

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Cossio-Bolaños, Marco; Lee-Andruske, Cynthia; de Arruda, Miguel; Luarte-Rocha, Cristian; Almonacid-Fierro, Alejandro; Gómez-Campos, Rossana

2018-03-02

Maintaining and building healthy bones during the lifetime requires a complicated interaction between a number of physiological and lifestyle factors. Our goal of this study was to analyze the association between hand grip strength and the maximum peak expiratory flow with bone mineral density and content in adolescent students. The research team studied 1427 adolescent students of both sexes (750 males and 677 females) between the ages of 11.0 and 18.9 years in the Maule Region of Talca (Chile). Weight, standing height, sitting height, hand grip strength (HGS), and maximum peak expiratory flow (PEF) were measured. Furthermore, bone mineral density (BMD) and total body bone mineral content (BMC) were determined by using the Dual-Energy X-Ray Absorptiometry (DXA). Hand grip strength and PEF were categorized in tertiles (lowest, middle, and highest). Linear regression was performed in steps to analyze the relationship between the variables. Differences between categories were determined through ANOVA. In males, the hand grip strength explained 18-19% of the BMD and 20-23% of the BMC. For the females, the percentage of variation occurred between 12 and 13% of the BMD and 17-18% of the BMC. The variation of PEF for the males was observed as 33% of the BMD and 36% of the BMC. For the females, both the BMD and BMC showed a variation of 19%. The HGS and PEF were divided into three categories (lowest, middle, and highest). In both cases, significant differences occurred in bone density health between the three categories. In conclusion, the HGS and the PEF related positively to the bone density health of both sexes of adolescent students. The adolescents with poor values for hand grip strength and expiratory flow showed reduced values of BMD and BMC for the total body. Furthermore, the PEF had a greater influence on bone density health with respect to the HGS of the adolescents of both sexes.

Normal Expiratory Flow Rate and Lung Volumes in Patients with Combined Emphysema and Interstitial Lung Disease: A Case Series and Literature Review

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Karen L Heathcote

2011-01-01

Full Text Available Pulmonary function tests in patients with idiopathic pulmonary fibrosis characteristically show a restrictive pattern including small lung volumes and increased expiratory flow rates resulting from a reduction in pulmonary compliance due to diffuse fibrosis. Conversely, an obstructive pattern with hyperinflation results in emphysema by loss of elastic recoil, expiratory collapse of the peripheral airways and air trapping. When the diseases coexist, pulmonary volumes are compensated, and a smaller than expected reduction or even normal lung volumes can be found. The present report describes 10 patients with progressive breathlessness, three of whom experienced severe limitation in their quality of life. All patients showed lung interstitial involvement and emphysema on computed tomography scan of the chest. The 10 patients showed normal spirometry and lung volumes with severe compromise of gas exchange. Normal lung volumes do not exclude diagnosis of idiopathic pulmonary fibrosis in patients with concomitant emphysema. The relatively preserved lung volumes may underestimate the severity of idiopathic pulmonary fibrosis and attenuate its effects on lung function parameters.

Validity of peak expiratory flow measurement in assessing reversibility of airflow obstruction.

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Dekker, F W; Schrier, A C; Sterk, P J; Dijkman, J H

1992-01-01

BACKGROUND: Assessing the reversibility of airflow obstruction by peak expiratory (PEF) measurements would be practicable in general practice, but its usefulness has not been investigated. METHODS: PEF measurements were performed (miniWright peak flow meter) in 73 general practice patients (aged 40 to 84) with a history of asthma or chronic obstructive lung disease before and after 400 micrograms inhaled sulbutamol. The change in PEF was compared with the change in forced expiratory volume in one second (FEV1). Reversible airflow obstruction was analysed in two ways according to previous criteria. When defined as a 9% or greater increase in FEV1 expressed as a percentage of predicted values reversibility was observed in 42% of patients. Relative operating characteristic analysis showed that an absolute improvement in PEF of 60 l/min or more gave optimal discrimination between patients with reversible and irreversible airflow obstruction (the sensitivity and specificity of an increase of 60 l/min in detecting a 9% or more increase in FEV1 as a percentage of predicted values were 68% and 93% respectively, with a positive predictive value of 87%). When defined as an increase of 190 ml or more in FEV1, reversible airflow obstruction was observed in 53% of patients. Again an absolute improvement in PEF of 60 l/min or more gave optimal discrimination between patients with reversible and irreversible airflow obstruction (sensitivity 56%, specificity 94%, and positive predictive value 92%). CONCLUSION: Absolute changes in PEF can be used as a simple technique to diagnose reversible airflow obstruction in patients from general practice. PMID:1519192

Expiratory timing in obstructive sleep apnoeas.

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Cibella, F; Marrone, O; Sanci, S; Bellia, V; Bonsignore, G

1990-03-01

Diaphragmatic electromyogram was recorded during NREM sleep in 4 patients affected by obstructive sleep apnoea (OSA) syndrome in order to evaluate the behaviour of expiratory time (TE) in the course of the obstructive apnoea-ventilation cycle. The two components of TE, i.e. time of post-inspiratory inspiratory activity (TPIIA) and time of expiratory phase 2 (TE2) were separately analysed. TPIIA showed a short duration, with only minor variations, within the apnoea, while its duration was more variable and longer in the interapnoeic periods: the longest TPIIA values were associated with the highest inspiratory volumes in the same breaths. This behaviour seemed regulated according to the need of a more or less effective expiratory flow braking, probably as a result of pulmonary stretch receptors discharge. Conversely TE2 showed a continuous gradual modulation, progressively increasing in the pre-apnoeic period, decreasing during the apnoea and increasing in the post-apnoeic period: these TE2 variations seemed related to oscillations in chemical drive. These data show that TE in the obstructive apnoea-ventilation cycle results from a different modulation in its two components and suggest that both mechanical and chemical influences play a role in its overall duration.

Peak expiratory flow rate (PEFR) among Nuclear Fuel Complex (NFC) employees

International Nuclear Information System (INIS)

Vijay Rao, J.; Venkaiah, K.; Mohan Rao, N.

2010-01-01

At Nuclear Fuel Complex (NFC), employees are exposed to ammonia, hydrofluoric acid, acetone, etc., which are respiratory toxicants and inhalation of these pollutants may produce irritation and obstruction in airways. Due to nature of their occupation, tradesman working in plants are having longer duration of exposure (LDE) and others, such as supervisors, scientific officers, helpers, etc., that occasionally visit plants are having shorter duration of exposure (SDE) to these pollutants. The peak expiratory flow rate (PEFR) is an index to diagnose obstruction in larger airways and this is metered with mini peak flow meter among 835 NFC employees. Using ANOVA test, PEFR value was compared according to age and smoking. The value was compared between LDE and SDE employees according to smoking and duration of employment. The multiple regression equation for prediction of PEFR was developed. Age, smokers and higher duration of LDE employees demonstrated significantly lower PEFR value. In comparison to 10 year duration, 30 and above year duration of employment, LDE employees showed a higher decline in PEFR, that is 95 L (17.6%) and in SDE employees, that is 41L (7.8%). This may be due to longer duration of employment of LD employees smoking prevention and follow up study is suggested. (author)

Distribution of peak expiratory flow variability by age, gender and smoking habits in a random population sample aged 20-70 yrs

NARCIS (Netherlands)

Boezen, H M; Schouten, J. P.; Postma, D S; Rijcken, B

1994-01-01

Peak expiratory flow (PEF) variability can be considered as an index of bronchial lability. Population studies on PEF variability are few. The purpose of the current paper is to describe the distribution of PEF variability in a random population sample of adults with a wide age range (20-70 yrs),

Relationship between spontaneous expiratory flow-volume curve pattern and air-flow obstruction in elderly COPD patients.

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Nozoe, Masafumi; Mase, Kyoshi; Murakami, Shigefumi; Okada, Makoto; Ogino, Tomoyuki; Matsushita, Kazuhiro; Takashima, Sachie; Yamamoto, Noriyasu; Fukuda, Yoshihiro; Domen, Kazuhisa

2013-10-01

Assessment of the degree of air-flow obstruction is important for determining the treatment strategy in COPD patients. However, in some elderly COPD patients, measuring FVC is impossible because of cognitive dysfunction or severe dyspnea. In such patients a simple test of airways obstruction requiring only a short run of tidal breathing would be useful. We studied whether the spontaneous expiratory flow-volume (SEFV) curve pattern reflects the degree of air-flow obstruction in elderly COPD patients. In 34 elderly subjects (mean ± SD age 80 ± 7 y) with stable COPD (percent-of-predicted FEV(1) 39.0 ± 18.5%), and 12 age-matched healthy subjects, we measured FVC and recorded flow-volume curves during quiet breathing. We studied the SEFV curve patterns (concavity/convexity), spirometry results, breathing patterns, and demographics. The SEFV curve concavity/convexity prediction accuracy was examined by calculating the receiver operating characteristic curves, cutoff values, area under the curve, sensitivity, and specificity. Fourteen subjects with COPD had a concave SEFV curve. All the healthy subjects had convex SEFV curves. The COPD subjects who had concave SEFV curves often had very severe airway obstruction. The percent-of-predicted FEV(1)% (32.4%) was the most powerful SEFV curve concavity predictor (area under the curve 0.92, 95% CI 0.83-1.00), and had the highest sensitivity (0.93) and specificity (0.88). Concavity of the SEFV curve obtained during tidal breathing may be a useful test for determining the presence of very severe obstruction in elderly patients unable to perform a satisfactory FVC maneuver.

Functional Magnetic Stimulation of Inspiratory and Expiratory Muscles in Subjects With Tetraplegia.

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Zhang, Xiaoming; Plow, Ela; Ranganthan, Vinoth; Huang, Honglian; Schmitt, Melissa; Nemunaitis, Gregory; Kelly, Clay; Frost, Frederick; Lin, Vernon

2016-07-01

Respiratory complications are major causes of morbidity and mortality in persons with a spinal cord injury, partly because of respiratory muscle paralysis. Earlier investigation has demonstrated that functional magnetic stimulation (FMS) can be used as a noninvasive technology for activating expiratory muscles, thus producing useful expiratory functions (simulated cough) in subjects with spinal cord injury. To evaluate the effectiveness of FMS for conditioning inspiratory and expiratory muscles in persons with tetraplegia. A prospective before and after trial. FMS Laboratory, Louis Stokes Cleveland VA Medical Center, Cleveland, OH. Six persons with tetraplegia. Each subject participated in a 6-week FMS protocol for conditioning the inspiratory and expiratory muscles. A magnetic stimulator was used with the center of a magnetic coil placed at the C7-T1 and T9-T10 spinous processes, respectively. Pulmonary function tests were performed before, during, and after the protocol. Respiratory variables included maximal inspiratory pressure (MIP), inspiratory reserve volume (IRV), peak inspiratory flow (PIF), maximal expiratory pressure (MEP), expiratory reserve volume (ERV), and peak expiratory flow (PEF). After 6 weeks of conditioning, the main outcome measurements (mean ± standard error) were as follows: MIP, 89.6 ± 7.3 cm H2O; IRV, 1.90 ± 0.34 L; PIF, 302.4 ± 36.3 L/min; MEP, 67.4 ± 11.1 cm H2O; ERV, 0.40 ± 0.06 L; and PEF, 372.4 ± 31.9 L/min. These values corresponded to 117%, 107%, 136%, 109%, 130%, and 124% of pre-FMS conditioning values, respectively. Significant improvements were observed in MIP (P = .022), PIF (P = .0001), and PEF (P = .0006), respectively. When FMS was discontinued for 4 weeks, these values showed decreases from their values at the end of the conditioning protocol, which suggests that continual FMS may be necessary to maintain improved respiratory functions. FMS conditioning of the inspiratory and expiratory muscles improved

Decreased peak expiratory flow in pediatric passive smokers

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Fitri Yanti

2011-08-01

Full Text Available Background Indonesia ranks fifth among countries with the highest aggregate levels of tobacco consumption in the world. Infants and children exposed to environmental tobacco smoke have increased rates of asthma, respiratory and ear infections, as well as reduced lung function. The effects of tobacco smoke exposure on lung function in children have been reported to be dependent on the source of smoke and the length and dose of exposure. Lung function may also be affected by a child’s gender and asthma status. Objective To compare peak expiratory flow (PEF in pediatric passive smokers to that of children not exposed to second hand smoke, and to define factors that may affect PEF in passive smokers. Methods In August 2009 we conducted a cross-sectional study at an elementary school in the Langkat district. Subjects were aged 6 to 12 years, and divided into two groups: passive smokers and those not exposed to secondhand smoke. Subjects’ PEFs were measured with a Mini-Wright peak flow meter. Measurements were performed in triplicate with the highest value recorded as the PEF. Demographic data including age, sex, weight, height, family income, parental education levels and occupations were obtained through questionnaires. Results Of the 170 participants, 100 were passive smokers and 70 were not exposed to secondhand smoke. Age distribution, weight and height were similar in both groups. We observed a significant difference in PEFs between the group of passive smokers and the group not exposed to secondhand smoke, 211.3 L/minute (SD 61.08 and 242.7 L/minute (SD 77.09, respectively (P < 0.005. The number of years of exposure to smoke (P = 0.079 and the number of cigarettes smoked daily in the household (P = 0.098 did not significantly influence PEF. Conclusion The PEF in pediatric passive smokers was significantly lower than that of children not exposed to secondhand smoke. PEF in passive smokers was not influenced by the number of years of smoke

Peak expiratory flow rate in healthy rural school going children (5-16 years) of bellur region for construction of nomogram.

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Cb, Manjunath; Sc, Kotinatot; Babu, Manjunatha

2013-12-01

Peak Expiratory Flow Rate (PEFR) recording is an essential measure in the management and evaluation of asthmatic children.It is helpful in monitoring disease progression and response to treatment. The PEFR can be measured by a simple instrument-peak expiratory flow meter. To construct nomogram of PEFR in healthy rural school going children from Mandya district of Karnataka state, India and to use these nomograms for comparison with that of children with obstructive lung diseases for this region. The study was conducted on Healthy rural school going children, both boys and girls between the age group of 5-16 years. For the determination of PEFR we used Mini Wright Peak Flow Meter. At three time measurement, the highest value of PEFR was recorded. Formula for prediction of PEFR was estimated by linear regression analysis after the correlation of PEFR with age and height for both boys and girls. PEFR was measured in 1028 children aged 5 to 16 years by using Wright's mini peak flow meter. Prediction equations were derived for PEFR with height in boys and girls. Normograms were plotted based on the observed values of PEFR in the study population. Significant linear correlation was seen of PEFR with height in boys (paffected by regional, environmental and anthropometric factors. Hence, it is necessary to have regional reference values for children. Among different factors affecting PEFR, height correlates better with PEFR than weight and sex. Hence nomograms constructed can be used for this region.

Peak expiratory flow as a predictor for the effectiveness of sport for patients with COPD.

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Jungblut, S; Frickmann, H; Klingler, J; Zimmermann, B; Bargon, Joachim

2006-01-31

This study intended to find simple parameters that were able to determine the increase in physical performance as a result of sport in a group of patients with COPD (lung sport). We regularly investigated pulse, oxygenation and peak expiratory flow in participants with COPD of a "lung sport group", who participated in a structured weekly training program under professional supervision. Ten volunteers (7 females, 3 males, median of age = 69) with COPD (grade II-III) took part in the study. - The relative changes after 3 and 6 months were compared with the values of the first month of exercise. Measurements were carried out before exercise, after stamina training and at the end of the program. - Pulse and oxygenation did not show any changes. However, there was a significant improvement of peak flow after 6 months. - These peak flow changes represent further evidence of positive effects of sport in COPD and provide a parameter which allows the patients themselves to measure and evaluate the success of their physical activity.

What's in a name? Expiratory tracheal narrowing in adults explained

International Nuclear Information System (INIS)

Leong, P.; Bardin, P.G.; Lau, K.K.

2013-01-01

Tracheomalacia, tracheobronchomalacia, and excessive dynamic airway collapse are all terms used to describe tracheal narrowing in expiration. The first two describe luminal reduction from cartilage softening and the latter refers to luminal reduction from exaggerated posterior membrane movement. Expiratory tracheal narrowing is a frequent occurrence that can cause symptoms of airway obstruction, such as dyspnoea, wheeze, and exercise intolerance. The accurate diagnosis and quantification of expiratory tracheal narrowing has important aetiological, therapeutic, and prognostic implications. The reference standard for diagnosis has traditionally been bronchoscopy; however, this method has significant limitations. Expiratory tracheal disorders are readily detected by four-dimensional dynamic volume multidetector computed tomography (4D-CT), an emerging, non-invasive method that will potentially enable detection and quantification of these conditions. This review discusses the morphological forms of expiratory tracheal narrowing and demonstrates the utility of 4D-CT in the diagnosis, quantification, and treatment of these important conditions

ERGONOMIC CONSIDERATION OF THE EFFECT OF FLOUR DUST ON PEAK EXPIRATORY FLOW RATE OF BAKERS IN ABEOKUTA, OGUN STATE

Directory of Open Access Journals (Sweden)

Adekunle Ibrahim MUSA

2017-06-01

Full Text Available Flour dusts are one of the most harmful chemicals in the bakery industries which could lead to serious heart and lung diseases. This study investigated the effect of flour dust on Peak Expiratory Flow Rate of male bakers in Abeokuta, Ogun State, Nigeria with the relationship to the anthropometrical parameters. A total of One hundred Eighty (180 male participants were investigated, where ninety (90 participants were bakers and ninety (90 individuals as control group. The Peak expiratory flow rate (PEFR and anthropometrical parameters of the participant were measured using mini-Wright peak flow meter (PFM 20, OMRON and Detecto PD300MDHR (Cardinal Scale manufacturing company, USA column scale with digital height rod was used to measure body mass [kg] and height (cm respectively. The PEFR and anthropometrical parameters of the bakers and control groups were analysed using descriptive statistics and T-test with SPSS. The results showed that lower PEFR, 182.67 ± 16.34 L/min existed in bakers compared to 287.67 ± 17.02 L/min in the control study. The result also showed that a significant correlation exist between body mass, height and age (P < 0.01, PEFR, height (P < 0.05 and years of exposure (P < 0.01 of the bakers respectively. Furthermore, the results also showed that workers in the dusting and mixing of flour are at a risk of developing related pulmonary function impairment such as asthma. The study concluded that there is need to develop an effective intervention strategy, treatment seeking behaviour through awareness programs to prevent lung impairment diseases among the bakery workers.

[Modification of expiratory peak flow (EPF) in 14 asthmatic subjects from Benin by short duration exercise training].

Science.gov (United States)

Lawani, M M; Hounkpatin, S; Akplogan, B

2006-01-01

Asthma is a world wide public health problem. It is the most commom chronic disease of school age children. Its severity is in constant increase. The frequency of the hospitalizations for asthma increased in practically all countries. Physical exercises and sport are used more and more as therapeutic means, in northern deveopped countries of where it was very early understood that it is necessary to integrate the asthmatic subjects into a program of specific physical training. This study undertaken in south saharian african country considers also assiduity in a physical training program as the factor of increase in the expiratory peak flow, of reinforcement of some principal muscles necessary to the improvement, and of the respiratory function of the asthmatic subject. Physical exercise is used as a non pharmacological therapy of asthma. This transversal study was carried out on fourteen asthmatic subjects of colleges in Porto-Novo's town, aged 15 years old to 25 years, of the two sexes. The results showed that: the Expiratory Peak Flow of Point (EPF) of the subjects at the beginning of the program is lower than the minimal average value of the group whatever the sex; the subjects average EPF increased from approximately 35% compared to the average at the beginning of the program; the subjects from family with asthmatic line, are much more inclined with respiratory embarrassments post-exercises than those who did not come from it; the respiratory embarrassments post-exercises noticed in the first weeks, grew blurred before the end of the program. This study suggests physical exercise adapted to the asthmatic subjects for the improvement of their health.

Hyperinflation and intrinsic positive end-expiratory pressure: less room to breathe.

Science.gov (United States)

Krieger, Bruce P

2009-01-01

Clinically, the symptoms and limited exercise capabilities of patients with chronic obstructive pulmonary disease (COPD) correlate better with changes in lung volumes than with airflow measurements. The realization of the clinical importance of hyperinflation has been overshadowed for decades by the use of forced expiratory volume during 1 s (FEV(1)) and the ratio of the FEV(1) to the forced expiratory vital capacity (FEV(1)/FVC) to categorize the severity and progression of COPD. Hyperinflation is defined as an elevation in the end-expiratory lung volume or functional residual capacity. When severe hyperinflation encroaches upon inspiratory capacity and limits vital capacity, it results in elevated intrinsic positive end-expiratory pressure (PEEPi) that places the diaphragm at a mechanical disadvantage and increases the work of breathing. Severe hyperinflation is the major physiologic cause of the resulting hypercarbic respiratory failure and patients' inability to transition (i.e. wean) from mechanical ventilatory support to spontaneous breathing. This paper reviews the basic physiologic principles of hyperinflation and its clinical manifestations as demonstrated by PEEPi. Also reviewed are the adverse effects of hyperinflation and PEEPi in critically ill patients with COPD, and methods for minimizing or counterbalancing these effects. Copyright 2009 S. Karger AG, Basel.

Multi-detector CT evaluation in patients suspected of tracheobronchomalacia: Comparison of end-expiratory with dynamic expiratory volumetric acquisitions

Energy Technology Data Exchange (ETDEWEB)

Ferretti, Gilbert R. [Department of Radiology (France)], E-mail: gferretti@chu-grenoble.fr; Jankowski, Adrien [Department of Radiology (France)], E-mail: ajankowski@chu-grenoble.fr; Perrin, Marie Amelie [Department of Radiology (France)], E-mail: maperrin@chu-grenoble.fr; Chouri, Nathalie [Department of Respiratory Diseases (France)], E-mail: nchouri@chu-grenoble.fr; Arnol, Nathalie [Sleep Laboratory and EFCR, University Hospital, Grenoble (France); HP2 Laboratory, INSERM ERI 0017 (Hypoxia: Pathophysiology), Joseph Fourier University, Grenoble (France)], E-mail: narnold@chu-grenoble.fr; Aubaud, Laurent [Department of Radiology (France)], E-mail: laubaud@chu-grenoble.fr; Pepin, Jean-Louis [Sleep Laboratory and EFCR, University Hospital, Grenoble (France); HP2 Laboratory, INSERM ERI 0017 (Hypoxia: Pathophysiology), Joseph Fourier University, Grenoble (France)], E-mail: jlpepin@chu-grenoble.fr

2008-11-15

Purpose: The aim of this study was to compare dynamic expiratory imaging and end-expiratory imaging using multi-detector CT (MDCT) of the central airways in patients suspected of tracheobronchomalacia (TBM). Methods: This study had local ethical committee approval. Seventy patients suspected of TBM were prospectively included. All patients underwent evaluation of central airways by three different low-dose MDCT acquisitions: end inspiration, end expiration, and dynamic expiration. Degree of airway collapse was measured by calculating the percentage change in the area and diameter of the airways between inspiratory and the two expiratory techniques at three levels of the trachea and in the sagittal diameter of the right and left main bronchi. Three threshold levels of percentage reduction in diameter or area (30%, 50%, and 70%) for defining TBM were evaluated. Results: In the entire population, the mean percentage of airway collapse was significantly greater with dynamic expiratory imaging than with the end-expiratory imaging at three different levels: lower thoracic trachea (26% vs. 16.6%, p < 0.009), right (25.2% vs. 14%, p < 0.01) and left main (24.7% vs. 13.3%, p < 0.01) bronchus. Whatever the threshold value for defining TBM, dynamic expiratory imaging always resulted in diagnosing TBM in more patients than end-expiratory imaging. Conclusions: Dynamic expiratory imaging shows a significantly greater degree and a significantly greater extent of airway collapse than standard end-expiratory imaging in patients suspected of TBM. Further evaluation of the clinical relevance of such findings is warranted.

Knowledge, attitude and practice of nurses toward peak expiratory ...

African Journals Online (AJOL)

Background: Peak expiratory flow meter (PEFM) is an easy to use, relatively cheap device that can be used for guiding management of bronchial asthma by the patients at home according to a preset plan by health care workers. Objective: The aim of the study is to reveal the extent of knowledge and perception of nurses ...

Comparison of changes in tidal volume associated with expiratory rib cage compression and expiratory abdominal compression in patients on prolonged mechanical ventilation.

Science.gov (United States)

Morino, Akira; Shida, Masahiro; Tanaka, Masashi; Sato, Kimihiro; Seko, Toshiaki; Ito, Shunsuke; Ogawa, Shunichi; Takahashi, Naoaki

2015-07-01

[Purpose] This study was designed to compare and clarify the relationship between expiratory rib cage compression and expiratory abdominal compression in patients on prolonged mechanical ventilation, with a focus on tidal volume. [Subjects and Methods] The subjects were 18 patients on prolonged mechanical ventilation, who had undergone tracheostomy. Each patient received expiratory rib cage compression and expiratory abdominal compression; the order of implementation was randomized. Subjects were positioned in a 30° lateral recumbent position, and a 2-kgf compression was applied. For expiratory rib cage compression, the rib cage was compressed unilaterally; for expiratory abdominal compression, the area directly above the navel was compressed. Tidal volume values were the actual measured values divided by body weight. [Results] Tidal volume values were as follows: at rest, 7.2 ± 1.7 mL/kg; during expiratory rib cage compression, 8.3 ± 2.1 mL/kg; during expiratory abdominal compression, 9.1 ± 2.2 mL/kg. There was a significant difference between the tidal volume during expiratory abdominal compression and that at rest. The tidal volume in expiratory rib cage compression was strongly correlated with that in expiratory abdominal compression. [Conclusion] These results indicate that expiratory abdominal compression may be an effective alternative to the manual breathing assist procedure.

Positive expiratory pressure - Common clinical applications and physiological effects.

Science.gov (United States)

Fagevik Olsén, Monika; Lannefors, Louise; Westerdahl, Elisabeth

2015-03-01

Breathing out against resistance, in order to achieve positive expiratory pressure (PEP), is applied by many patient groups. Pursed lips breathing and a variety of devices can be used to create the resistance giving the increased expiratory pressure. Effects on pulmonary outcomes have been discussed in several publications, but the expected underlying physiology of the effect is seldom discussed. The aim of this article is to describe the purpose, performance, clinical application and underlying physiology of PEP when it is used to increase lung volumes, decrease hyperinflation or improve airway clearance. In clinical practice, the instruction how to use an expiratory resistance is of major importance since it varies. Different breathing patterns during PEP increase or reduce expiratory flow, result in movement of EPP centrally or peripherally and can increase or decrease lung volume. It is therefore necessary to give the right instructions to obtain the desired effects. As the different PEP techniques are being used by diverse patient groups it is not possible to give standard instructions. Based on the information given in this article the instructions have to be adjusted to give the optimal effect. There is no consensus regarding optimal treatment frequency and number of cycles included in each treatment session and must also be individualized. In future research, more precise descriptions are needed about physiological aims and specific instructions of how the treatments have been performed to assure as good treatment quality as possible and to be able to evaluate and compare treatment effects. Copyright © 2014 Elsevier Ltd. All rights reserved.

Tracheal sound parameters of respiratory cycle phases show differences between flow-limited and normal breathing during sleep

International Nuclear Information System (INIS)

Kulkas, A; Huupponen, E; Virkkala, J; Saastamoinen, A; Rauhala, E; Tenhunen, M; Himanen, S-L

2010-01-01

The objective of the present work was to develop new computational parameters to examine the characteristics of respiratory cycle phases from the tracheal breathing sound signal during sleep. Tracheal sound data from 14 patients (10 males and 4 females) were examined. From each patient, a 10 min long section of normal and a 10 min section of flow-limited breathing during sleep were analysed. The computationally determined proportional durations of the respiratory phases were first investigated. Moreover, the phase durations and breathing sound amplitude levels were used to calculate the area under the breathing sound envelope signal during inspiration and expiration phases. An inspiratory sound index was then developed to provide the percentage of this type of area during the inspiratory phase with respect to the combined area of inspiratory and expiratory phases. The proportional duration of the inspiratory phase showed statistically significantly higher values during flow-limited breathing than during normal breathing and inspiratory pause displayed an opposite difference. The inspiratory sound index showed statistically significantly higher values during flow-limited breathing than during normal breathing. The presented novel computational parameters could contribute to the examination of sleep-disordered breathing or as a screening tool

Abdominal wall reconstruction for large incisional hernia restores expiratory lung function

DEFF Research Database (Denmark)

Jensen, Kristian K; Backer, Vibeke; Jorgensen, Lars N

2017-01-01

BACKGROUND: Respiratory complications secondary to intermittent intra-abdominal hypertension and/or atelectasis are common after abdominal wall reconstruction for large incisional hernias. It is unknown if the respiratory function of this patient group is affected long term or impairs activities...... of daily living. We hypothesized that abdominal wall reconstruction for large incisional hernia would not lead to improved, long-term pulmonary function or respiratory quality of life. METHODS: Eighteen patients undergoing open abdominal wall reconstruction with mesh for a large incisional hernia...... (horizontal fascial defect width >10 cm) were compared with 18 patients with an intact abdominal wall who underwent colorectal resection. Patients were examined pre- and 1-year postoperatively. Examined measures included forced vital capacity, forced expiratory volume in first second, peak expiratory flow...

Comparison of changes in tidal volume associated with expiratory rib cage compression and expiratory abdominal compression in patients on prolonged mechanical ventilation

OpenAIRE

Morino, Akira; Shida, Masahiro; Tanaka, Masashi; Sato, Kimihiro; Seko, Toshiaki; Ito, Shunsuke; Ogawa, Shunichi; Takahashi, Naoaki

2015-01-01

[Purpose] This study was designed to compare and clarify the relationship between expiratory rib cage compression and expiratory abdominal compression in patients on prolonged mechanical ventilation, with a focus on tidal volume. [Subjects and Methods] The subjects were 18 patients on prolonged mechanical ventilation, who had undergone tracheostomy. Each patient received expiratory rib cage compression and expiratory abdominal compression; the order of implementation was randomized. Subjects ...

Expiratory muscle control during vomiting - Role of brain stem expiratory neurons

Science.gov (United States)

Miller, A. D.; Tan, L. K.

1987-01-01

The neural mechanisms controlling the muscles involved during vomiting were examined using decerebrated cats. In one experiment, the activity of the ventral respiratory group (VRG) expiratory (E) neurons was recorded during induced 'fictive vomiting' (i.e., a series of bursts of coactivation of abdominal and phrenic nerves that would be expected to produce expulsion in unparalyzed animals) and vomiting. In a second, abdominal muscle electromyographic and nerve activity were compared before and after sectioning the axons of descending VRG E neurons as they cross the midline between C1 and the obex (the procedure that is known to abolish expiratory modulation of internal intercostal muscle activity). The results of the study indicate that the abdominal muscles are controlled differently during respiration and vomiting.

Effects of positive end-expiratory pressure on renal function.

Science.gov (United States)

Järnberg, P O; de Villota, E D; Eklund, J; Granberg, P O

1978-01-01

The effects were studied positive end-expiratory pressure (PEEP) on renal function in eight patients with acute respiratory failure, requiring mechanical ventilation. On application of PEEP + 10 cm H2O, central venous pressure increased, systolic blood pressure decreased, urine flow and PAH-clearance were reduced, while inulin clearance remained stable. There was a marked increase in fractional sodium reabsorption and a concurrent decrease in fractional osmolal excretion. Fractional free-water clearance and the ratio UOsm/POsm did change.

Paired maximum inspiratory and expiratory plain chest radiographs for assessment of airflow limitation in chronic obstructive pulmonary disease

Energy Technology Data Exchange (ETDEWEB)

Kinoshita, Takashi, E-mail: tkino@med.kurume-u.ac.jp [Division of Respirology, Neurology, and Rheumatology, Department of Medicine, Kurume University School of Medicine, Kurume (Japan); Kawayama, Tomotaka, E-mail: kawayama_tomotaka@med.kurume-u.ac.jp [Division of Respirology, Neurology, and Rheumatology, Department of Medicine, Kurume University School of Medicine, Kurume (Japan); Imamura, Youhei, E-mail: mamura_youhei@med.kurume-u.ac.jp [Division of Respirology, Neurology, and Rheumatology, Department of Medicine, Kurume University School of Medicine, Kurume (Japan); Sakazaki, Yuki, E-mail: sakazaki@med.kurume-u.ac.jp [Division of Respirology, Neurology, and Rheumatology, Department of Medicine, Kurume University School of Medicine, Kurume (Japan); Hirai, Ryo, E-mail: hirai_ryou@kurume-u.ac.jp [Division of Respirology, Neurology, and Rheumatology, Department of Medicine, Kurume University School of Medicine, Kurume (Japan); Ishii, Hidenobu, E-mail: shii_hidenobu@med.kurume-u.ac.jp [Division of Respirology, Neurology, and Rheumatology, Department of Medicine, Kurume University School of Medicine, Kurume (Japan); Suetomo, Masashi, E-mail: jin_t_f_c@yahoo.co.jp [Division of Respirology, Neurology, and Rheumatology, Department of Medicine, Kurume University School of Medicine, Kurume (Japan); Matsunaga, Kazuko, E-mail: kmatsunaga@kouhoukai.or.jp [Division of Respirology, Neurology, and Rheumatology, Department of Medicine, Kurume University School of Medicine, Kurume (Japan); Azuma, Koichi, E-mail: azuma@med.kurume-u.ac.jp [Division of Respirology, Neurology, and Rheumatology, Department of Medicine, Kurume University School of Medicine, Kurume (Japan); Fujimoto, Kiminori, E-mail: kimichan@med.kurume-u.ac.jp [Department of Radiology, Kurume University School of Medicine, Kurume (Japan); Hoshino, Tomoaki, E-mail: hoshino@med.kurume-u.ac.jp [Division of Respirology, Neurology, and Rheumatology, Department of Medicine, Kurume University School of Medicine, Kurume (Japan)

2015-04-15

Highlights: •It is often to use computed tomography (CT) scan for diagnosis of chronic obstructive pulmonary disease. •CT scan is more expensive and higher. •A plane chest radiography more simple and cheap. Moreover, it is useful as detection of pulmonary emphysema, but not airflow limitation. •Our study demonstrated that the maximum inspiratory and expiratory plane chest radiography technique could detect severe airflow limitations. •We believe that the technique is helpful to diagnose the patients with chronic obstructive pulmonary disease. -- Abstract: Background: The usefulness of paired maximum inspiratory and expiratory (I/E) plain chest radiography (pCR) for diagnosis of chronic obstructive pulmonary disease (COPD) is still unclear. Objectives: We examined whether measurement of the I/E ratio using paired I/E pCR could be used for detection of airflow limitation in patients with COPD. Methods: Eighty patients with COPD (GOLD stage I = 23, stage II = 32, stage III = 15, stage IV = 10) and 34 control subjects were enrolled. The I/E ratios of frontal and lateral lung areas, and lung distance between the apex and base on pCR views were analyzed quantitatively. Pulmonary function parameters were measured at the same time. Results: The I/E ratios for the frontal lung area (1.25 ± 0.01), the lateral lung area (1.29 ± 0.01), and the lung distance (1.18 ± 0.01) were significantly (p < 0.05) reduced in COPD patients compared with controls (1.31 ± 0.02 and 1.38 ± 0.02, and 1.22 ± 0.01, respectively). The I/E ratios in frontal and lateral areas, and lung distance were significantly (p < 0.05) reduced in severe (GOLD stage III) and very severe (GOLD stage IV) COPD as compared to control subjects, although the I/E ratios did not differ significantly between severe and very severe COPD. Moreover, the I/E ratios were significantly correlated with pulmonary function parameters. Conclusions: Measurement of I/E ratios on paired I/E pCR is simple and

Paired maximum inspiratory and expiratory plain chest radiographs for assessment of airflow limitation in chronic obstructive pulmonary disease

International Nuclear Information System (INIS)

Kinoshita, Takashi; Kawayama, Tomotaka; Imamura, Youhei; Sakazaki, Yuki; Hirai, Ryo; Ishii, Hidenobu; Suetomo, Masashi; Matsunaga, Kazuko; Azuma, Koichi; Fujimoto, Kiminori; Hoshino, Tomoaki

2015-01-01

Highlights: •It is often to use computed tomography (CT) scan for diagnosis of chronic obstructive pulmonary disease. •CT scan is more expensive and higher. •A plane chest radiography more simple and cheap. Moreover, it is useful as detection of pulmonary emphysema, but not airflow limitation. •Our study demonstrated that the maximum inspiratory and expiratory plane chest radiography technique could detect severe airflow limitations. •We believe that the technique is helpful to diagnose the patients with chronic obstructive pulmonary disease. -- Abstract: Background: The usefulness of paired maximum inspiratory and expiratory (I/E) plain chest radiography (pCR) for diagnosis of chronic obstructive pulmonary disease (COPD) is still unclear. Objectives: We examined whether measurement of the I/E ratio using paired I/E pCR could be used for detection of airflow limitation in patients with COPD. Methods: Eighty patients with COPD (GOLD stage I = 23, stage II = 32, stage III = 15, stage IV = 10) and 34 control subjects were enrolled. The I/E ratios of frontal and lateral lung areas, and lung distance between the apex and base on pCR views were analyzed quantitatively. Pulmonary function parameters were measured at the same time. Results: The I/E ratios for the frontal lung area (1.25 ± 0.01), the lateral lung area (1.29 ± 0.01), and the lung distance (1.18 ± 0.01) were significantly (p < 0.05) reduced in COPD patients compared with controls (1.31 ± 0.02 and 1.38 ± 0.02, and 1.22 ± 0.01, respectively). The I/E ratios in frontal and lateral areas, and lung distance were significantly (p < 0.05) reduced in severe (GOLD stage III) and very severe (GOLD stage IV) COPD as compared to control subjects, although the I/E ratios did not differ significantly between severe and very severe COPD. Moreover, the I/E ratios were significantly correlated with pulmonary function parameters. Conclusions: Measurement of I/E ratios on paired I/E pCR is simple and

Lung volume and expiratory flow rates from pre- to post-puberty.

Science.gov (United States)

Smith, Joshua R; Emerson, Sam R; Kurti, Stephanie P; Gandhi, Kirti; Harms, Craig A

2015-08-01

The purpose was to determine if the airways and lungs grow disproportionately from pre- to post-puberty in boys and girls. We hypothesized that the airways grow at a slower rate than lung volume (i.e. dysanapsis growth) during puberty and boys would exhibit more dysanaptic growth compared to girls. Twenty-one pre-pubescent children [11 boys (pre 10.1 ± 0.5 years, post 15.3 ± 0.5 years); 10 girls (pre 9.4 ± 1.0 years, post 14.1 ± 1.0 years)] performed pulmonary function tests (PFTs) ~5 years ago from an original cohort of 40 children. These 21 children performed PFTs, which included forced vital capacity (FVC) and forced expiratory flow at 50 % FVC (FEF50). Static pressure at 50 % of FVC [Pst(L)50 %] was estimated based on age. Dysanapsis ratio (DR) was calculated [FEF50 × FVC(-1) × Pst(L) 50 % (-1) ]. Maturation status was determined via Tanner stages. Stage of maturation was not different (p > 0.05) between boys and girls (4.2 ± 0.6 stage vs. 3.7 ± 0.7 stage, respectively). FVC and FEF50 increased (p 0.05) from pre- to post-puberty. FEF50 and FVC significantly increased and DR decreased (p puberty for both sexes. Post-puberty, boys had a significantly larger FVC, but FEF50, DR, and FEF50/FVC were not different (p > 0.05) compared to girls. These data suggest that dysanaptic growth occurs during puberty and that it is not different between boys and girls.

Can Preoperative Peak Expiratory Flow Predict Postoperative Pulmonary Complications in Lung Cancer Patients Undergoing Lobectomy?

Directory of Open Access Journals (Sweden)

Kun ZHOU

2017-09-01

Full Text Available Background and objective Postoperative pulmonary complications (PPCs, especially postoperative pneumonia (POP, directly affect the rapid recovery of lung cancer patients after surgery. Peak expiratory flow (PEF can reflect airway patency and cough efficiency. Moreover, cough impairment may lead to accumulation of pulmonary secretions which can increase the risk of PPCs. The aim of this study is to investigate the effect of preoperative PEF on PPCs in patients with lung cancer. Methods Retrospective research was conducted on 433 lung cancer patients who underwent lobectomy at the West China Hospital of Sichuan University from January 2014 to December 2015. The associations between preoperative PEF and PPCs were analyzed based on patients’ basic characteristics and clinical data in hospital. Results Preoperative PEF value in PPCs group (280.93±88.99 L/min was significantly lower than that in non-PPCs group (358.38±93.69 L/min (P320 L/min group (9.4%(P<0.001. Conclusion Preoperative PEF and PPCs are correlated, and PEF may be used as a predictor of PPCs.

Volumetric expiratory high-resolution CT of the lung

International Nuclear Information System (INIS)

Nishino, Mizuki; Hatabu, Hiroto

2004-01-01

We developed a volumetric expiratory high-resolution CT (HRCT) protocol that provides combined inspiratory and expiratory volumetric imaging of the lung without increasing radiation exposure, and conducted a preliminary feasibility assessment of this protocol to evaluate diffuse lung disease with small airway abnormalities. The volumetric expiratory high-resolution CT increased the detectability of the conducting airway to the areas of air trapping (P<0.0001), and added significant information about extent and distribution of air trapping (P<0.0001)

First characterization of the expiratory flow increase technique: method development and results analysis

International Nuclear Information System (INIS)

Maréchal, L; Barthod, C; Jeulin, J C

2009-01-01

This study provides an important contribution to the definition of the expiratory flow increase technique (EFIT). So far, no measuring means were suited to assess the manual EFIT performed on infants. The proposed method aims at objectively defining the EFIT based on the quantification of pertinent cognitive parameters used by physiotherapists when practicing. We designed and realized customized instrumented gloves endowed with pressure and displacement sensors, and the associated electronics and software. This new system is specific to the manoeuvre, to the user and innocuous for the patient. Data were collected and analysed on infants with bronchiolitis managed by an expert physiotherapist. The analysis presented is realized on a group of seven subjects (mean age: 6.1 months, SD: 1.1; mean chest circumference: 44.8 cm, SD: 1.9). The results are consistent with the physiotherapist's tactility. In spite of inevitable variability due to measurements on infants, repeatable quantitative data could be reported regarding the manoeuvre characteristics: the magnitudes of displacements do not exceed 10 mm on both hands; the movement of the thoracic hand is more vertical than the movement of the abdominal hand; the maximum applied pressure with the thoracic hand is about twice higher than with the abdominal hand; the thrust of the manual compression lasts (590 ± 62) ms. Inter-operators measurements are in progress in order to generalize these results

The effects of smokeless cookstoves on peak expiratory flow rates in rural Honduras.

Science.gov (United States)

Rennert, W P; Porras Blanco, R M; Muniz, G B

2015-09-01

The use of biomass fuel for cooking in traditional cookstove designs negatively affects respiratory health of communities in developing countries. Indoor pollution affects particularly women and children, who are participating in food preparation. The effects of smokeless cookstove designs on indoor pollution are well documented, but few studies exist to assess the effects of improved stove designs on the respiratory health of community members. This study uses peak expiratory flow rate (PEFR) measurements in a before-and-after format to assess respiratory function of inhabitants of all 30 houses of Buenas Noches in central Honduras. PEFRs are measured before and 6 months after the installation of Justa stoves in people's homes. Health behaviors, respiratory symptoms and fire wood use are evaluated in a door-to-door survey format. A total of 137 eligible women and children between 6 and 14 years participated in the study. PEFR improved by 9.9-18.5% (P < 0.001) depending on the participants' exposure to indoor pollution. Health complaints like cough and behaviors like clinic visits did not change with the introduction of smokeless cookstove technology. Smokeless stoves improve respiratory health in an environment of high levels of indoor pollution. © The Author 2014. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Age group classification and gender detection based on forced expiratory spirometry.

Science.gov (United States)

Cosgun, Sema; Ozbek, I Yucel

2015-08-01

This paper investigates the utility of forced expiratory spirometry (FES) test with efficient machine learning algorithms for the purpose of gender detection and age group classification. The proposed method has three main stages: feature extraction, training of the models and detection. In the first stage, some features are extracted from volume-time curve and expiratory flow-volume loop obtained from FES test. In the second stage, the probabilistic models for each gender and age group are constructed by training Gaussian mixture models (GMMs) and Support vector machine (SVM) algorithm. In the final stage, the gender (or age group) of test subject is estimated by using the trained GMM (or SVM) model. Experiments have been evaluated on a large database from 4571 subjects. The experimental results show that average correct classification rate performance of both GMM and SVM methods based on the FES test is more than 99.3 % and 96.8 % for gender and age group classification, respectively.

An asthma patient with steroid-resistant decrease in peak expiratory flow after the Great East Japan earthquake showing spontaneous recovery after 1 month.

Science.gov (United States)

Yanagimoto, Shintaro; Haida, Michiko; Suko, Matsunobu

2012-01-01

People living in Japan were affected in various ways after the Great East Japan earthquake of March 11, 2011. A 52-year-old female asthma patient not directly affected by the disaster experienced a decrease in peak expiratory flow (PEF) immediately after the earthquake. Despite increasing the inhaled and oral corticosteroid doses, her PEF did not recover. One month later, her PEF level abruptly returned to normal with minimal medications, which were previously ineffective, and the asthma-related symptoms vanished. The stabilization of her state of mind and actual social state seemed to be a part of the reason for the patient's recovery.

Influence Of Number Of Pregnancies In Peak Expiratory Flow And Body Composition Of Pregnant Women

Directory of Open Access Journals (Sweden)

Andrea Carla Brandao da Costa Santos

2017-06-01

Full Text Available Objectives: to describe and compare the mean values of the body composition and the peak expiratory flow (PEF in primigravidae and multigravidae and, to determine its correlation with obstetric, anthropometric and body composition variables. Method: it was performed a cross-sectional study of 120 healthy pregnant women at low risk, including 77 primigravidae and 43 multigravidae. The PEF was measured by spirometry and the body composition by multisegmental electrical impedance. The unpaired t test was used to compare the groups and the Pearson correlation test was used to determine the association between PEF and independent variables. A multiple linear regression was used to estimate the relationship between the dependent variable, the PEF and the independent variables. Results: the body composition variables in multigravidae women showed higher values compared to the primigravidae, being statistically significant, except for fat mass. In primigravidae, the PEF was correlated significantly with maternal age and height. In multigravidae, the PEF was correlated with maternal age, height, pre-pregnancy and current weight, total body water, extracellular water, fat mass, lean mass and fat-free mass. A Multiple linear regression analysis showed that, in primigravidae, height and maternal age were associated with PEF, being responsible for explaining 14.5% of its variability. The current weight and the maternal age explained 42.3% of peak flow variability in multigravidae. Conclusion: The PEF seemed to be influenced by the number of pregnancies. Changes were observed in relation to the body composition, as it was evidenced in correlation with the PEF in multigravidae women. Keywords: Pregnancy. Spirometry. Weight gain.

The longitudinal relationship of work stress with peak expiratory flow: a cohort study.

Science.gov (United States)

Loerbroks, Adrian; Karrasch, Stefan; Lunau, Thorsten

2017-10-01

Research has suggested that psychological stress is associated with reduced lung function and with the development of respiratory disease. Among the major potential sources of stress in adulthood are working conditions. We aimed to examine the relationship of work stress with lung function. We drew on 4-year prospective data from the Survey of Health, Ageing and Retirement in Europe. The analyzed sample comprised 2627 workers aged 50 years or older who were anamnestically free of respiratory disease. Work stress at baseline was operationalized by abbreviated instruments measuring the well-established effort-reward imbalance model (seven items) and the control component of the job-demand control (two items). Peak expiratory flow (PEF) was determined at baseline and at follow-up. Continuous and categorized (i.e., by the tertile) work stress variables were employed in multivariable linear regression models to predict PEF change. Work stress did not show statistically significant associations with PEF change. For instance, the unstandardized regression coefficient for PEF decline according to high versus low effort-reward imbalance was -1.41 (95% confidence interval = -3.75, 0.94). Our study is the first to examine prospective relationships between work stress and PEF. Overall, we did not observe meaningful associations. Future studies should consider a broader spectrum of spirometric parameters and should expand research to younger and possibly less-selected working populations (i.e., aged <50 years).

Potential hazard of the Neopuff T-piece resuscitator in the absence of flow limitation.

LENUS (Irish Health Repository)

Hawkes, C P

2012-01-31

OBJECTIVE: (1) To assess peak inspiratory pressure (PIP), positive end expiratory pressure (PEEP) and maximum pressure relief (P(max)) at different rates of gas flow, when the Neopuff had been set to function at 5 l\\/min. (2) To assess maximum PIP and PEEP at a flow rate of 10 l\\/min with a simulated air leak of 50%. DESIGN: 5 Neopuffs were set to a PIP of 20, PEEP of 5 and P(max) of 30 cm H(2)O at a gas flow of 5 l\\/min. PIP, PEEP and P(max) were recorded at flow rates of 10, 15 l\\/min and maximum flow. Maximum achievable pressures at 10 l\\/min gas flow, with a 50% air leak, were measured. RESULTS: At gas flow of 15 l\\/min, mean PEEP increased to 20 (95% CI 20 to 21), PIP to 28 (95% CI 28 to 29) and the P(max) to 40 cm H(2)O (95% CI 38 to 42). At maximum flow (85 l\\/min) a PEEP of 71 (95% CI 51 to 91) and PIP of 92 cm H(2)O (95% CI 69 to 115) were generated. At 10 l\\/min flow, with an air leak of 50%, the maximum PEEP and PIP were 21 (95% CI 19 to 23) and 69 cm H(2)O (95% CI 66 to 71). CONCLUSIONS: The maximum pressure relief valve is overridden by increasing the rate of gas flow and potentially harmful PIP and PEEP can be generated. Even in the presence of a 50% gas leak, more than adequate pressures can be provided at 10 l\\/min gas flow. We recommend the limitation of gas flow to a rate of 10 l\\/min as an added safety mechanism for this device.

Cystic lung disease: a comparison of cystic size, as seen on expiratory and inspiratory HRCT scans

International Nuclear Information System (INIS)

Lee, Ki Nam; Yoon, Seong Kuk; Nam, Kyung Jin; Choi, Seok Jin; Goo, Jin Mo

2000-01-01

To determine the effects of respiration on the size of lung cysts by comparing inspiratory and expiratory high-resolution CT (HRCT) scans. The authors evaluated the size of cystic lesions, as seen on paired inspiratory and expiratory HRCT scans, in 54 patients with Langerhans cell histiocytosis (n = 3), pulmonary lymphangiomyomatosis (n = 4), confluent centrilobular emphysema (n = 9), paraseptal emphysema and bullae (n = 16), cystic bronchiectasis (n = 13), and honeycombing (n = 9). Using paired inspiratory and expiratory HRCT scans obtained at the corresponding anatomic level, a total of 270 cystic lesions were selected simultaneously on the basis of five lesions per lung disease. Changes in lung cyst size observed during respiration were assessed by two radiologists. In a limited number of cases (n = 11), pathologic specimens were obtained by open lung biopsy or lobectomy. All cystic lesions in patients with Langerhans cell histiocytosis, lymphangiomyomatosis, cystic bronchiectasis, honeycombing, and confluent centrilobular emphysema became smaller on expiration, but in two cases of paraseptal emphysema and bullae there was no change. In cases in which expiratory CT scans indicate that cysts have become smaller, cystic lesions may communicate with the airways. To determine whether, for cysts and cystic lesions, this connection does in fact exist, paired inspiratory and expiratory HRCT scans are necessary

Cystic lung disease: a comparison of cystic size, as seen on expiratory and inspiratory HRCT scans

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Lee, Ki Nam; Yoon, Seong Kuk; Nam, Kyung Jin [Donga University College of Medicine, Pusan (Korea, Republic of); Choi, Seok Jin [Inje University College of Medicine, Gimhae (Korea, Republic of); Goo, Jin Mo [Seoul National University College of Medicine, Seoul (Korea, Republic of)

2000-06-01

To determine the effects of respiration on the size of lung cysts by comparing inspiratory and expiratory high-resolution CT (HRCT) scans. The authors evaluated the size of cystic lesions, as seen on paired inspiratory and expiratory HRCT scans, in 54 patients with Langerhans cell histiocytosis (n = 3), pulmonary lymphangiomyomatosis (n = 4), confluent centrilobular emphysema (n = 9), paraseptal emphysema and bullae (n = 16), cystic bronchiectasis (n = 13), and honeycombing (n = 9). Using paired inspiratory and expiratory HRCT scans obtained at the corresponding anatomic level, a total of 270 cystic lesions were selected simultaneously on the basis of five lesions per lung disease. Changes in lung cyst size observed during respiration were assessed by two radiologists. In a limited number of cases (n = 11), pathologic specimens were obtained by open lung biopsy or lobectomy. All cystic lesions in patients with Langerhans cell histiocytosis, lymphangiomyomatosis, cystic bronchiectasis, honeycombing, and confluent centrilobular emphysema became smaller on expiration, but in two cases of paraseptal emphysema and bullae there was no change. In cases in which expiratory CT scans indicate that cysts have become smaller, cystic lesions may communicate with the airways. To determine whether, for cysts and cystic lesions, this connection does in fact exist, paired inspiratory and expiratory HRCT scans are necessary.

Effect of Training Frequency on Maximum Expiratory Pressure

Science.gov (United States)

Anand, Supraja; El-Bashiti, Nour; Sapienza, Christine

2012-01-01

Purpose: To determine the effects of expiratory muscle strength training (EMST) frequency on maximum expiratory pressure (MEP). Method: We assigned 12 healthy participants to 2 groups of training frequency (3 days per week and 5 days per week). They completed a 4-week training program on an EMST trainer (Aspire Products, LLC). MEP was the primary…

Impact of humidification and nebulization during expiratory limb protection: an experimental bench study.

Science.gov (United States)

Tonnelier, Alexandre; Lellouche, François; Bouchard, Pierre Alexandre; L'Her, Erwan

2013-08-01

Different filtering devices are used during mechanical ventilation to avoid dysfunction of flow and pressure transducers or for airborne microorganisms containment. Water condensates, resulting from the use of humidifiers, but also residual nebulization particles may have a major influence on expiratory limb resistance. To evaluate the influence of nebulization and active humidification on the resistance of expiratory filters. A respiratory system analog was constructed using a test lung, an ICU ventilator, heated humidifiers, and a piezoelectric nebulizer. Humidifiers were connected to different types of circuits (unheated, mono-heated, new-generation and old-generation bi-heated). Five filter types were evaluated: electrostatic, heat-and-moisture exchanger, standard, specific, and internal heated high-efficiency particulate air [HEPA] filter. Baseline characteristics were obtained from each dry filter. Differential pressure measurements were carried out after 24 hours of continuous in vitro use for each condition, and after 24 hours of use with an old-generation bi-heated circuit without nebulization. While using unheated circuits, measurements had to be interrupted before 24 hours for all the filtering devices except the internal heated HEPA filter. The heat-and-moisture exchangers occluded before 24 hours with the unheated and mono-heated circuits. The circuit type, nebulization practice, and duration of use did not influence the internal heated HEPA filter resistance. Expiratory limb filtration is likely to induce several major adverse events. Expiratory filter resistance increase is due mainly to the humidification circuit type, rather than to nebulization. If filtration is mandatory while using an unheated circuit, a dedicated filter should be used for ≤ 24 hours, or a heated HEPA for a longer duration.

COMBINED REDUCED FORCED EXPIRATORY VOLUME IN 1-SECOND (FEV1) AND PERIPHERAL ARTERY DISEASE IN SEDENTARY ELDERS WITH FUNCTIONAL LIMITATIONS

Science.gov (United States)

Vaz Fragoso, Carlos A.; Hsu, Fang-Chi; Brinkley, Tina; Church, Timothy; Liu, Christine K.; Manini, Todd; Newman, Anne B.; Stafford, Randall S.; McDermott, Mary M.; Gill, Thomas M.

2014-01-01

Objectives Because they are potentially modifiable and may coexist, we evaluated the combined occurrence of a reduced forced expiratory volume in 1-second (FEV1) and peripheral artery disease (PAD), including its association with exertional symptoms, physical inactivity, and impaired mobility, in sedentary elders with functional limitations. Design Cross-sectional. Setting Lifestyle Interventions and Independence in Elder (LIFE) Study. Participants 1307 sedentary community-dwelling persons, mean age 78.9, with functional limitations (Short Physical Performance Battery [SPPB] the San Diego Claudication Questionnaire. Physical inactivity was evaluated by percent of accelerometry wear-time with activity the 400MWT (gait-speed The two combined conditions were associated with exertional dyspnea (adjusted odds ratio [adjOR] 2.59 [1.20, 5.60]) and slow gait-speed (adjOR 3.15 [1.72, 5.75]) but not with exertional leg symptoms, high sedentary-time, and moderate-to-severe mobility impairment. Conclusions In sedentary community-dwelling elders with functional limitations, a reduced FEV1 and PAD frequently coexisted and, in combination, were strongly associated with exertional dyspnea and slow gait-speed (a frailty indicator that increases the risk of deleterious outcomes). PMID:24973990

The effect of positive end-expiratory pressure on pulse pressure ...

African Journals Online (AJOL)

The effect of positive end-expiratory pressure on pulse pressure variation. FJ Smith, M Geyser, I Schreuder, PJ Becker. Abstract. Objectives: To determine the effect of different levels of positive end-expiratory pressure (PEEP) on pulse pressure variation (PPV). Design: An observational study. Setting: Operating theatres of a ...

Inspiratory and expiratory HRCT findings in healthy smokers' lung

International Nuclear Information System (INIS)

Park, Hyeon Seon; Kwak, Byung Kook; Choi, Chi Hoon; Yang, Keun Mung; Lee, Chang Joon; Joo, Dong Il; Kim, Yang Soo

1998-01-01

The purpose of this study is to evaluate the lung changes in healthy smokers, as seen on inspiratory and expiratory high-resolution computed tomography (HRCT). Twenty-seven healthy smokers (light smokers, below 20 pack-years, n=16; heavy smokers, above 20 pack-years, n=11) and 25 nonsmokers underwent inspiratory and expiratory HRCT. All healthy smokers had normal pulmonary function and chest radiography. Parenchymal and subpleural micronodules, ground-glass attenuation, centrilobular and paraseptal emphysema, bronchial wall thickening, bronchiectasis and septal line were evaluated on inspiratory scan and by air-trapping on expiratory scan. According to the findings of HRCT, heavy smokers and higher frequency of parenchymal micronodules, ground-glass attenuation, centrilobular and paraseptal emphysema, and air-trapping than nonsmokers and light smokers. (author). 13 refs., 1 tab., 4 figs

Difficulty in obtaining peak expiratory flow measurements in children with acute asthma.

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Gorelick, Marc H; Stevens, Molly W; Schultz, Theresa; Scribano, Philip V

2004-01-01

To determine the frequency with which children >or=6 years with acute asthma can perform peak expiratory flow rate measurements (PEFR) in an emergency department (ED). Data were obtained from a prospective cohort study of children with acute asthma. All children (age 2-18 years old) treated in an urban pediatric ED for an acute exacerbation during randomly selected days over a 12-month period were prospectively evaluated. According to treatment protocols, PEFR was to be measured in all children age 6 years and older before therapy and after each treatment with inhaled bronchodilators. Registered respiratory therapists obtained PEFR and evaluated whether patients were able to perform the maneuver adequately. Four hundred and fifty-six children, 6 to 18 years old (median 10 years), were enrolled; 291 (64%) had PEFR measured at least once. Of those in whom PEFR was attempted at least once, only 190 (65%) were able to perform adequately. At the start of therapy, 54% (142/262) were able to perform PEFR. Of the 120 who were unable to perform initially, 76 had another attempt at the end of the ED treatment, and 55 (72%) were still unable to perform. A total of 149 patients had attempts at PEFR both at the start and end of treatment, of these, only 71 (48%) provided valid information on both attempts. Patients unable to perform PEFR were younger (mean +/- SD = 8.7 +/- 2.8 years) than those who were able to perform successfully (11.2 +/- 3.2 years) and those with no attempts (10.0 +/- 3.4 years). Children admitted to the hospital were more likely to be unable to perform PEFR (58/126 = 46%) than those discharged from the ED (43/330 = 13%, P < 0.0001). Adequate PEFR measurements are difficult to obtain in children with acute asthma. Treatment and research protocols cannot rely exclusively on PEFR for evaluation of severity.

Interaction between intra-abdominal pressure and positive-end expiratory pressure

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Jamili Anbar Torquato

2009-02-01

Full Text Available OBJECTIVE: The aim of this study was to quantify the interaction between increased intra-abdominal pressure and Positive-End Expiratory Pressure. METHODS: In 30 mechanically ventilated ICU patients with a fixed tidal volume, respiratory system plateau and abdominal pressure were measured at a Positive-End Expiratory Pressure level of zero and 10 cm H2O. The measurements were repeated after placing a 5 kg weight on the patients' belly. RESULTS: After the addition of 5 kg to the patients' belly at zero Positive-End Expiratory Pressure, both intra-abdominal pressure (p<0.001 and plateau pressures (p=0.005 increased significantly. Increasing the Positive-End Expiratory Pressure levels from zero to 10 cm H2O without weight on the belly did not result in any increase in intra-abdominal pressure (p=0.165. However, plateau pressures increased significantly (p< 0.001. Increasing Positive-End Expiratory Pressure from zero to 10 cm H2O and adding 5 kg to the belly increased intra-abdominal pressure from 8.7 to 16.8 (p<0.001 and plateau pressure from 18.26 to 27.2 (p<0.001. Maintaining Positive-End Expiratory Pressure at 10 cm H2O and placing 5 kg on the belly increased intra-abdominal pressure from 12.3 +/- 1.7 to 16.8 +/- 1.7 (p<0.001 but did not increase plateau pressure (26.6+/-1.2 to 27.2 +/-1.1 -p=0.83. CONCLUSIONS: The addition of a 5kg weight onto the abdomen significantly increased both IAP and the airway plateau pressure, confirming that intra-abdominal hypertension elevates the plateau pressure. However, plateau pressure alone cannot be considered a good indicator for the detection of elevated intra-abdominal pressure in patients under mechanical ventilation using PEEP. In these patients, the intra-abdominal pressure must also be measured.

Penrose limits and RG flows

International Nuclear Information System (INIS)

Gimon, Eric G.; Sonnenschein, Jacob; Pando Zayas, Leopoldo A.

2002-01-01

The Penrose-Gueven limit simplifies a given supergravity solution into a pp-wave background. Aiming at clarifying its relation to renormalization group flow we study the Penrose-Guven limit of supergravity backgrounds that are dual to non-conformal gauge theories. The resulting backgrounds fall in a class simple enough that the quantum particle is exactly solvable. We propose a map between the effective time-dependent quantum mechanical problem and the RG flow in the gauge theory. As a testing ground we consider explicitly two Penrose limits of the infrared fixed point of the Pilch-Warner solution. We analyze the corresponding gauge theory picture and write down the operators which are the duals of the low lying string states. We also address RG flows of a different nature by considering the Penrose-Gueven limit of a stack of N D p branes. We note that in the far IR (for p<3)the limit generically has negative mass-squared. This phenomenon signals, in the world sheet picture, the necessity to transform to another description. In this regard, we consider explicitly the cases of M2 from D2 and F1 from D1. (author)

Short-term effects of positive expiratory airway pressure in patients being weaned from mechanical ventilation

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Marcelo de Mello Rieder

2009-05-01

Full Text Available OBJECTIVE: To investigate the feasibility and the cardiorespiratory effects of using positive expiratory airway pressure, a physiotherapeutic tool, in comparison with a T-tube, to wean patients from mechanical ventilation. METHODS/DESIGN: A prospective, randomized, cross-over study. SETTING: Two intensive care units. PATIENTS AND INTERVENTIONS: We evaluated forty patients who met weaning criteria and had been mechanically-ventilated for more than 48 hours, mean age 59 years, including 23 males. All patients were submitted to the T-tube and Expiratory Positive Airway Pressure devices, at 7 cm H2O, during a 30-minute period. Cardiorespiratory variables including work of breathing, respiratory rate (rr, peripheral oxygen saturation (SpO2, heart rate (hr, systolic, diastolic and mean arterial pressures (SAP, DAP, MAP were measured in the first and thirtieth minutes. The condition was analyzed as an entire sample set (n=40 and was also divided into subconditions: chronic obstructive pulmonary disease (n=14 and non-chronic obstructive pulmonary disease (non- chronic obstructive pulmonary disease (n=26 categories. Comparisons were made using a t-test and Analysis of Variance. The level of significance was p < 0.05. RESULTS: Our data showed an increase in work of breathing in the first and thirtieth minutes in the EPAP condition (0.86+ 0.43 and 1.02+1.3 as compared with the T-tube condition (0.25+0.26 and 0.26+0.35 (p<0.05, verified by the flow-sensor monitor (values in J/L. No statistical differences were observed when comparing the Expiratory Positive Airway Pressure and T-tube conditions with regard to cardiorespiratory measurements. The same result was observed for both chronic obstructive pulmonary disease and non- chronic obstructive pulmonary disease subconditions. CONCLUSIONS: Our study demonstrated that, in weaning patients from mechanical ventilation, the use of a fixed level of Expiratory Positive Airway Pressure caused an increase in work of

Diffusion-limited mixing by incompressible flows

Science.gov (United States)

Miles, Christopher J.; Doering, Charles R.

2018-05-01

Incompressible flows can be effective mixers by appropriately advecting a passive tracer to produce small filamentation length scales. In addition, diffusion is generally perceived as beneficial to mixing due to its ability to homogenize a passive tracer. However we provide numerical evidence that, in cases where advection and diffusion are both actively present, diffusion may produce negative effects by limiting the mixing effectiveness of incompressible optimal flows. This limitation appears to be due to the presence of a limiting length scale given by a generalised Batchelor length (Batchelor 1959 J. Fluid Mech. 5 113–33). This length scale limitation may in turn affect long-term mixing rates. More specifically, we consider local-in-time flow optimisation under energy and enstrophy flow constraints with the objective of maximising the mixing rate. We observe that, for enstrophy-bounded optimal flows, the strength of diffusion may not impact the long-term mixing rate. For energy-constrained optimal flows, however, an increase in the strength of diffusion can decrease the mixing rate. We provide analytical lower bounds on mixing rates and length scales achievable under related constraints (point-wise bounded speed and rate-of-strain) by extending the work of Lin et al (2011 J. Fluid Mech. 675 465–76) and Poon (1996 Commun. PDE 21 521–39).

Parameters affecting the tidal volume during expiratory abdominal compression in patients with prolonged tracheostomy mechanical ventilation.

Science.gov (United States)

Morino, Akira; Shida, Masahiro; Tanaka, Masashi; Sato, Kimihiro; Seko, Toshiaki; Ito, Shunsuke; Ogawa, Shunichi; Takahashi, Naoaki

2015-07-01

[Purpose] The aim of this study was to clarify physical parameters affecting the tidal volume during expiratory abdominal compression in patients with prolonged tracheostomy mechanical ventilation. [Methods] Eighteen patients with prolonged mechanical ventilation were included in this study. Expiratory abdominal compression was performed on patients lying in a supine position. The abdomen above the navel was vertically compressed in synchronization with expiration and released with inspiration. We measured the tidal volume during expiratory abdominal compression. [Results] The mean tidal volume during expiratory abdominal compression was higher than that at rest (430.6 ± 127.1 mL vs. 344.0 ± 94.3 mL). The tidal volume during expiratory abdominal compression was correlated with weight, days of ventilator support, dynamic compliance and abdominal expansion. Stepwise multiple regression analysis revealed that weight (β = 0.499), dynamic compliance (β = 0.387), and abdominal expansion (β = 0.365) were factors contributing to the tidal volume during expiratory abdominal compression. [Conclusion] Expiratory abdominal compression increased the tidal volume in patients with prolonged tracheostomy mechanical ventilation. The tidal volume during expiratory abdominal compression was influenced by each of the pulmonary conditions and the physical characteristics.

Impact of expiratory strength training in amyotrophic lateral sclerosis.

Science.gov (United States)

Plowman, Emily K; Watts, Stephanie A; Tabor, Lauren; Robison, Raele; Gaziano, Joy; Domer, Amanda S; Richter, Joel; Vu, Tuan; Gooch, Clifton

2016-06-01

We evaluated the feasibility and impact of expiratory muscle strength training (EMST) on respiratory and bulbar function in persons with amyotrophic lateral sclerosis (ALS). Twenty-five ALS patients participated in this delayed intervention open-label clinical trial. Following a lead-in period, patients completed a 5-week EMST protocol. Outcome measures included: maximum expiratory pressure (MEP); physiologic measures of swallow and cough; and penetration-aspiration scale (PAS) scores. Of participants who entered the active phase of the study (n = 15), EMST was well tolerated and led to significant increases in MEPs and maximum hyoid displacement during swallowing post-EMST (P < 0.05). No significant differences were observed for PAS scores or cough spirometry measures. EMST was feasible and well tolerated in this small cohort of ALS patients and led to improvements in expiratory force-generating pressures and swallow kinematics. Further investigation is warranted to confirm these preliminary findings. Muscle Nerve 54: 48-53, 2016. Published 2015. This article is a U.S. Government work and is in the public domain in the USA.

Peak expiratory flow mediates the relationship between handgrip strength and timed up and go performance in elderly women, but not men.

Science.gov (United States)

Ritti-Dias, Raphael Mendes; Cucato, Gabriel Grizzo; de Mello Franco, Fábio Gazelato; Cendoroglo, Maysa Seabra; Nasri, Fábio; Monteiro-Costa, Maria Luiza; de Carvalho, José Antonio Maluf; de Matos, Luciana Diniz Nagem Janot

2016-09-01

The aim of the present study was to verify if there is sex difference in the associations among handgrip strength, peak expiratory flow (PEF) and timed up and go (TUG) test results. The sample included 288 consecutive elderly men (n=93) and women (n=195). Functional capacity was measured using the TUG test, and muscle strength was measured based on handgrip. Moreover, as a measure of current health status, PEF was evaluated. Linear regression procedures were performed to analyze the relationships between handgrip and both PEF and TUG test results, with adjustment for confounders, and to identify the possible mediating role of PEF in the association between handgrip strength and TUG test results. In men, handgrip strength was associated with both PEF and TUG performance (prelationship between handgrip strength and TUG performance remained significant. In women, handgrip strength was also associated with both PEF and TUG performance (prelationship between handgrip strength and TUG performance was no longer significant. Mobility in the elderly is sex dependent. In particular, PEF mediates the relationship between handgrip strength and TUG performance in women, but not in men.

Computer quantification of “angle of collapse” on maximum expiratory flow volume curve for diagnosing asthma-COPD overlap syndrome

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Wang W

2016-12-01

Full Text Available Wei Wang, Mengshuang Xie, Shuang Dou, Liwei Cui, Wei Xiao Department of Pulmonary Medicine, Qilu Hospital, Shandong University, Jinan, People’s Republic of China Background: In a previous study, we demonstrated that asthma patients with signs of emphysema on quantitative computed tomography (CT fulfill the diagnosis of asthma-COPD overlap syndrome (ACOS. However, quantitative CT measurements of emphysema are not routinely available for patients with chronic airway disease, which limits their application. Spirometry was a widely used examination tool in clinical settings and shows emphysema as a sharp angle in the maximum expiratory flow volume (MEFV curve, called the “angle of collapse (AC”. The aim of this study was to investigate the value of the AC in the diagnosis of emphysema and ACOS. Methods: This study included 716 participants: 151 asthma patients, 173 COPD patients, and 392 normal control subjects. All the participants underwent pulmonary function tests. COPD and asthma patients also underwent quantitative CT measurements of emphysema. The AC was measured using computer models based on Matlab software. The value of the AC in the diagnosis of emphysema and ACOS was evaluated using receiver-operating characteristic (ROC curve analysis. Results: The AC of COPD patients was significantly lower than that of asthma patients and control subjects. The AC was significantly negatively correlated with emphysema index (EI; r=-0.666, P<0.001, and patients with high EI had a lower AC than those with low EI. The ROC curve analysis showed that the AC had higher diagnostic efficiency for high EI (area under the curve =0.876 than did other spirometry parameters. In asthma patients, using the AC ≤137° as a surrogate criterion for the diagnosis of ACOS, the sensitivity and specificity were 62.5% and 89.1%, respectively. Conclusion: The AC on the MEFV curve quantified by computer models correlates with the extent of emphysema. The AC may become a

An expiratory assist during spontaneous breathing can compensate for endotracheal tube resistance.

Science.gov (United States)

Uchiyama, Akinori; Chang, Cheng; Suzuki, Shinya; Mashimo, Takashi; Fujino, Yuji

2009-08-01

Although inspiratory assist of spontaneous breathing in intubated patients is common, expiratory assist functions have rarely been reported. Effective expiratory support (ES) could be used to compensate for endotracheal tube (ETT) resistance during spontaneous breathing. In this study, we examined the performance of a new system designed to provide both inspiratory support (IS) and ES during spontaneous breathing with the goal of reducing the effective resistance of the ETT. The ES system consisted of a ventilator demand valve and a computer-controlled piston cylinder, which aspirated gas from the respiratory circuit during the expiratory phase. The movement of the piston was synchronized with spontaneous breathing. We compared the pressures at the tip of the ETT and in the breathing circuit during spontaneous breathing through an ETT of internal diameter (ID) 5 mm with that of an ETT with ID 8 mm in nine healthy adult male volunteers. The ventilatory mode was set to maintain a continuous airway pressure of 0 cm H(2)O. Three ventilator settings (no support, IS only, and IS plus ES) were compared using ID 5 mm ETT. We monitored pressure in the breathing circuit (P(aw)), ETT tip pressure (P(tip)), and respiratory flow. The P(tip) of the ID 5 mm ETT showed a large negative deflection during inspiration and a positive deflection during expiration without support. IS alone did not improve the respiratory pattern through the small ETT. However, IS plus ES resulted in negative P(aw) during expiration in addition to positive deflection of P(aw) during inspiration, making the pressure characteristics of P(tip) similar to those of ID 8 mm ETT. Moreover, IS plus ES produced a respiratory pattern through the ID 5 mm ETT that was similar to that through the ID 8 mm ETT. In this study of healthy volunteers, IS plus ES compensated for the airway resistance imposed by a ID 5.0 mm ETT to create pressure changes at the tip of the ETT similar to those of an ID 8.0 mm ETT.

UV DRIVEN EVAPORATION OF CLOSE-IN PLANETS: ENERGY-LIMITED, RECOMBINATION-LIMITED, AND PHOTON-LIMITED FLOWS

International Nuclear Information System (INIS)

Owen, James E.; Alvarez, Marcelo A.

2016-01-01

We have investigated the evaporation of close-in exoplanets irradiated by ionizing photons. We find that the properties of the flow are controlled by the ratio of the recombination time to the flow timescale. When the recombination timescale is short compared to the flow timescale, the flow is in approximate local ionization equilibrium with a thin ionization front where the photon mean free path is short compared to the flow scale. In this “recombination-limited” flow the mass-loss scales roughly with the square root of the incident flux. When the recombination time is long compared to the flow timescale the ionization front becomes thick and encompasses the entire flow with the mass-loss rate scaling linearly with flux. If the planet's potential is deep, then the flow is approximately “energy-limited”; however, if the planet's potential is shallow, then we identify a new limiting mass-loss regime, which we term “photon-limited.” In this scenario, the mass-loss rate is purely limited by the incoming flux of ionizing photons. We have developed a new numerical approach that takes into account the frequency dependence of the incoming ionizing spectrum and performed a large suite of 1D simulations to characterize UV driven mass-loss around low-mass planets. We find that the flow is “recombination-limited” at high fluxes but becomes “energy-limited” at low fluxes; however, the transition is broad occurring over several orders of magnitude in flux. Finally, we point out that the transitions between the different flow types do not occur at a single flux value but depend on the planet's properties, with higher-mass planets becoming “energy-limited” at lower fluxes

Counter-current flow limited CHF in thin rectangular channels

International Nuclear Information System (INIS)

Cheng, L.Y.

1990-01-01

An analytical expression for counter-current-flow-limitation (CCFL) was used to predict critical heat flux (CHF) for downward flow in thin vertical rectangular channels which are prototypes of coolant channels in test and research nuclear reactors. Top flooding is the mechanism for counter-current flow limited CHF. The CCFL correlation also was used to determine the circulation and flooding-limited CHF. Good agreements were observed between the period the model predictions and data on the CHF for downflow. The minimum CHF for downflow is lower than the flooding-limited CHF and it is predicted to occur at a liquid flow rate higher than that at the flooding limit. 17 refs., 7 figs

Calculation of the capnographic index based on expiratory molar mass-volume-curves--a suitable tool to screen for cystic fibrosis lung disease.

Science.gov (United States)

Fuchs, Susanne I; Junge, Sibylle; Ellemunter, Helmut; Ballmann, Manfred; Gappa, Monika

2013-05-01

Volumetric capnography reflecting the course of CO2-exhalation is used to assess ventilation inhomogeneity. Calculation of the slope of expiratory phase 3 and the capnographic index (KPIv) from expirograms allows quantification of extent and severity of small airway impairment. However, technical limitations have hampered more widespread use of this technique. Using expiratory molar mass-volume-curves sampled with a handheld ultrasonic flow sensor during tidal breathing is a novel approach to extract similar information from expirograms in a simpler manner possibly qualifying as a screening tool for clinical routine. The aim of the present study was to evaluate calculation of the KPIv based on molar mass-volume-curves sampled with an ultrasonic flow sensor in patients with CF and controls by assessing feasibility, reproducibility and comparability with the Lung Clearance Index (LCI) derived from multiple breath washout (MBW) used as the reference method. Measurements were performed in patients with CF and healthy controls during a single test occasion using the EasyOne Pro, MBW Module (ndd Medical Technologies, Switzerland). Capnography and MBW were performed in 87/96 patients with CF and 38/42 controls, with a success rate of 90.6% for capnography. Mean age (range) was 12.1 (4-25) years. Mean (SD) KPIv was 6.94 (3.08) in CF and 5.10 (2.06) in controls (p=0.001). Mean LCI (SD) was 8.0 (1.4) in CF and 6.2 (0.4) in controls (p=molar mass-volume-curves is feasible. KPIv is significantly different between patients with CF and controls and correlates with the LCI. However, individual data revealed a relevant overlap between patients and controls requiring further evaluation, before this method can be recommended for clinical use. Copyright © 2012 European Cystic Fibrosis Society. Published by Elsevier B.V. All rights reserved.

Analysis and design of flow limiter used in steam generator

International Nuclear Information System (INIS)

Liu Shixun; Gao Yongjun

1995-10-01

Flow limiter is an important safety component of PWR steam generator. It can limit the blowdown rate of steam generator inventory in case of the main steam pipeline breaks, so that the rate of the primary coolant temperature reduction can be slowed down in order to prevent fuel element from burn-out. The venturi type flow limiter is analysed, its flow characteristics are delineated, physical and mathematical models defined; the detail mathematical derivation provided. The research lays down a theoretic basis for flow limiter design. The governing equations and formulas given can be directly applied to computer analysis of the flow limiter. (3 refs., 3 figs.)

The Neopuff's PEEP valve is flow sensitive.

LENUS (Irish Health Repository)

Hawkes, Colin Patrick

2011-03-01

The current recommendation in setting up the Neopuff is to use a gas flow of 5-15 L\\/min. We investigated if the sensitivity of the positive end expiratory pressure (PEEP) valve varies at different flow rates within this range.

factors influencing peak expiratory flow in teenage boys

African Journals Online (AJOL)

smoked. Regression analysis suggested peak flow differenct.s ... Medical Research Council Centre for Molecular and Cellular Biology, Department ... J leasure of lung function and a tool for asthma management.'.2 ... by the subjects were assigned a numerical value based on how .... Our data differ marginally from data.

variations of peak expiratory flow rate with anthropometric

African Journals Online (AJOL)

admin

Decreased bronchomotor tone would lead to a fall in airway resistance, and hence increased flow rate of air along it. Tests of. PEFR reflect changes in airway calibers. (Hughes and Empey, 1981). There have been reports on the variations of various ventilatory parameters with anthropometric determinants in. Nigerians.

Inspiratory and expiratory computed tomographic volumetry for lung volume reduction surgery.

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Morimura, Yuki; Chen, Fengshi; Sonobe, Makoto; Date, Hiroshi

2013-06-01

Three-dimensional (3D) computed tomographic (CT) volumetry has been introduced into the field of thoracic surgery, and a combination of inspiratory and expiratory 3D-CT volumetry provides useful data on regional pulmonary function as well as the volume of individual lung lobes. We report herein a case of a 62-year-old man with severe emphysema who had undergone lung volume reduction surgery (LVRS) to assess this technique as a tool for the evaluation of regional lung function and volume before and after LVRS. His postoperative pulmonary function was maintained in good condition despite a gradual slight decrease 2 years after LVRS. This trend was also confirmed by a combination of inspiratory and expiratory 3D-CT volumetry. We confirm that a combination of inspiratory and expiratory 3D-CT volumetry might be effective for the preoperative assessment of LVRS in order to determine the amount of lung tissue to be resected as well as for postoperative evaluation. This novel technique could, therefore, be used more widely to assess local lung function.

Effects of nasal positive expiratory pressure on dynamic hyperinflation and 6-minute walk test in patients with COPD.

Science.gov (United States)

Wibmer, Thomas; Rüdiger, Stefan; Heitner, Claudia; Kropf-Sanchen, Cornelia; Blanta, Ioanna; Stoiber, Kathrin M; Rottbauer, Wolfgang; Schumann, Christian

2014-05-01

Dynamic hyperinflation is an important target in the treatment of COPD. There is increasing evidence that positive expiratory pressure (PEP) could reduce dynamic hyperinflation during exercise. PEP application through a nasal mask and a flow resistance device might have the potential to be used during daily physical activities as an auxiliary strategy of ventilatory assistance. The aim of this study was to determine the effects of nasal PEP on lung volumes during physical exercise in patients with COPD. Twenty subjects (mean ± SD age 69.4 ± 6.4 years) with stable mild-to-severe COPD were randomized to undergo physical exercise with nasal PEP breathing, followed by physical exercise with habitual breathing, or vice versa. Physical exercise was induced by a standard 6-min walk test (6 MWT) protocol. PEP was applied by means of a silicone nasal mask loaded with a fixed-orifice flow resistor. Body plethysmography was performed immediately pre-exercise and post-exercise. Differences in mean pre- to post-exercise changes in total lung capacity (-0.63 ± 0.80 L, P = .002), functional residual capacity (-0.48 ± 0.86 L, P = .021), residual volume (-0.56 ± 0.75 L, P = .004), S(pO2) (-1.7 ± 3.4%, P = .041), and 6 MWT distance (-30.8 ± 30.0 m, P = .001) were statistically significant between the experimental and the control interventions. The use of flow-dependent expiratory pressure, applied with a nasal mask and a PEP device, might promote significant reduction of dynamic hyperinflation during walking exercise. Further studies are warranted addressing improvements in endurance performance under regular application of nasal PEP during physical activities.

Diagnostic methods to assess inspiratory and expiratory muscle strength

Directory of Open Access Journals (Sweden)

Pedro Caruso

2015-04-01

Full Text Available Impairment of (inspiratory and expiratory respiratory muscles is a common clinical finding, not only in patients with neuromuscular disease but also in patients with primary disease of the lung parenchyma or airways. Although such impairment is common, its recognition is usually delayed because its signs and symptoms are nonspecific and late. This delayed recognition, or even the lack thereof, occurs because the diagnostic tests used in the assessment of respiratory muscle strength are not widely known and available. There are various methods of assessing respiratory muscle strength during the inspiratory and expiratory phases. These methods are divided into two categories: volitional tests (which require patient understanding and cooperation; and non-volitional tests. Volitional tests, such as those that measure maximal inspiratory and expiratory pressures, are the most commonly used because they are readily available. Non-volitional tests depend on magnetic stimulation of the phrenic nerve accompanied by the measurement of inspiratory mouth pressure, inspiratory esophageal pressure, or inspiratory transdiaphragmatic pressure. Another method that has come to be widely used is ultrasound imaging of the diaphragm. We believe that pulmonologists involved in the care of patients with respiratory diseases should be familiar with the tests used in order to assess respiratory muscle function.Therefore, the aim of the present article is to describe the advantages, disadvantages, procedures, and clinical applicability of the main tests used in the assessment of respiratory muscle strength.

Changes in forced expiratory volume in 1 second over time in COPD

DEFF Research Database (Denmark)

Vestbo, Jørgen; Edwards, Lisa D; Scanlon, Paul D

2011-01-01

A key feature of chronic obstructive pulmonary disease (COPD) is an accelerated rate of decline in forced expiratory volume in 1 second (FEV(1)), but data on the variability and determinants of this change in patients who have established disease are scarce.......A key feature of chronic obstructive pulmonary disease (COPD) is an accelerated rate of decline in forced expiratory volume in 1 second (FEV(1)), but data on the variability and determinants of this change in patients who have established disease are scarce....

Ventilatory responses to exercise training in obese adolescents.

Science.gov (United States)

Mendelson, Monique; Michallet, Anne-Sophie; Estève, François; Perrin, Claudine; Levy, Patrick; Wuyam, Bernard; Flore, Patrice

2012-10-15

The aim of this study was to examine ventilatory responses to training in obese adolescents. We assessed body composition, pulmonary function and ventilatory responses (among which expiratory flow limitation and operational lung volumes) during progressive cycling exercise in 16 obese adolescents (OB) before and after 12 weeks of exercise training and in 16 normal-weight volunteers. As expected, obese adolescents' resting expiratory reserve volume was lower and inversely correlated with thoraco-abdominal fat mass (r = -0.74, p<0.0001). OB presented lower end expiratory (EELV) and end inspiratory lung volumes (EILV) at rest and during submaximal exercise, and modest expiratory flow limitation. After training, OB increased maximal aerobic performance (+19%) and maximal inspiratory pressure (93.7±31.4 vs. 81.9±28.2 cm H2O, +14%) despite lack of decrease in trunk fat and body weight. Furthermore, EELV and EILV were greater during submaximal exercise (+11% and +9% in EELV and EILV, respectively), expiratory flow limitation delayed but was not accompanied by increased V(T). However, submaximal exertional symptoms (dyspnea and leg discomfort) were significantly decreased (-71.3% and -70.7%, respectively). Our results suggest that exercise training can improve pulmonary function at rest (static inspiratory muscle strength) and exercise (greater operating lung volumes and delayed expiratory flow limitation) but these modifications did not entirely account for improved dyspnea and exercise performance in obese adolescents. Copyright © 2012 Elsevier B.V. All rights reserved.

Some infant ventilators do not limit peak inspiratory pressure reliably during active expiration.

Science.gov (United States)

Kirpalani, H; Santos-Lyn, R; Roberts, R

1988-09-01

In order to minimize barotrauma in newborn infants with respiratory failure, peak inspiratory pressures should not exceed those required for adequate gas exchange. We examined whether four commonly used pressure-limited, constant flow ventilators limit pressure reliably during simulated active expiration against the inspiratory stroke of the ventilator. Three machines of each type were tested at 13 different expiratory flow rates (2 to 14 L/min). Flow-dependent pressure overshoot above a dialed pressure limit of 20 cm H2O was observed in all machines. However, the magnitude differed significantly between ventilators from different manufacturers (p = .0009). Pressure overshoot above 20 cm H2O was consistently lowest in the Healthdyne (0.8 cm H2O at 2 L/min, 3.6 cm H2O at 14 L/min) and highest in the Bourns BP200 (3.0 cm H2O at 2 L/min, 15.4 cm H2O at 14 L/min). We conclude that peak inspiratory pressure overshoots on pressure-limited ventilators occur during asynchronous expiration. This shortcoming may contribute to barotrauma in newborn infants who "fight" positive-pressure ventilation.

The limiting current in a one-dimensional situation: Transition from a space charge limited to magnetically limited flow

International Nuclear Information System (INIS)

Kumar, Raghwendra; Biswas, Debabrata

2008-01-01

For a nonrelativistic electron beam propagating in a cylindrical drift tube, it is shown that the limiting current density does not saturate to the electrostatic one-dimensional (1D) estimate with increasing beam radius. Fully electromagnetic particle-in-cell (PIC) simulation studies show that beyond a critical aspect ratio, the limiting current density is lower than the 1D electrostatic prediction. The lowering in the limiting current density is found to be due to the transition from the space charge limited to magnetically limited flow. An adaptation of Alfven's single particle trajectory method is used to estimate the magnetically limited current as well as the critical radius beyond which the flow is magnetically limited in a drift tube. The predictions are found to be in close agreement with PIC simulations

Focal airtrapping at expiratory high-resolution CT: comparison with pulmonary function tests

International Nuclear Information System (INIS)

Kauczor, H.U.; Hast, J.; Heussel, C.P.; Mildenberger, P.; Thelen, M.; Schlegel, J.

2000-01-01

This study was undertaken to determine prevalence, extent, and severity of focal airtrapping at expiratory high-resolution CT, and to compare focal airtrapping with age, gender, pulmonary function tests, and blood gas analysis. Two-hundred seventeen patients with and without pulmonary disease underwent paired inspiratory/expiratory high-resolution CT. Six scan pairs with corresponding scan levels were visually assessed for focal - not diffuse - airtrapping using a four-point scale. Pulmonary function tests and blood gas analysis were available for correlation in all patients (mean interval 5 days). Focal airtrapping with lower lung predominance was observed in 80 % of patients. Twenty-six of 26 patients with restrictive lung function impairment exhibited focal airtrapping (mean score 2.4), whereas only 72 of 98 (74 %) patients with obstruction did (mean score 1.5; p < 0.05). Fifty-eight of 70 (83 %) patients with normal lung function (mean score 1.8) and 19 of 23 (83 %) patients with mixed impairment (mean score 1.8) had focal airtrapping. Focal airtrapping showed negative correlations with static lung volumes (-0.27 to -0.37; p < 0.001) in all patients and moderate positive correlations with dynamic parameters (0.3-0.4; p < 0.001) in patients with obstruction. No significant correlations were found with age, gender, and blood gas analysis. Visual assessment of focal - not diffuse - airtrapping at expiratory high-resolution CT does not correlate with physiological evidence of obstruction as derived from pulmonary function tests since the perception of focal airtrapping requires an adequate expiratory increase in lung density. (orig.)

Study of Peak Expiratory Flow Rate as the Assessment of Lung Function in Occupationally Exposed Petrol Pump Workers of Western Maharashtra

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Patil Smita V

2016-04-01

Full Text Available Background: Fast urbanization trends, rapid industrial growth, globalization, and poor environmental conditions at work places have created a lot of healthrelated issues. Aim and Objectives: The aim of this study is to investigate Peak Expiratory Flow Rate (PEFR as the assessment of lung function in occupationally exposed petrol pump workers and also check whether PEFR increases or decreases with duration of exposure. Material and Methods: The study was conducted on 60 male petrol pump workers between age group of 20-40 years who were working as petrol filling attendants for more than one year from western Maharashtra. 50 normal healthy males with same socioeconomic status were chosen as controls to find out the effect of occupational exposure to petroleum product on PEFR as the assessment of lung function tests. Petrol pump workers were divided into three groups based on their duration of exposure i.e. 1- 5 yrs, 6- 10 yrs and more than 11 years. PEFR of petrol pump workers and control was measured by using a Mini Wright peak flow meter which is a portable device for measuring ventilator functions. Comparisons was done using unpaired t-test for 2 groups comparisons and one way ANOVAfor multiple groups of exposures. Results: The PEFR was significantly lower decrease (p=0.001 around petrol pump workers (389.17 as compared to control (534.2. As year of exposure increased mean value of PEFR was significantly decreased from 452.17, 378.00 and 283.64 respectively in petrol pump workers. Conclusion: The results suggested that respiratory functions i.e. PEFR of occupationally exposed petrol pump workers are significantly reduced as compared to controls, also PEFR is significantly reduced with increase in the duration of exposure.

Correlation of Normal Gravity Mixed Convection Blowoff Limits with Microgravity Forced Flow Blowoff Limits

Science.gov (United States)

Marcum, Jeremy W.; Olson, Sandra L.; Ferkul, Paul V.

2016-01-01

The axisymmetric rod geometry in upward axial stagnation flow provides a simple way to measure normal gravity blowoff limits to compare with microgravity Burning and Suppression of Solids - II (BASS-II) results recently obtained aboard the International Space Station. This testing utilized the same BASS-II concurrent rod geometry, but with the addition of normal gravity buoyant flow. Cast polymethylmethacrylate (PMMA) rods of diameters ranging from 0.635 cm to 3.81 cm were burned at oxygen concentrations ranging from 14 to 18% by volume. The forced flow velocity where blowoff occurred was determined for each rod size and oxygen concentration. These blowoff limits compare favorably with the BASS-II results when the buoyant stretch is included and the flow is corrected by considering the blockage factor of the fuel. From these results, the normal gravity blowoff boundary for this axisymmetric rod geometry is determined to be linear, with oxygen concentration directly proportional to flow speed. We describe a new normal gravity 'upward flame spread test' method which extrapolates the linear blowoff boundary to the zero stretch limit in order to resolve microgravity flammability limits-something current methods cannot do. This new test method can improve spacecraft fire safety for future exploration missions by providing a tractable way to obtain good estimates of material flammability in low gravity.

Evaluation of Pressure Generated by Resistors From Different Positive Expiratory Pressure Devices.

Science.gov (United States)

Fagevik Olsén, Monika; Carlsson, Maria; Olsén, Erik; Westerdahl, Elisabeth

2015-10-01

Breathing exercises with positive expiratory pressure (PEP) are used to improve pulmonary function and airway clearance. Different PEP devices are available, but there have been no studies that describe the pressure generated by different resistors. The purpose of this study was to compare pressures generated from the proprietary resistor components of 4 commercial flow-dependent PEP valves with all other parameters kept constant. Resistors from 4 flow-regulated PEP devices (Pep/Rmt system, Wellspect HealthCare; Pipe P breathing exerciser, Koo Medical Equipment; Mini-PEP, Philips Respironics [including resistors by Rüsch]; and 15-mm endo-adapter, VBM Medizintechnik) were tested randomly by a blinded tester at constant flows of 10 and 18 L/min from an external gas system. All resistors were tested 3 times. Resistors with a similar diameter produced statistically significant different pressures at the same flow. The differences were smaller when the flow was 10 L/min compared with 18 L/min. The differences were also smaller when the diameter of the resistor was increased. The pressures produced by the 4 resistors of the same size were all significantly different when measuring 1.5- and 2.0-mm resistors at a flow of 10 L/min and 2.0-mm resistors at a flow of 18 L/min (P < .001). There were no significant differences between any of the resistors when testing sizes of 4.5 and 5.0 mm at either flow. The Mini-PEP and adapter resistors gave the highest pressures. Pressures generated by the different proprietary resistor components of 4 commercial PEP devices were not comparable, even though the diameter of the resistors is reported to be the same. The pressures generated were significantly different, particularly when using small-diameter resistors at a high flow. Therefore, the resistors may not be interchangeable. This is important information for clinicians, particularly when considering PEP for patients who do not tolerate higher pressures. Copyright © 2015 by

Airborne spread of expiratory droplet nuclei between the occupants of indoor environments: A review.

Science.gov (United States)

Ai, Z T; Melikov, A K

2018-07-01

This article reviews past studies of airborne transmission between occupants in indoor environments, focusing on the spread of expiratory droplet nuclei from mouth/nose to mouth/nose for non-specific diseases. Special attention is paid to summarizing what is known about the influential factors, the inappropriate simplifications of the thermofluid boundary conditions of thermal manikins, the challenges facing the available experimental techniques, and the limitations of available evaluation methods. Secondary issues are highlighted, and some new ways to improve our understanding of airborne transmission indoors are provided. The characteristics of airborne spread of expiratory droplet nuclei between occupants, which are influenced correlatively by both environmental and personal factors, were widely revealed under steady-state conditions. Owing to the different boundary conditions used, some inconsistent findings on specific influential factors have been published. The available instrumentation was too slow to provide accurate concentration profiles for time-dependent evaluations of events with obvious time characteristics, while computational fluid dynamics (CFD) studies were mainly performed in the framework of inherently steady Reynolds-averaged Navier-Stokes modeling. Future research needs in 3 areas are identified: the importance of the direction of indoor airflow patterns, the dynamics of airborne transmission, and the application of CFD simulations. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

High resolution CT in cystic fibrosis--the contribution of expiratory scans

International Nuclear Information System (INIS)

Dorloechter, Ludger; Nes, Harald; Fluge, Gjermund; Rosendahl, Karen

2003-01-01

Introduction: The use of high-resolution computed tomography (HRCT) is well accepted as an accurate method for evaluation of lung parenchyma in cystic fibrosis (CF). Several scoring methods exist and, in common, all are based on HRCT findings during inspiration alone. Objective: To examine whether expiratory HRCT scans could add information about the degree of mosaic perfusion in patients with CF. Methods and patients: Pulmonary HRCT was performed in 17 CF patients (median age of 12 years) with 1-mm thin sections and 10-mm intervals during inspiration, followed by 1-mm thin sections with 20-mm intervals during expiration. HRCT was scored by using a modified Bhalla method. Results: The mean HRCT score was 8.2. Out of 17 patients, 11 (65%) demonstrated a pathological mosaic perfusion in expiration, while only three patients showed mosaic perfusion in inspiration. The degree of expiratory mosaic perfusion was graded as severe in nine patients and moderate in two patients. There was a significant correlation between our modified HRCT score and lung function, as measured by forced expiratory volume in 1 s (FEV1% predicted, P<0.01). Conclusion: Mosaic perfusion in expiration was a common pathological HRCT finding in our study group. The clinical significance of this finding needs further evaluation

Two-phase-flow models and their limitations

International Nuclear Information System (INIS)

Ishii, M.; Kocamustafaogullari, G.

1982-01-01

An accurate prediction of transient two-phase flow is essential to safety analyses of nuclear reactors under accident conditions. The fluid flow and heat transfer encountered are often extremely complex due to the reactor geometry and occurrence of transient two-phase flow. Recently considerable progresses in understanding and predicting these phenomena have been made by a combination of rigorous model development, advanced computational techniques, and a number of small and large scale supporting experiments. In view of their essential importance, the foundation of various two-phase-flow models and their limitations are discussed in this paper

Investigations on interactions between the flowing liquid lithium limiter and plasmas

International Nuclear Information System (INIS)

Ren, J.; Zuo, G.Z.; Hu, J.S.; Sun, Z.; Li, J.G.; Zakharov, L.E.; Ruzic, D.N.; Xu, W.Y.

2016-01-01

Two different designs of flowing liquid lithium limiter were first tested for power exhaust and particle removal in HT-7 in 2012 autumn campaign. During the experiments, the reliability and compatibility of the limiters within Tokamak were experimentally demonstrated, and some positive results were achieved. It was found that the flowing liquid lithium limiter was effective for suppressing H concentration and led to a low ratio of H/(H + D). O impurity was slightly decreased by using limiters as well as when using a Li coating. A significant increase of the wall retention ratio was also observed which resulted from the outstanding D particles pumping ability of flowing liquid lithium limiters. The strong interaction between plasma and lithium surface could cause lithium ejection into plasma and lead to disruptions. The stable plasmas produced by uniform Li flow were in favor of lithium control. While the limiters were applied with a uniform Li flow, the normal plasma was easy to be obtained, and the energy confinement time increased from ∼0.025 s to 0.04 s. Furthermore, it was encouraging to note that the application of flowing liquid lithium limiters could further improve the confinement of plasma by ∼10% on the basis of Li coating. These remarkable results will help for the following design of flowing liquid lithium limiter in EAST to improve the plasma operation.

Volume-monitored chest CT: a simplified method for obtaining motion-free images near full inspiratory and end expiratory lung volumes

Energy Technology Data Exchange (ETDEWEB)

Mueller, Kathryn S. [The Ohio State University College of Medicine, Columbus, OH (United States); Long, Frederick R. [Nationwide Children' s Hospital, The Children' s Radiological Institute, Columbus, OH (United States); Flucke, Robert L. [Nationwide Children' s Hospital, Department of Pulmonary Medicine, Columbus, OH (United States); Castile, Robert G. [The Research Institute at Nationwide Children' s Hospital, Center for Perinatal Research, Columbus, OH (United States)

2010-10-15

Lung inflation and respiratory motion during chest CT affect diagnostic accuracy and reproducibility. To describe a simple volume-monitored (VM) method for performing reproducible, motion-free full inspiratory and end expiratory chest CT examinations in children. Fifty-two children with cystic fibrosis (mean age 8.8 {+-} 2.2 years) underwent pulmonary function tests and inspiratory and expiratory VM-CT scans (1.25-mm slices, 80-120 kVp, 16-40 mAs) according to an IRB-approved protocol. The VM-CT technique utilizes instruction from a respiratory therapist, a portable spirometer and real-time documentation of lung volume on a computer. CT image quality was evaluated for achievement of targeted lung-volume levels and for respiratory motion. Children achieved 95% of vital capacity during full inspiratory imaging. For end expiratory scans, 92% were at or below the child's end expiratory level. Two expiratory exams were judged to be at suboptimal volumes. Two inspiratory (4%) and three expiratory (6%) exams showed respiratory motion. Overall, 94% of scans were performed at optimal volumes without respiratory motion. The VM-CT technique is a simple, feasible method in children as young as 4 years to achieve reproducible high-quality full inspiratory and end expiratory lung CT images. (orig.)

Comparison of peak expiratory flow rate and lipid profile in asymptomatic smokers and non-smokers

International Nuclear Information System (INIS)

Fatima, F.; Abbasi, M.A.; Jadoon, J.; Sohail, M.; Shah, J.; Afridi, U.; Noor, M.M.

2015-01-01

Tobacco is the major risk factor for chronic obstructive airway disease (COAD), other pulmonary diseases, cancer, cardiovascular and cerebrovascular diseases. The objective of study was to determine the mean Peak Expiratory Flow Rate (PEFR) and serum lipid profile in apparently healthy male smokers and non-smokers. Methods: This cross-sectional study was conducted in Ayub Teaching Hospital, Abbottabad from 15th December, 2009 to 15th June, 2010. Apparently healthy smokers and non-smokers from population coming to Hospital as attendants of the patients or as employees of the hospital were inducted in the study. PEFR and lipid profile of all the subjects was accessed. Results: There were total of 300 male subjects, 150 smokers and 150 non-smokers. The mean age of study subjects was 26.60 ± 5.5 years. The mean PEFR of smokers was 450.62l/min and that of non-smokers was 494.81 L/min, the difference being statistically significant (p-value <0.05).The mean total cholesterol of smokers is 5.30 ± 0.86 mmol/l and it was 3.84 ± 0.54 mmol/l in non-smokers. Mean serum Triacyl Glycerols (TAGs) and Low Density Lipoproteins (LDL) cholesterol of smokers was 2.04 ± 0.38 and 3.5 ± 0.83 mmol/l whereas it was 1.44 ± 0.52 and 2.02 ± 0.66 mmol/l in non-smokers. Mean High Density Lipo-protein (HDL) of smokers was 0.86 ± 0.30 mmol/l and of non-smokers is 1.20 ± 0.41 mmo/l. There was statistically significant difference between serum lipid profile of smokers and non-smokers (p<0.05). the mean serum Total Cholesterol (TC), TAGs and LDL were significantly higher in smokers as compared to non-smokers. However HDL was significantly lower in smokers in comparison to non-smokers. Conclusion: There was statistically significant difference between PEFR of smokers and non-smokers. Higher and significant mean values of TC, TAG and LDL-C was observed in smokers as compared to non-smokers. (author)

High flow nasal cannula for respiratory support in preterm infants.

LENUS (Irish Health Repository)

Wilkinson, Dominic

2011-01-01

High flow nasal cannulae (HFNC) are small, thin, tapered cannulae used to deliver oxygen or blended oxygen and air at flow rates of > 1 L\\/min. HFNC can be used to provide high concentrations of oxygen and may deliver positive end-expiratory pressure.

Ventilator flow data predict bronchopulmonary dysplasia in extremely premature neonates

Directory of Open Access Journals (Sweden)

Mariann H. Bentsen

2018-03-01

Full Text Available Early prediction of bronchopulmonary dysplasia (BPD may facilitate tailored management for neonates at risk. We investigated whether easily accessible flow data from a mechanical ventilator can predict BPD in neonates born extremely premature (EP. In a prospective population-based study of EP-born neonates, flow data were obtained from the ventilator during the first 48 h of life. Data were logged for >10 min and then converted to flow–volume loops using custom-made software. Tidal breathing parameters were calculated and averaged from ≥200 breath cycles, and data were compared between those who later developed moderate/severe and no/mild BPD. Of 33 neonates, 18 developed moderate/severe and 15 no/mild BPD. The groups did not differ in gestational age, surfactant treatment or ventilator settings. The infants who developed moderate/severe BPD had evidence of less airflow obstruction, significantly so for tidal expiratory flow at 50% of tidal expiratory volume (TEF50 expressed as a ratio of peak tidal expiratory flow (PTEF (p=0.007. A compound model estimated by multiple logistic regression incorporating TEF50/PTEF, birthweight z-score and sex predicted moderate/severe BPD with good accuracy (area under the curve 0.893, 95% CI 0.735–0.973. This study suggests that flow data obtained from ventilators during the first hours of life may predict later BPD in premature neonates. Future and larger studies are needed to validate these findings and to determine their clinical usefulness.

Effect of bedding control on amount of house dust mite allergens, asthma symptoms, and peak expiratory flow rate.

Science.gov (United States)

Lee, Inn-Sook

2003-04-30

This quasi-experimental study was designed to investigate the effect of bedding control on the amount of house dust mite (HDM) allergens, asthma symptoms, and peak expiratory flow rate (PEFR) in asthmatics sensitive to HDMs. The subjects in the study were drawn from patients receiving treatment at the allergy clinics of three university-affiliated hospitals in Seoul. Forty-two patients without prior practice of the bedding control used in this study were selected. They commonly showed bronchial asthma caused by HDMs, and exhibited strong positive points (more than 3 points) in skin prick test (D. farinae, D. pteronyssinus), and positive response in both fluoro-allergosorbent test (FAST), and PC20 methacholine test. Of the subjects, alternatively, 22 were assigned to the experimental group and 20 to control group. Bedding control consisted of the use of outer cotton covers, boiling them for 10 minutes fortnightly, and disinfecting bedding by sunlight fortnightly. The experimental group was under bedding control for 4 weeks. The data were collected from October 2000 to January 2001. The results were as follows: 1. After bedding control, the total amount of HDM allergens decreased significantly in the experimental group. However there was no significant difference in the decrease of the amount of HDM allergens between the two groups. 2. Of the asthma symptoms, there was significant difference only in the decrease of the frequency of dyspnea, and in the increase of sleeping disturbance between the two groups after bedding control. 3. After bedding control, PEFR increased in the experimental group whereas it decreased in the control group. However, neither change was significant. The above findings indicate that bedding control improved several asthma symptoms in asthmatics sensitive to HDMs. Accordingly, we suggest that bedding control is adopted as a useful nursing intervention in the field.

Assessment of Factors Related to Auto-PEEP.

Science.gov (United States)

Natalini, Giuseppe; Tuzzo, Daniele; Rosano, Antonio; Testa, Marco; Grazioli, Michele; Pennestrì, Vincenzo; Amodeo, Guido; Marsilia, Paolo F; Tinnirello, Andrea; Berruto, Francesco; Fiorillo, Marialinda; Filippini, Matteo; Peratoner, Alberto; Minelli, Cosetta; Bernardini, Achille

2016-02-01

Previous physiological studies have identified factors that are involved in auto-PEEP generation. In our study, we examined how much auto-PEEP is generated from factors that are involved in its development. One hundred eighty-six subjects undergoing controlled mechanical ventilation with persistent expiratory flow at the beginning of each inspiration were enrolled in the study. Volume-controlled continuous mandatory ventilation with PEEP of 0 cm H2O was applied while maintaining the ventilator setting as chosen by the attending physician. End-expiratory and end-inspiratory airway occlusion maneuvers were performed to calculate respiratory mechanics, and tidal flow limitation was assessed by a maneuver of manual compression of the abdomen. The variable with the strongest effect on auto-PEEP was flow limitation, which was associated with an increase of 2.4 cm H2O in auto-PEEP values. Moreover, auto-PEEP values were directly related to resistance of the respiratory system and body mass index and inversely related to expiratory time/time constant. Variables that were associated with the breathing pattern (tidal volume, frequency minute ventilation, and expiratory time) did not show any relationship with auto-PEEP values. The risk of auto-PEEP ≥5 cm H2O was increased by flow limitation (adjusted odds ratio 17; 95% CI: 6-56.2), expiratory time/time constant ratio 15 cm H2O/L s (3; 1.3-6.9), age >65 y (2.8; 1.2-6.5), and body mass index >26 kg/m(2) (2.6; 1.1-6.1). Flow limitation, expiratory time/time constant, resistance of the respiratory system, and obesity are the most important variables that affect auto-PEEP values. Frequency expiratory time, tidal volume, and minute ventilation were not independently associated with auto-PEEP. Therapeutic strategies aimed at reducing auto-PEEP and its adverse effects should be primarily oriented to the variables that mainly affect auto-PEEP values. Copyright © 2016 by Daedalus Enterprises.

Application of the Novel Ventilation Mode FLow-Controlled EXpiration (FLEX): A Crossover Proof-of-Principle Study in Lung-Healthy Patients.

Science.gov (United States)

Wirth, Steffen; Springer, Sebastian; Spaeth, Johannes; Borgmann, Silke; Goebel, Ulrich; Schumann, Stefan

2017-10-01

Traditionally, mechanical ventilation is achieved via active lung inflation during inspiration and passive lung emptying during expiration. By contrast, the novel FLEX (FLow-controlled EXpiration) ventilator mode actively decreases the rate of lung emptying. We investigated whether FLEX can be used during intraoperative mechanical ventilation of lung-healthy patients. In 30 adult patients scheduled for neurosurgical procedures, we studied respiratory system mechanics, regional ventilation, oxygenation, and hemodynamics during ventilation with and without FLEX at positive end-expiratory pressure (PEEP) of 5 and 7 cm H2O. The FLEX system was integrated into the expiratory limb and modified the expiratory flow profile by continuously changing expiratory resistance according to a computer-controlled algorithm. Mean airway pressure increased with PEEP by 1.9 cm H2O and with FLEX by 1 cm H2O (all P ventilated during general anesthesia. FLEX improves the homogeneous distribution of ventilation in the lungs.

High frequency components of tracheal sound are emphasized during prolonged flow limitation

International Nuclear Information System (INIS)

Tenhunen, M; Huupponen, E; Saastamoinen, A; Kulkas, A; Himanen, S-L; Rauhala, E

2009-01-01

A nasal pressure transducer, which is used to study nocturnal airflow, also provides information about the inspiratory flow waveform. A round flow shape is presented during normal breathing. A flattened, non-round shape is found during hypopneas and it can also appear in prolonged episodes. The significance of this prolonged flow limitation is still not established. A tracheal sound spectrum has been analyzed further in order to achieve additional information about breathing during sleep. Increased sound frequencies over 500 Hz have been connected to obstruction of the upper airway. The aim of the present study was to examine the tracheal sound signal content of prolonged flow limitation and to find out whether prolonged flow limitation would consist of abundant high frequency activity. Sleep recordings of 36 consecutive patients were examined. The tracheal sound spectral analysis was performed on 10 min episodes of prolonged flow limitation, normal breathing and periodic apnea-hypopnea breathing. The highest total spectral amplitude, implicating loudest sounds, occurred during flow-limited breathing which also presented loudest sounds in all frequency bands above 100 Hz. In addition, the tracheal sound signal during flow-limited breathing constituted proportionally more high frequency activities compared to normal breathing and even periodic apnea-hypopnea breathing

High Flow Nasal Cannula Therapy for Improving Obstructive Sleep Apnea: A Case Report

Directory of Open Access Journals (Sweden)

Se Joong Kim

2015-06-01

Full Text Available Although continuous positive airway pressure is the treatment of choice for obstructive sleep apnea, its compliance is low. Therefore, alternative therapeutic strategies are often required. High flow nasal cannula therapy uses an air compressor to deliver a constant flow of oxygen via the nasal cannula at a maximum of 60 L/m. It can produce positive end expiratory pressure and increase end expiratory pharyngeal pressure, which can help to alleviate upper airway obstruction. This is a case report of high flow nasal cannula therapy for a 71 year-old man. He had an obstructive sleep apnea and severe desaturation but failed to use continuous positive airway pressure. He underwent titration with high flow nasal cannula under polysomnography. Using high flow nasal cannula at an airflow of 45 L/m, his apnea-hypopnea, respiratory arousal and oxygen desaturation were improved. Importantly, he is very compliant with high flow nasal cannula therapy.

Pulmonary function in men after oxygen breathing at 3.0 ATA for 3.5 h

Science.gov (United States)

Clark, J. M.; Jackson, R. M.; Lambertsen, C. J.; Gelfand, R.; Hiller, W. D. B.; Unger, M.

1991-01-01

A complete description of pulmonary measurements obtained after continuous O2 exposure of 13 healthy men at 3.0 ATA for 3.5 h is presented. Measurements included flow-volume loops, spirometry, and airway resistance(n = 12); CO diffusing capacity (n = 11); closing volumes (n= 6); and air vs. HeO2 forced vital capacity maneuvers (n = 5). The average difference in maximum mid expiratory flows at 50 percent vital capacity on air and HeO2 was found to be significantly reduced postexposure by 18 percent. Raw and CO diffusing capacity were not changed postexposure. It is concluded that the relatively large change in forced expiratory flow at 25-75 percent of vital capacity compared with the mean forced expiratory volume in 1 s, the reduction in density dependence of flow, and the normal Raw postexposure are all consistent with flow limitation in peripheral airways as a major cause of the observed reduction in expiratory flow.

Whole-lung volume and density in spirometrically-gated inspiratory and expiratory CT in systemic sclerosis: correlation with static volumes at pulmonary function tests.

Science.gov (United States)

Camiciottoli, G; Diciotti, S; Bartolucci, M; Orlandi, I; Bigazzi, F; Matucci-Cerinic, M; Pistolesi, M; Mascalchi, M

2013-03-01

Spiral low-dose computed tomography (LDCT) permits to measure whole-lung volume and density in a single breath-hold. To evaluate the agreement between static lung volumes measured with LDCT and pulmonary function test (PFT) and the correlation between the LDCT volumes and lung density in restrictive lung disease. Patients with Systemic Sclerosis (SSc) with (n = 24) and without (n = 16) pulmonary involvement on sequential thin-section CT and patients with chronic obstructive pulmonary disease (COPD)(n = 29) underwent spirometrically-gated LDCT at 90% and 10% of vital capacity to measure inspiratory and expiratory lung volumes and mean lung attenuation (MLA). Total lung capacity and residual volume were measured the same day of CT. Inspiratory [95% limits of agreement (95% LoA)--43.8% and 39.2%] and expiratory (95% LoA -45.8% and 37.1%) lung volumes measured on LDCT and PFT showed poor agreement in SSc patients with pulmonary involvement, whereas they were in substantial agreement (inspiratory 95% LoA -14.1% and 16.1%; expiratory 95% LoA -13.5% and 23%) in SSc patients without pulmonary involvement and in inspiratory scans only (95% LoA -23.1% and 20.9%) of COPD patients. Inspiratory and expiratory LDCT volumes, MLA and their deltas differentiated both SSc patients with or without pulmonary involvement from COPD patients. LDCT lung volumes and density were not correlated in SSc patients with pulmonary involvement, whereas they did correlate in SSc without pulmonary involvement and in COPD patients. In restrictive lung disease due to SSc there is poor agreement between static lung volumes measured using LDCT and PFT and the relationship between volume and density values on CT is altered.

Using an expiratory resistor, arterial pulse pressure variations predict fluid responsiveness during spontaneous breathing: an experimental porcine study.

Science.gov (United States)

Dahl, Michael K; Vistisen, Simon T; Koefoed-Nielsen, Jacob; Larsson, Anders

2009-01-01

Fluid responsiveness prediction is difficult in spontaneously breathing patients. Because the swings in intrathoracic pressure are minor during spontaneous breathing, dynamic parameters like pulse pressure variation (PPV) and systolic pressure variation (SPV) are usually small. We hypothesized that during spontaneous breathing, inspiratory and/or expiratory resistors could induce high arterial pressure variations at hypovolemia and low variations at normovolemia and hypervolemia. Furthermore, we hypothesized that SPV and PPV could predict fluid responsiveness under these conditions. Eight prone, anesthetized and spontaneously breathing pigs (20 to 25 kg) were subjected to a sequence of 30% hypovolemia, normovolemia, and 20% and 40% hypervolemia. At each volemic level, the pigs breathed in a randomized order either through an inspiratory and/or an expiratory threshold resistor (7.5 cmH2O) or only through the tracheal tube without any resistor. Hemodynamic and respiratory variables were measured during the breathing modes. Fluid responsiveness was defined as a 15% increase in stroke volume (DeltaSV) following fluid loading. Stroke volume was significantly lower at hypovolemia compared with normovolemia, but no differences were found between normovolemia and 20% or 40% hypervolemia. Compared with breathing through no resistor, SPV was magnified by all resistors at hypovolemia whereas there were no changes at normovolemia and hypervolemia. PPV was magnified by the inspiratory resistor and the combined inspiratory and expiratory resistor. Regression analysis of SPV or PPV versus DeltaSV showed the highest R2 (0.83 for SPV and 0.52 for PPV) when the expiratory resistor was applied. The corresponding sensitivity and specificity for prediction of fluid responsiveness were 100% and 100%, respectively, for SPV and 100% and 81%, respectively, for PPV. Inspiratory and/or expiratory threshold resistors magnified SPV and PPV in spontaneously breathing pigs during hypovolemia

Controlled expiration in mechanically-ventilated patients with chronic obstructive pulmonary disease (COPD)

NARCIS (Netherlands)

J.G.J.V. Aerts (Joachim); B.W. van den Berg (Bart); J.M. Bogaard (Jan)

1997-01-01

textabstractIn patients with severe chronic obstructive pulmonary disease (COPD), lung emptying may be affected by flow limitation. We tested the hypothesis that the airway compression leading to flow limitation can be counteracted by controlling the expiratory flow. The effects

Effect of simultaneous application of postural techniques and expiratory muscle strength training on the enhancement of the swallowing function of patients with dysphagia caused by parkinson's disease.

Science.gov (United States)

Byeon, Haewon

2016-06-01

[Purpose] This study aimed to investigate the effect of simultaneous application of postural techniques and expiratory muscle strength training on the enhancement of the swallowing function of patients with dysphagia caused by Parkinson's disease. [Subjects and Methods] The subjects of this study were 18 patients who received simultaneous application of postural techniques and expiratory muscle strength training and 15 patients who received expiratory muscle strength training only. Postural techniques were conducted in the order of chin tucking, head rotation, head tilting, bending head back, and lying down, while expiratory muscle strength training was conducted at a resistance level of about 70% of the maximal expiratory pressure. Swallowing recovery was assessed by using the Functional Dysphagia Scale based on videofluoroscopic studies. [Results] The mean value obtained in the videofluoroscopic studies for both groups decreased after the treatment. In the postural techniques plus expiratory muscle strength training group, the decrease was significantly greater than that in the expiratory muscle strength training-only group. [Conclusion] The results imply that simultaneous performance of postural techniques and expiratory muscle strength training is more effective than expiratory muscle strength training alone when applied in the swallowing rehabilitation for patients with dysphagia caused by Parkinson's disease.

Cystic Fibrosis: Are Volumetric Ultra-Low-Dose Expiratory CT Scans Sufficient for Monitoring Related Lung Disease?

DEFF Research Database (Denmark)

Loeve, Martine; Lequin, Maarten H; Bruijne, Marleen de

2009-01-01

Purpose: To assess whether chest computed tomography (CT) scores from ultra-low-dose end-expiratory scans alone could suffice for assessment of all cystic fibrosis (CF)-related structural lung abnormalities. Materials and Methods: In this institutional review board–approved study, 20 patients...... with CF aged 6–20 years (eight males, 12 females) underwent low-dose end-inspiratory CT and ultra-low-dose end-expiratory CT. Informed consent was obtained. Scans were randomized and scored by using the Brody-II CT scoring system to assess bronchiectasis, airway wall thickening, mucus plugging......-Altman plots. Results: Median age was 12.6 years (range, 6.3–20.3 years), median forced expiratory volume in 1 second was 100% (range, 46%–127%) of the predicted value, and median forced vital capacity was 99% (range, 61%–123%) of the predicted value. Very good agreement was observed between end...

Cool-down flow-rate limits imposed by thermal stresses in LNG pipelines

Science.gov (United States)

Novak, J. K.; Edeskuty, F. J.; Bartlit, J. R.

Warm cryogenic pipelines are usually cooled to operating temperature by a small, steady flow of the liquid cryogen. If this flow rate is too high or too low, undesirable stresses will be produced. Low flow-rate limits based on avoidance of stratified two-phase flow were calculated for pipelines cooled with liquid hydrogen or nitrogen. High flow-rate limits for stainless steel and aluminum pipelines cooled by liquid hydrogen or nitrogen were determined by calculating thermal stress in thick components vs flow rate and then selecting some reasonable stress limits. The present work extends these calculations to pipelines made of AISI 304 stainless steel, 6061 aluminum, or ASTM A420 9% nickel steel cooled by liquid methane or a typical natural gas. Results indicate that aluminum and 9% nickel steel components can tolerate very high cool-down flow rates, based on not exceeding the material yield strength.

Pulmonary emphysema quantitation with Computed Tomography. Comparison between the visual score with high resolution CT, expiratory density mask with spiral CT and lung function studies

International Nuclear Information System (INIS)

Zompatori, Maurizio; Battaglia, Milva; Rimondi, Maria Rita; Vivacqua, Donatella; Biscarini, Manuela; Fasano, Luca; Pacilli, Angela Maria Grazia; Guerrieri, Aldo; Fabbri, Mario; Cavina, Mauro

1997-01-01

CT is the most accurate method to detect pulmonary emphysema in vivo. They compared prospectively two different methods for emphysema quantitation in 5 normal volunteers and 20 consecutive patients with chronic obstructive pulmonary disease (COPD). All subjects were submitted to function tests and HRCT; three scans were acquired at preselected levels during inspiration. The type and extent of pulmonary emphysema were defined by two independent observers under blind conditions. Disagreements were subsequently settled by consent. All subjects were also examined with expiratory spiral CT using a density mask program, at two different cut-off levels (-850,-900 HU). Visual score and expiratory spiral density mask values (-850 HU) were significantly correlated (r = 0.86), but the visual extent of emphysema was always higher than shown by expiratory spiral CT. The emphysema extent assessed with both CT methods correlated with the function result of expiratory airflow obstruction and gas diffusion impairment (visual score versus forced expiratory volume in one second: r = -0.81, versus single breath carbon monoxide diffusion: r = -0.78. Spiral expiratory density mask -850 HU versus forced expiratory volume in one second: r = -0.85 versus single breath carbon monoxide diffusion: r = -0.77). When -900 HU was used as the cut-off value for the expiratory density mask, the correlation with single breath carbon monoxide diffusion worsened (r = -0.56). Visual score and expiratory density mask -850 HU gave similar results and permitted COPD patients to be clearly distinguished from normal controls (p < 0.01). They believe the true residual volume should lie somewhere in between the CT value and the function results with the helium dilution technique and conclude that the extent of pulmonary emphysema can be confidently assessed with CT methods. Finally, the simple visual score may be as reliable as such highly sophisticated new methods as the spiral expiratory density mask

Improved sensitivity and limit-of-detection of lateral flow devices using spatial constrictions of the flow-path.

Science.gov (United States)

Katis, Ioannis N; He, Peijun J W; Eason, Robert W; Sones, Collin L

2018-05-03

We report on the use of a laser-direct write (LDW) technique that allows the fabrication of lateral flow devices with enhanced sensitivity and limit of detection. This manufacturing technique comprises the dispensing of a liquid photopolymer at specific regions of a nitrocellulose membrane and its subsequent photopolymerisation to create impermeable walls inside the volume of the membrane. These polymerised structures are intentionally designed to create fluidic channels which are constricted over a specific length that spans the test zone within which the sample interacts with pre-deposited reagents. Experiments were conducted to show how these constrictions alter the fluid flow rate and the test zone area within the constricted channel geometries. The slower flow rate and smaller test zone area result in the increased sensitivity and lowered limit of detection for these devices. We have quantified these via the improved performance of a C-Reactive Protein (CRP) sandwich assay on our lateral flow devices with constricted flow paths which demonstrate an improvement in its sensitivity by 62x and in its limit of detection by 30x when compared to a standard lateral flow CRP device. Crown Copyright © 2018. Published by Elsevier B.V. All rights reserved.

THE EFFECT OF SUBMAXIMAL INHALATION ON MEASURES DERIVED FROM FORCED EXPIRATORY SPIROMETRY

Science.gov (United States)

THE EFFECT OF SUBMAXIMAL INHALATION ON MEASURES DERIVED FROM FORCED EXPIRATORY SPIROMETRY. William F. McDonnell Human Studies Division, NHEERL, U.S. Environmental Protection Agency, RTP, NC 27711. Short-term exposure to ozone results in a neurally-mediated decrease in the ab...

Changes in forced expiratory volume in 1 second over time in COPD

DEFF Research Database (Denmark)

Vestbo, Jørgen; Edwards, Lisa D; Scanlon, Paul D

2011-01-01

A key feature of chronic obstructive pulmonary disease (COPD) is an accelerated rate of decline in forced expiratory volume in 1 second (FEV(1)), but data on the variability and determinants of this change in patients who have established disease are scarce....

Dangerous Pressurization and Inappropriate Alarms during Water Occlusion of the Expiratory Circuit of Commonly Used Infant Ventilators.

Directory of Open Access Journals (Sweden)

Murray Hinder

Full Text Available Non-invasive continuous positive airways pressure is commonly a primary respiratory therapy delivered via multi-purpose ventilators in premature newborns. Expiratory limb occlusion due to water accumulation or 'rainout' from gas humidification is a frequent issue. A case of expiratory limb occlusion due to rainout causing unexpected and excessive repetitive airway pressurisation in a Draeger VN500 prompted a systematic bench test examination of currently available ventilators.To assess neonatal ventilator response to partial or complete expiratory limb occlusion when set to non-invasive continuous positive airway pressure mode.Seven commercially available neonatal ventilators connected to a test lung using a standard infant humidifier circuit with partial and/or complete expiratory limb occlusion were examined in a bench test study. Each ventilator was set to deliver 6 cmH2O in non-invasive mode and respiratory mechanics data for 75%, 80% and 100% occlusion were collected.Several ventilators responded inappropriately with complete occlusion by cyclical pressurisation/depressurisation to peak pressures of between 19·4 and 64·6 cm H2O at rates varying between 2 to 77 inflations per minute. Tidal volumes varied between 10·1 and 24·3mL. Alarm responses varied from 'specific' (tube occluded to 'ambiguous' (Safety valve open. Carefusion Avea responded by continuing to provide the set distending pressure and displaying an appropriate alarm message. Draeger Babylog 8000 did not alarm with partial occlusions and incorrectly displayed airways pressure at 6·1cmH2O compared to the measured values of 13cmH2O.This study found a potential for significant adverse ventilator response due to complete or near complete expiratory limb occlusion in CPAP mode.

Determining the Limiting Current Density of Vanadium Redox Flow Batteries

Directory of Open Access Journals (Sweden)

Jen-Yu Chen

2014-09-01

Full Text Available All-vanadium redox flow batteries (VRFBs are used as energy storage systems for intermittent renewable power sources. The performance of VRFBs depends on materials of key components and operating conditions, such as current density, electrolyte flow rate and electrolyte composition. Mass transfer overpotential is affected by the electrolyte flow rate and electrolyte composition, which is related to the limiting current density. In order to investigate the effect of operating conditions on mass transport overpotential, this study established a relationship between the limiting current density and operating conditions. First, electrolyte solutions with different states of charge were prepared and used for a single cell to obtain discharging polarization curves under various operating conditions. The experimental results were then analyzed and are discussed in this paper. Finally, this paper proposes a limiting current density as a function of operating conditions. The result helps predict the effect of operating condition on the cell performance in a mathematical model.

The role of heater thermal response in reactor thermal limits during oscillartory two-phase flows

Energy Technology Data Exchange (ETDEWEB)

Ruggles, A.E.; Brown, N.W. [Univ. of Tennessee, Knoxville, TN (United States); Vasil`ev, A.D. [Nuclear Safety Institute, Moscow, (Russian Federation); Wendel, M.W. [Oak Ridge National Lab., TN (United States)

1995-09-01

Analytical and numerical investigations of critical heat flux (CHF) and reactor thermal limits are conducted for oscillatory two-phase flows often associated with natural circulation conditions. It is shown that the CHF and associated thermal limits depend on the amplitude of the flow oscillations, the period of the flow oscillations, and the thermal properties and dimensions of the heater. The value of the thermal limit can be much lower in unsteady flow situations than would be expected using time average flow conditions. It is also shown that the properties of the heater strongly influence the thermal limit value in unsteady flow situations, which is very important to the design of experiments to evaluate thermal limits for reactor fuel systems.

Prediction of Spirometric Forced Expiratory Volume (FEV1) Data Using Support Vector Regression

Science.gov (United States)

Kavitha, A.; Sujatha, C. M.; Ramakrishnan, S.

2010-01-01

In this work, prediction of forced expiratory volume in 1 second (FEV1) in pulmonary function test is carried out using the spirometer and support vector regression analysis. Pulmonary function data are measured with flow volume spirometer from volunteers (N=175) using a standard data acquisition protocol. The acquired data are then used to predict FEV1. Support vector machines with polynomial kernel function with four different orders were employed to predict the values of FEV1. The performance is evaluated by computing the average prediction accuracy for normal and abnormal cases. Results show that support vector machines are capable of predicting FEV1 in both normal and abnormal cases and the average prediction accuracy for normal subjects was higher than that of abnormal subjects. Accuracy in prediction was found to be high for a regularization constant of C=10. Since FEV1 is the most significant parameter in the analysis of spirometric data, it appears that this method of assessment is useful in diagnosing the pulmonary abnormalities with incomplete data and data with poor recording.

Physiologic Evaluation of Ventilation Perfusion Mismatch and Respiratory Mechanics at Different Positive End-expiratory Pressure in Patients Undergoing Protective One-lung Ventilation.

Science.gov (United States)

Spadaro, Savino; Grasso, Salvatore; Karbing, Dan Stieper; Fogagnolo, Alberto; Contoli, Marco; Bollini, Giacomo; Ragazzi, Riccardo; Cinnella, Gilda; Verri, Marco; Cavallesco, Narciso Giorgio; Rees, Stephen Edward; Volta, Carlo Alberto

2018-03-01

Arterial oxygenation is often impaired during one-lung ventilation, due to both pulmonary shunt and atelectasis. The use of low tidal volume (VT) (5 ml/kg predicted body weight) in the context of a lung-protective approach exacerbates atelectasis. This study sought to determine the combined physiologic effects of positive end-expiratory pressure and low VT during one-lung ventilation. Data from 41 patients studied during general anesthesia for thoracic surgery were collected and analyzed. Shunt fraction, high V/Q and respiratory mechanics were measured at positive end-expiratory pressure 0 cm H2O during bilateral lung ventilation and one-lung ventilation and, subsequently, during one-lung ventilation at 5 or 10 cm H2O of positive end-expiratory pressure. Shunt fraction and high V/Q were measured using variation of inspired oxygen fraction and measurement of respiratory gas concentration and arterial blood gas. The level of positive end-expiratory pressure was applied in random order and maintained for 15 min before measurements. During one-lung ventilation, increasing positive end-expiratory pressure from 0 cm H2O to 5 cm H2O and 10 cm H2O resulted in a shunt fraction decrease of 5% (0 to 11) and 11% (5 to 16), respectively (P ventilation, high positive end-expiratory pressure levels improve pulmonary function without increasing high V/Q and reduce driving pressure.

Positive end-expiratory pressure increases pulmonary clearance of inhaled 99mTc-DTPA in nonsmokers but not in healthy smokers

International Nuclear Information System (INIS)

Nolop, K.B.; Braude, S.; Royston, D.; Maxwell, D.L.; Hughes, J.M.B.

1987-01-01

Positive end-expiratory pressure (PEEP) is widely used in the treatment of severe pulmonary oedema, although its effects on the clearance of water and small solutes from alveolus to blood are not well characterized. We studied the effect of the application of 10 cmH 2 O of PEEP on the flux of inhaled 99 mTc-diethylene-triamine-penta-acetic acid (DTPA) from lung to blood in six healthy smoking and six nonsmoking subjects. The rate of flux was corrected for possible changes in pulmonary blood volume during PEEP by use of an intravenous injection of 99m Tc-DTPA. The baseline clearance rate (K,%.min -1 ) for nonsmokers was 1.48±0.12 (mean±SE) and increased to 2.40±0.29 during PEEP (p<0.05). In contrast, the mean clearance rate for smokers was 3.26±0.82 at baseline and 3.03±0.82 during PEEP (p=NS). The application of positive end-expiratory pressure appears to increase alveolar solute flux in nonsmokers but not in smokers, suggesting that the pathway for solute clearance in smokers is governed by different rate-limiting steps to those of nonsmokers

Inadequate peak expiratory flow meter characteristics detected by a computerised explosive decompression device

DEFF Research Database (Denmark)

Miller, M.R.; Atkins, P.R.; Pedersen, O.F.

2003-01-01

Methods: The dynamic response of mini-Wright (MW), Vitalograph (V), TruZone (TZ), MultiSpiro (MS) and pneumotachograph (PT) flow meters was tested by delivering two differently shaped flow-time profiles from a computer controlled explosive decompression device fitted with a fast response solenoid.......1) and 257 (39.2), respectively, and at ≈200 l/min they were 51 (23.9) and 1 (0.5). All the meters met ATS accuracy requirements when tested with their waveforms. Conclusions: An improved method for testing the dynamic response of flow meters detects marked overshoot (underdamping) of TZ and MS responses...

Flow reversal power limit for the HFBR

International Nuclear Information System (INIS)

Cheng, L.Y.; Tichler, P.R.

1997-01-01

The High Flux Beam Reactor (HFBR) is a pressurized heavy water moderated and cooled research reactor that began operation at 40 MW. The reactor was subsequently upgraded to 60 MW and operated at that level for several years. The reactor undergoes a buoyancy-driven reversal of flow in the reactor core following certain postulated accidents. Questions which were raised about the afterheat removal capability during the flow reversal transition led to a reactor shutdown and subsequent resumption of operation at a reduced power of 30 MW. An experimental and analytical program to address these questions is described in this report. The experiments were single channel flow reversal tests under a range of conditions. The analytical phase involved simulations of the tests to benchmark the physical models and development of a criterion for dryout. The criterion is then used in simulations of reactor accidents to determine a safe operating power level. It is concluded that the limit on the HFBR operating power with respect to the issue of flow reversal is in excess of 60 MW. Direct use of the experimental results and an understanding of the governing phenomenology supports this conclusion

Respiratory System Mechanics During Low Versus High Positive End-Expiratory Pressure in Open Abdominal Surgery: A Substudy of PROVHILO Randomized Controlled Trial

NARCIS (Netherlands)

D'Antini, Davide; Huhle, Robert; Herrmann, Jacob; Sulemanji, Demet S.; Oto, Jun; Raimondo, Pasquale; Mirabella, Lucia; Hemmes, Sabrine N. T.; Schultz, Marcus J.; Pelosi, Paolo; Kaczka, David W.; Vidal Melo, Marcos Francisco; Gama de Abreu, Marcelo; Cinnella, Gilda

2018-01-01

In the 2014 PROtective Ventilation using HIgh versus LOw positive end-expiratory pressure (PROVHILO) trial, intraoperative low tidal volume ventilation with high positive end-expiratory pressure (PEEP = 12 cm H2O) and lung recruitment maneuvers did not decrease postoperative pulmonary complications

Pharmacologic Interventions to Improve Splanchnic Oxygenation During Ventilation with Positive End-Expiratory Pressure

NARCIS (Netherlands)

Fournell, A.; Scheeren, T. W. L.; Picker, O.; Schwarte, L. A.; Wolf, M; Bucher, HU; Rudin, M; VanHuffel, S; Wolf, U; Bruley, DF; Harrison, DK

2012-01-01

Mechanical ventilation with positive end-expiratory pressure (PEEP) is an indispensable tool in the management of respiratory failure to preserve or improve lung function and systemic oxygenation. However, PEEP per se may also, as has been shown in experimental animals, impair regional

Dead space and slope indices from the expiratory carbon dioxide tension-volume curve

NARCIS (Netherlands)

A.H. Kars (Alice); J.M. Bogaard (Jan); Th. Stijnen (Theo); J. de Vries; A.F.M. Verbraak (Anton); C. Hilvering

1997-01-01

textabstractThe slope of phase 3 and three noninvasively determined dead space estimates derived from the expiratory carbon dioxide tension (PCO2) versus volume curve, including the Bohr dead space (VD,Bohr), the Fowler dead space (VD,Fowler) and pre-interface expirate

16 reference population equations using peak expiratory flow meters

African Journals Online (AJOL)

DR. AMINU

Many formulae for predicting lung function values for Nigerians have been produced by a lot of investigators. The same principle ... equations in current use are based on linear statistical models which are subject to change and they did not express the .... that present lower limits of normal or present information from which ...

Effect of pilates method on inspiratory and expiratory muscle strength in the elderly

Directory of Open Access Journals (Sweden)

Beatriz Mendes Tozim

2018-03-01

Full Text Available With aging, the respiratory muscle strength decreases and the pilates method is a technique that uses respiration as one of its principles. The present study has the aim of analyzing the influence of the pilates method on respiratory muscle strength in older women. For the evaluation of respiratory muscle strength (inspiratory and expiratory, manovacuometer was used. Thirty-one older women were divided into two groups: 14 participated in the pilates group and 17 in the control group. Participants of the pilates group performed 16 sessions of pilates method with an hour of training, twice week for eight weeks. The control group participated in four educational lectures for eight weeks. For statistical analysis, Shapiro-Wilk, ANOVA for repeated measures (p <0.05 and Cohen’s D index were performed. The results showed significant difference and the mean effect for the Cohen’s D index expiratory muscle strength of the pilates group when comparing before (69.71 ± 25.48 and after (85.23 ± 22.21 training (p<0.05 with an increase of 23%. The results of inspiratory muscle strength were not significant but presented an average effect for the Cohen’s D index for the pilates group before (69.71 ± 35.46 and after (88.00 ± 34.87 training, with an increase of 27%. The control group did not present significant differences for the variables evaluated. It could be concluded that the pilates method is effective in improving expiratory muscle strength and provides positive effects on the increase in inspiratory muscle strength.

[The influence of positive end-expiratory pressure on cerebral blood flow and cerebrovascular autoregulation in patients with acute respiratory distress syndrome].

Science.gov (United States)

Yang, Chunli; Chen, Zhi; Lu, Yuanhua; He, Huiwei; Zeng, Weihua

2014-05-01

To explore the influence of different positive end-expiratory pressure (PEEP) levels on cerebral blood flow (CBF) and cerebrovascular autoregulation in patients with acute respiratory distress syndrome(ARDS). A prospective study was conducted. Moderate or severe ARDS patients admitted to Department of Critical Care Medicine of Jiangxi Provincial People's Hospital from January 1st, 2013 to October 1st, 2013 were enrolled. The changes in hemodynamics, respiratory mechanics and gas exchange under different levels of PEEP were observed. CBF velocity of middle cerebral artery (MCA) was measured using transcranial Doppler (TCD), and breath-holding index (BHI) was also calculated. 35 patients with ARDS were included. The oxygenation index (OI), peak inspiratory pressure (PIP), plat pressure (Pplat) and central venous pressure (CVP) were markedly elevated (OI: 324.7±117.2 mmHg vs. 173.4±95.8 mmHg, t=5.913, P=0.000; PIP: 34.7±9.1 cmH2O vs. 26.1±7.9 cmH2O,t=4.222, P=0.000; Pplat: 30.5±8.4 cmH2O vs. 22.2±7.1 cmH2O, t=4.465, P=0.000; CVP: 12.1±3.5 mmHg vs. 8.8±2.2 mmHg, t=4.723, P=0.000) when PEEP was increased from (6.4±1.0) cmH2O to (14.5±2.0) cmH2O (1 cmH2O=0.098 kPa). But no significant difference in the heart rate (85.5±19.1 beats/min vs. 82.7±17.3 beats/min, t=0.643, P=0.523), mean arterial pressure (73.5±12.4 mmHg vs. 76.4±15.1 mmHg, t=0.878, P=0.383) and CBF velocity of MCA [peak systolic flow velocity (Vmax): 91.26±17.57 cm/s vs. 96.64±18.71 cm/s, t=1.240, P=0.219; diastolic flow velocity (Vmin): 31.54±7.71 cm/s vs. 33.87±8.53 cm/s, t=1.199, P=0.235; mean velocity (Vmean): 51.19±12.05 cm/s vs. 54.27±13.36 cm/s, t=1.013, P=0.315] was found. 18 patients with BHI<0.1 at baseline demonstrated that cerebral vasomotor reactivity was poor. BHI was slightly decreased with increase in PEEP (0.78±0.16 vs. 0.86±0.19, t=1.905, P=0.061). Some of moderate or severe ARDS patients without central nervous system disease have independent of preexisting cerebral

A Simple Measure to Assess Hyperinflation and Air Trapping: 1-Forced Expiratory Volume in Three Second / Forced Vital Capacity

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Sermin Börekçi

2017-04-01

Full Text Available Background: Several recent studies have suggested that 1 minus-forced expiratory volume expired in 3 seconds / forced vital capacity (1-FEV3/FVC may be an indicator of distal airway obstruction and a promising measure to evaluate small airways dysfunction. Aims: To investigate the associations of 1-FEV3/FVC with the spirometric measures and lung volumes that assess small airways dysfunction and reflects hyperinflation and air trapping. Study Design: Retrospective cross-sectional study. Methods: Retrospective assessment of a total of 1110 cases who underwent body plethysmographic lung volume estimations between a time span from 2005 to 2012. Patients were assigned into two groups: firstly by FEV1/FVC (FEV1/FVC <70% vs. FEV1/FVC ≥70%; secondly by FEV3/FVC < lower limits of normal (LLN (FEV3/FVC < LLN vs. FEV3/FVC ≥ LLN. Spirometric indices and lung volumes measured by whole-body plethysmography were compared in groups. Also the correlation of spirometric indices with measured lung volumes were assessed in the whole-study population and in subgroups stratified according to FEV1/FVC and FEV3/FVC. Results: Six hundred seven (54.7% were male and 503 (45.3% were female, with a mean age of 52.5±15.6 years. Mean FEV3/FVC and 1-FEV3/FVC were 87.05%, 12.95%, respectively. The mean 1-FEV3/FVC was 4.9% in the FEV1/FVC ≥70% group (n=644 vs. 24.1% in the FEV1/FVC <70% group (n=466. A positive correlation was found between 1-FEV3/FVC and residual volume (r=0.70; p<0.0001, functional residual capacity-pleth (r=0.61; p<0.0001, and total lung capacity (r=0.47; p<0.0001. 1-FEV3/FVC was negatively correlated with forced expiratory flow25-75 (r=−0.84; p<0.0001. The upper limit of 95% confidence interval for 1-FEV3/FVC was 13.7%. 1-FEV3/FVC showed significant correlations with parameters of air trapping and hyperinflation measured by whole-body plethysmography. Importantly, these correlations were higher in study participants with FEV1/FVC <70% or FEV3/FVC

Limiting photocurrent analysis of a wide channel photoelectrochemical flow reactor

International Nuclear Information System (INIS)

Davis, Jonathan T; Esposito, Daniel V

2017-01-01

The development of efficient and scalable photoelectrochemical (PEC) reactors is of great importance for the eventual commercialization of solar fuels technology. In this study, we systematically explore the influence of convective mass transport and light intensity on the performance of a 3D-printed PEC flow cell reactor based on a wide channel, parallel plate geometry. Using this design, the limiting current density generated from the hydrogen evolution reaction at a p-Si metal–insulator–semiconductor (MIS) photocathode was investigated under varied reactant concentration, fluid velocity, and light intensity. Additionally, a simple model is introduced to predict the range of operating conditions (reactant concentration, light intensity, fluid velocity) for which the photocurrent generated in a parallel plate PEC flow cell is limited by light absorption or mass transport. This model can serve as a useful guide for the design and operation of wide-channel PEC flow reactors. The results of this study have important implications for PEC reactors operating in electrolytes with dilute reactant concentrations and/or under high light intensities where high fluid velocities are required in order to avoid operation in the mass transport-limited regime. (paper)

Comparative evaluation of ventilatory function through pre and postoperative peak expiratory flow in patients submitted to elective upper abdominal surgery.

Science.gov (United States)

Scheeren, Caio Fernando Cavanus; Gonçalves, José Júlio Saraiva

2016-01-01

to evaluate the ventilatory function by Peak Expiratory Flow (PEF) in the immediate pre and postoperative periods of patients undergoing elective surgical procedures in the upper abdomen. we conducted a prospective cohort study including 47 patients admitted to the Hospital Regional de Mato Grosso do Sul from July to December 2014, who underwent elective surgeries of the upper abdomen, and submiited to spirometric evaluation and measurement of PEF immediately before and after surgery. of the 47 patients, 22 (46.8%) were male and 25 (53.20%) female. The mean preoperative PEF was 412.1±91.7, and postoperative, 331.0±87.8, indicating significant differences between the two variables. Men had higher PEF values than women, both in the pre and postoperative periods. There was a reasonable inverse correlation between age and decreased PEF. Both situations showed statistical significance (pvalores de PFE do que o feminino, tanto no pré-cirúrgico quanto no pós-cirúrgico. Observou-se razoável correlação inversamente proporcional entre as variáveis idade e diminuição do PFE. Ambas as situações mostraram significância estatística (pvalores de PFE tanto no pré como no pós-operatório. O grupo composto por portadores de co-morbidades (HAS e/ou DM) apresentou menores valores de PFE tanto no pré como no pós-operatório (p=0,005). Em ambos os grupos, o pós-operatório determinou uma diminuição significativa do PFE (p<0,001). O tipo de cirurgia realizada e o tipo de anestesia não mostraram diferenças significantes em relação ao PFE. as variáveis mais implicadas na diminuição da função ventilatória, avaliadas através da PFE, foram: idade avançada, tabagismo e presença de comorbidades.

Effects of positive end-expiratory pressure and recruitment maneuvers in a ventilator-induced injury mouse model.

Directory of Open Access Journals (Sweden)

Laura A Cagle

Full Text Available Positive-pressure mechanical ventilation is an essential therapeutic intervention, yet it causes the clinical syndrome known as ventilator-induced lung injury. Various lung protective mechanical ventilation strategies have attempted to reduce or prevent ventilator-induced lung injury but few modalities have proven effective. A model that isolates the contribution of mechanical ventilation on the development of acute lung injury is needed to better understand biologic mechanisms that lead to ventilator-induced lung injury.To evaluate the effects of positive end-expiratory pressure and recruitment maneuvers in reducing lung injury in a ventilator-induced lung injury murine model in short- and longer-term ventilation.5-12 week-old female BALB/c mice (n = 85 were anesthetized, placed on mechanical ventilation for either 2 hrs or 4 hrs with either low tidal volume (8 ml/kg or high tidal volume (15 ml/kg with or without positive end-expiratory pressure and recruitment maneuvers.Alteration of the alveolar-capillary barrier was noted at 2 hrs of high tidal volume ventilation. Standardized histology scores, influx of bronchoalveolar lavage albumin, proinflammatory cytokines, and absolute neutrophils were significantly higher in the high-tidal volume ventilation group at 4 hours of ventilation. Application of positive end-expiratory pressure resulted in significantly decreased standardized histology scores and bronchoalveolar absolute neutrophil counts at low- and high-tidal volume ventilation, respectively. Recruitment maneuvers were essential to maintain pulmonary compliance at both 2 and 4 hrs of ventilation.Signs of ventilator-induced lung injury are evident soon after high tidal volume ventilation (as early as 2 hours and lung injury worsens with longer-term ventilation (4 hrs. Application of positive end-expiratory pressure and recruitment maneuvers are protective against worsening VILI across all time points. Dynamic compliance can be used guide

Effects of positive end-expiratory pressure and recruitment maneuvers in a ventilator-induced injury mouse model

Science.gov (United States)

Franzi, Lisa M.; Linderholm, Angela L.; Last, Jerold A.; Adams, Jason Y.; Harper, Richart W.

2017-01-01

Background Positive-pressure mechanical ventilation is an essential therapeutic intervention, yet it causes the clinical syndrome known as ventilator-induced lung injury. Various lung protective mechanical ventilation strategies have attempted to reduce or prevent ventilator-induced lung injury but few modalities have proven effective. A model that isolates the contribution of mechanical ventilation on the development of acute lung injury is needed to better understand biologic mechanisms that lead to ventilator-induced lung injury. Objectives To evaluate the effects of positive end-expiratory pressure and recruitment maneuvers in reducing lung injury in a ventilator-induced lung injury murine model in short- and longer-term ventilation. Methods 5–12 week-old female BALB/c mice (n = 85) were anesthetized, placed on mechanical ventilation for either 2 hrs or 4 hrs with either low tidal volume (8 ml/kg) or high tidal volume (15 ml/kg) with or without positive end-expiratory pressure and recruitment maneuvers. Results Alteration of the alveolar-capillary barrier was noted at 2 hrs of high tidal volume ventilation. Standardized histology scores, influx of bronchoalveolar lavage albumin, proinflammatory cytokines, and absolute neutrophils were significantly higher in the high-tidal volume ventilation group at 4 hours of ventilation. Application of positive end-expiratory pressure resulted in significantly decreased standardized histology scores and bronchoalveolar absolute neutrophil counts at low- and high-tidal volume ventilation, respectively. Recruitment maneuvers were essential to maintain pulmonary compliance at both 2 and 4 hrs of ventilation. Conclusions Signs of ventilator-induced lung injury are evident soon after high tidal volume ventilation (as early as 2 hours) and lung injury worsens with longer-term ventilation (4 hrs). Application of positive end-expiratory pressure and recruitment maneuvers are protective against worsening VILI across all time points

Effects of positive end-expiratory pressure and recruitment maneuvers in a ventilator-induced injury mouse model.

Science.gov (United States)

Cagle, Laura A; Franzi, Lisa M; Linderholm, Angela L; Last, Jerold A; Adams, Jason Y; Harper, Richart W; Kenyon, Nicholas J

2017-01-01

Positive-pressure mechanical ventilation is an essential therapeutic intervention, yet it causes the clinical syndrome known as ventilator-induced lung injury. Various lung protective mechanical ventilation strategies have attempted to reduce or prevent ventilator-induced lung injury but few modalities have proven effective. A model that isolates the contribution of mechanical ventilation on the development of acute lung injury is needed to better understand biologic mechanisms that lead to ventilator-induced lung injury. To evaluate the effects of positive end-expiratory pressure and recruitment maneuvers in reducing lung injury in a ventilator-induced lung injury murine model in short- and longer-term ventilation. 5-12 week-old female BALB/c mice (n = 85) were anesthetized, placed on mechanical ventilation for either 2 hrs or 4 hrs with either low tidal volume (8 ml/kg) or high tidal volume (15 ml/kg) with or without positive end-expiratory pressure and recruitment maneuvers. Alteration of the alveolar-capillary barrier was noted at 2 hrs of high tidal volume ventilation. Standardized histology scores, influx of bronchoalveolar lavage albumin, proinflammatory cytokines, and absolute neutrophils were significantly higher in the high-tidal volume ventilation group at 4 hours of ventilation. Application of positive end-expiratory pressure resulted in significantly decreased standardized histology scores and bronchoalveolar absolute neutrophil counts at low- and high-tidal volume ventilation, respectively. Recruitment maneuvers were essential to maintain pulmonary compliance at both 2 and 4 hrs of ventilation. Signs of ventilator-induced lung injury are evident soon after high tidal volume ventilation (as early as 2 hours) and lung injury worsens with longer-term ventilation (4 hrs). Application of positive end-expiratory pressure and recruitment maneuvers are protective against worsening VILI across all time points. Dynamic compliance can be used guide the frequency

Limiting fragmentation in a thermal model with flow

Energy Technology Data Exchange (ETDEWEB)

Kumar Tiwari, Swatantra; Sahoo, Raghunath [Indian Institute of Technology Indore, Discipline of Physics, School of Basic Sciences, Simrol, Indore (India)

2016-12-15

The property of limiting fragmentation of various observables such as rapidity distributions (dN/dy), elliptic flow (v{sub 2}), average transverse momentum (left angle p{sub T} right angle) etc. of charged particles is observed when they are plotted as a function of rapidity (y) shifted by the beam rapidity (y{sub beam}) for a wide range of energies from AGS to RHIC. Limiting fragmentation (LF) is a well-studied phenomenon as observed in various collision energies and colliding systems experimentally. It is very interesting to verify this phenomenon theoretically. We study such a phenomenon for pion rapidity spectra using our hydrodynamic-like model where the collective flow is incorporated in a thermal model in the longitudinal direction. Our findings advocate the observation of extended longitudinal scaling in the rapidity spectra of pions from AGS to lower RHIC energies, while it is observed to be violated at top RHIC and LHC energies. Prediction of LF hypothesis for Pb+Pb collisions at √(s{sub NN}) = 5.02 TeV is given. (orig.)

Flux Limiter Lattice Boltzmann for Compressible Flows

International Nuclear Information System (INIS)

Chen Feng; Li Yingjun; Xu Aiguo; Zhang Guangcai

2011-01-01

In this paper, a new flux limiter scheme with the splitting technique is successfully incorporated into a multiple-relaxation-time lattice Boltzmann (LB) model for shacked compressible flows. The proposed flux limiter scheme is efficient in decreasing the artificial oscillations and numerical diffusion around the interface. Due to the kinetic nature, some interface problems being difficult to handle at the macroscopic level can be modeled more naturally through the LB method. Numerical simulations for the Richtmyer-Meshkov instability show that with the new model the computed interfaces are smoother and more consistent with physical analysis. The growth rates of bubble and spike present a satisfying agreement with the theoretical predictions and other numerical simulations. (electromagnetism, optics, acoustics, heat transfer, classical mechanics, and fluid dynamics)

PIC simulations of conical magnetically insulated transmission line with LTD generator: Transition from self-limited to load-limited flow

Science.gov (United States)

Liu, Laqun; Wang, Huihui; Guo, Fan; Zou, Wenkang; Liu, Dagang

2017-04-01

Based on the 3-dimensional Particle-In-Cell (PIC) code CHIPIC3D, with a new circuit boundary algorithm we developed, a conical magnetically insulated transmission line (MITL) with a 1.0-MV linear transformer driver (LTD) is explored numerically. The values of switch jitter time of LTD are critical parameters for the system, which are difficult to be measured experimentally. In this paper, these values are obtained by comparing the PIC results with experimental data of large diode-gap MITL. By decreasing the diode gap, we find that all PIC results agree well with experimental data only if MITL works on self-limited flow no matter how large the diode gap is. However, when the diode gap decreases to a threshold, the self-limited flow would transfer to a load-limited flow. In this situation, PIC results no longer agree with experimental data anymore due to the anode plasma expansion in the diode load. This disagreement is used to estimate the plasma expansion speed.

Effects of positive end-expiratory pressure on arthroscopic shoulder surgery under general anesthesia.

Science.gov (United States)

Ersoy, Ayşın; Çakırgöz, Mensure; Ervatan, Zekeriya; Kıran, Özlem; Türkmen, Aygen; Esenyel, Cem Zeki

2016-01-01

Our study is a prospective, randomized study on patients undergoing arthroscopic shoulder surgery in the beach-chair position to evaluate the effects of positive end-expiratory pressure (PEEP) on hemodynamic stability, providing a bloodless surgical field and surgical satisfaction. Fifty patients were divided into two groups. Group I (n=25) had zero end-expiratory pressure (ZEEP) administered under general anesthesia, and group II (n=25) had +5 PEEP administered. During surgery, intraarticular hemorrhage and surgical satisfaction were evaluated on a scale of 0-10. During surgery, at the 5th, 30th, 60th, and 90th minutes and at the end of surgery, heart rate, mean arterial pressure (MAP), and positive inspiratory pressure were recorded. At the end of the surgery, the amount of bleeding and duration of the operation were recorded. In group I, the duration of operation and amount of bleeding were found to be significantly greater than those in group II (pshoulder surgery in the beach-chair position reduces the amount of hemorrhage in the surgical field and thus increases surgical satisfaction without requiring the creation of controlled hypotension.

Weighted Polynomial Approximation for Automated Detection of Inspiratory Flow Limitation

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Sheng-Cheng Huang

2017-01-01

Full Text Available Inspiratory flow limitation (IFL is a critical symptom of sleep breathing disorders. A characteristic flattened flow-time curve indicates the presence of highest resistance flow limitation. This study involved investigating a real-time algorithm for detecting IFL during sleep. Three categories of inspiratory flow shape were collected from previous studies for use as a development set. Of these, 16 cases were labeled as non-IFL and 78 as IFL which were further categorized into minor level (20 cases and severe level (58 cases of obstruction. In this study, algorithms using polynomial functions were proposed for extracting the features of IFL. Methods using first- to third-order polynomial approximations were applied to calculate the fitting curve to obtain the mean absolute error. The proposed algorithm is described by the weighted third-order (w.3rd-order polynomial function. For validation, a total of 1,093 inspiratory breaths were acquired as a test set. The accuracy levels of the classifications produced by the presented feature detection methods were analyzed, and the performance levels were compared using a misclassification cobweb. According to the results, the algorithm using the w.3rd-order polynomial approximation achieved an accuracy of 94.14% for IFL classification. We concluded that this algorithm achieved effective automatic IFL detection during sleep.

Incidence of tracheobronchomalacia associated with pulmonary emphysema. Detection with paired inspiratory-expiratory multidetector computed tomography using a low-dose technique

International Nuclear Information System (INIS)

Inoue, Masanori; Hasegawa, Ichiro; Nakano, Keiko; Yamaguchi, Kazuhiro; Kuribayashi, Sachio

2009-01-01

The purpose of this study was to evaluate the frequency of tracheobronchomalacia (TBM) associated with pulmonary emphysema with paired inspiratory-expiratory multidetector computed tomography (MDCT) using a low-dose technique. This study included 56 consecutive patients (55 men, 1 woman; mean age 68.9 years) with pulmonary emphysema who had undergone paired inspiratory-expiratory CT scanning with a low-dose technique (40 mA). All images were retrospectively examined by two thoracic radiologists in a blinded fashion. The diagnosis of TBM was based on the standard criterion of >50% reduction in the cross-sectional area of the tracheobronchial lumen at the end-expiratory phase. A mild TBM criterion of >30% reduction was also reviewed. All patients underwent pulmonary function tests. The relation between the forced expiratory volume in 1 s (FEV 1.0% ) and TBM was statistically analyzed. Four (7.1%) and eight (14.3%) patients were diagnosed as TBM based on the standard and mild criteria, respectively. In four patients, the percentages of luminal narrowing were 63.4% and 51.2%, respectively for tracheomalacia and 59.2% and 62.0%, respectively, for bronchomalacia. The FEV 1.0% values between patients with and without TBM showed no statistical difference. The incidence of TBM associated with pulmonary emphysema was 7.1% with the standard criterion. It is possible that TBM has been underdiagnosed in a number of patients with pulmonary emphysema. (author)

Unidirectional Expiratory Valve Method to Assess Maximal Inspiratory Pressure in Individuals without Artificial Airway.

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Samantha Torres Grams

Full Text Available Maximal Inspiratory Pressure (MIP is considered an effective method to estimate strength of inspiratory muscles, but still leads to false positive diagnosis. Although MIP assessment with unidirectional expiratory valve method has been used in patients undergoing mechanical ventilation, no previous studies investigated the application of this method in subjects without artificial airway.This study aimed to compare the MIP values assessed by standard method (MIPsta and by unidirectional expiratory valve method (MIPuni in subjects with spontaneous breathing without artificial airway. MIPuni reproducibility was also evaluated.This was a crossover design study, and 31 subjects performed MIPsta and MIPuni in a random order. MIPsta measured MIP maintaining negative pressure for at least one second after forceful expiration. MIPuni evaluated MIP using a unidirectional expiratory valve attached to a face mask and was conducted by two evaluators (A and B at two moments (Tests 1 and 2 to determine interobserver and intraobserver reproducibility of MIP values. Intraclass correlation coefficient (ICC[2,1] was used to determine intraobserver and interobserver reproducibility.The mean values for MIPuni were 14.3% higher (-117.3 ± 24.8 cmH2O than the mean values for MIPsta (-102.5 ± 23.9 cmH2O (p<0.001. Interobserver reproducibility assessment showed very high correlation for Test 1 (ICC[2,1] = 0.91, and high correlation for Test 2 (ICC[2,1] = 0.88. The assessment of the intraobserver reproducibility showed high correlation for evaluator A (ICC[2,1] = 0.86 and evaluator B (ICC[2,1] = 0.77.MIPuni presented higher values when compared with MIPsta and proved to be reproducible in subjects with spontaneous breathing without artificial airway.

Effect of simultaneous application of postural techniques and expiratory muscle strength training on the enhancement of the swallowing function of patients with dysphagia caused by parkinson?s disease

OpenAIRE

Byeon, Haewon

2016-01-01

[Purpose] This study aimed to investigate the effect of simultaneous application of postural techniques and expiratory muscle strength training on the enhancement of the swallowing function of patients with dysphagia caused by Parkinson?s disease. [Subjects and Methods] The subjects of this study were 18 patients who received simultaneous application of postural techniques and expiratory muscle strength training and 15 patients who received expiratory muscle strength training only. Postural t...

The respiratory drive to thoracic motoneurones in the cat and its relation to the connections from expiratory bulbospinal neurones

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Saywell, S A; Anissimova, N P; Ford, T W; Meehan, C F; Kirkwood, P A

2007-01-01

The descending control of respiratory-related motoneurones in the thoracic spinal cord remains the subject of some debate. In this study, direct connections from expiratory bulbospinal neurones to identified motoneurones were investigated using spike-triggered averaging and the strengths of connection revealed were related to the presence and size of central respiratory drive potentials in the same motoneurones. Intracellular recordings were made from motoneurones in segments T5–T9 of the spinal cord of anaesthetized cats. Spike-triggered averaging from expiratory bulbospinal neurones in the caudal medulla revealed monosynaptic EPSPs in all groups of motoneurones, with the strongest connections to expiratory motoneurones with axons in the internal intercostal nerve. In the latter, connection strength was similar irrespective of the target muscle (e.g. external abdominal oblique or internal intercostal) and the EPSP amplitude was positively correlated with the amplitude of the central respiratory drive potential of the motoneurone. For this group, EPSPs were found in 45/83 bulbospinal neurone/motoneurone pairs, with a mean amplitude of 40.5 μV. The overall strength of the connection supports previous measurements made by cross-correlation, but is about 10 times stronger than that reported in the only previous similar survey to use spike-triggered averaging. Calculations are presented to suggest that this input alone is sufficient to account for all the expiratory depolarization seen in the recorded motoneurones. However, extra sources of input, or amplification of this one, are likely to be necessary to produce a useful motoneurone output. PMID:17204500

The ω-limit sets of a flow and periodic orbits

International Nuclear Information System (INIS)

Wang Xiaoxia; Blackmore, Denis; Wang Chengwen

2009-01-01

In this paper we discuss the ω-limit sets of a flow using the Conley theory, chain recurrence and Morse decompositions. Our results generalize and improve the related result in [Schropp J. A reduction principle for ω-limit sets. Z Angew Math Meth 1996;76(6):349-56], and we also show how they can be used as a basis for some new criteria for the existence of periodic orbits.

The unique contribution of manual chest compression-vibrations to airflow during physiotherapy in sedated, fully ventilated children.

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Gregson, Rachael K; Shannon, Harriet; Stocks, Janet; Cole, Tim J; Peters, Mark J; Main, Eleanor

2012-03-01

This study aimed to quantify the specific effects of manual lung inflations with chest compression-vibrations, commonly used to assist airway clearance in ventilated patients. The hypothesis was that force applied during the compressions made a significant additional contribution to increases in peak expiratory flow and expiratory to inspiratory flow ratio over and above that resulting from accompanying increases in inflation volume. Prospective observational study. Cardiac and general pediatric intensive care. Sedated, fully ventilated children. Customized force-sensing mats and a commercial respiratory monitor recorded force and respiration during physiotherapy. Percentage changes in peak expiratory flow, peak expiratory to inspiratory flow ratios, inflation volume, and peak inflation pressure between baseline and manual inflations with and without compression-vibrations were calculated. Analysis of covariance determined the relative contribution of changes in pressure, volume, and force to influence changes in peak expiratory flow and peak expiratory to inspiratory flow ratio. Data from 105 children were analyzed (median age, 1.3 yrs; range, 1 wk to 15.9 yrs). Force during compressions ranged from 15 to 179 N (median, 46 N). Peak expiratory flow increased on average by 76% during compressions compared with baseline ventilation. Increases in peak expiratory flow were significantly related to increases in inflation volume, peak inflation pressure, and force with peak expiratory flow increasing by, on average, 4% for every 10% increase in inflation volume (p children.

Feasibility study of respiratory questionnaire and peak flow recordings in autobody shop workers exposed to isocyanate-containing spray paint: observations and limitations.

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Cullen, M R; Redlich, C A; Beckett, W S; Weltmann, B; Sparer, J; Jackson, G; Ruff, T; Rubinstein, E; Holden, W

1996-06-01

Diisocyanates, highly reactive monomers which cross-link polyurethane, are the most widely recognized causes of occupational asthma. Many exposed workers are end-users, including autobody spray painters who form a large population at risk. Neither the factors which determine incidence rate nor strategies for control have been adequately studied in this setting. We have conducted a cross-sectional survey of 23 (about one in five) autobody shops in the New Haven area to determine the feasibility of clinical epidemiological studies in this population. Among 102 workers, there was a high rate of airway symptoms consistent with occupational asthma (19.6%). Symptoms were most prevalent among those with the greatest opportunity for exposure (dedicated spray painters) and least among office workers; part-time painters had intermediate rates. Atopy was not associated with risk while smoking seemed to correlate with symptoms. Regular use of air-supplied respirators appeared to be associated with lower risk among workers who painted part- or full-time. We were unable to validate the questionnaire responses with peak expiratory flow record data attempted on a 1/3 sample of the workers. Despite intensive training and effort, subject compliance was limited. Among those who provided adequate data (24 of 38), only two demonstrated unequivocal evidence of labile airways; two others demonstrated lesser changes consistent with an occupational effect on flow rates. There was no clear association between these findings and either questionnaire responses or exposure classification. Overall, the survey suggests that there is a high prevalence of airway symptoms among workers in autobody shops, at least in part due to work-related asthma. However, there is need for both methodological and substantive research in this setting to document rates of occupational asthma and to develop a scientific basis for its effective control.

High Performance Redox Flow Batteries: An Analysis of the Upper Performance Limits of Flow Batteries Using Non-aqueous Solvents

International Nuclear Information System (INIS)

Sun, C.-N.; Mench, M.M.; Zawodzinski, T.A.

2017-01-01

Redox Flow Batteries (RFBs) are a promising technology for grid-scale electrochemical energy storage. In this work, we use a recently achieved high-performance flow battery performance curve as a basis to assess the maximum achievable performance of a RFB employing non-aqueous solutions as active materials. First we show high performance in a vanadium redox flow battery (VRFB), specifically a limiting situation in which the cell losses are ohmic in nature and derive from electrolyte conductance. Based on that case, we analyze the analogous limiting behavior of non-aqueous (NA) systems using a series of calculations assuming similar ohmic losses, scaled by the relative electrolyte resistances, with a higher voltage redox couple assumed for the NA battery. The results indicate that the NA battery performance is limited by the low electrolyte conductivity to a fraction of the performance of the VRFB. Given the narrow window in which the NARFB offers advantages, even for the most generous limiting assumptions related to performance while ignoring the numerous other disadvantageous aspects of these systems, we conclude that this technology is unlikely under present circumstances to provide practical large-scale energy storage solutions.

Flow motifs reveal limitations of the static framework to represent human interactions

Science.gov (United States)

Rocha, Luis E. C.; Blondel, Vincent D.

2013-04-01

Networks are commonly used to define underlying interaction structures where infections, information, or other quantities may spread. Although the standard approach has been to aggregate all links into a static structure, some studies have shown that the time order in which the links are established may alter the dynamics of spreading. In this paper, we study the impact of the time ordering in the limits of flow on various empirical temporal networks. By using a random walk dynamics, we estimate the flow on links and convert the original undirected network (temporal and static) into a directed flow network. We then introduce the concept of flow motifs and quantify the divergence in the representativity of motifs when using the temporal and static frameworks. We find that the regularity of contacts and persistence of vertices (common in email communication and face-to-face interactions) result on little differences in the limits of flow for both frameworks. On the other hand, in the case of communication within a dating site and of a sexual network, the flow between vertices changes significantly in the temporal framework such that the static approximation poorly represents the structure of contacts. We have also observed that cliques with 3 and 4 vertices containing only low-flow links are more represented than the same cliques with all high-flow links. The representativity of these low-flow cliques is higher in the temporal framework. Our results suggest that the flow between vertices connected in cliques depend on the topological context in which they are placed and in the time sequence in which the links are established. The structure of the clique alone does not completely characterize the potential of flow between the vertices.

Segmentation of expiratory and inspiratory sounds in baby cry audio recordings using hidden Markov models.

Science.gov (United States)

Aucouturier, Jean-Julien; Nonaka, Yulri; Katahira, Kentaro; Okanoya, Kazuo

2011-11-01

The paper describes an application of machine learning techniques to identify expiratory and inspiration phases from the audio recording of human baby cries. Crying episodes were recorded from 14 infants, spanning four vocalization contexts in their first 12 months of age; recordings from three individuals were annotated manually to identify expiratory and inspiratory sounds and used as training examples to segment automatically the recordings of the other 11 individuals. The proposed algorithm uses a hidden Markov model architecture, in which state likelihoods are estimated either with Gaussian mixture models or by converting the classification decisions of a support vector machine. The algorithm yields up to 95% classification precision (86% average), and its ability generalizes over different babies, different ages, and vocalization contexts. The technique offers an opportunity to quantify expiration duration, count the crying rate, and other time-related characteristics of baby crying for screening, diagnosis, and research purposes over large populations of infants.

Control of positive end-expiratory pressure (PEEP for small animal ventilators

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Leão Nunes Marcelo V

2010-07-01

Full Text Available Abstract Background The positive end-expiratory pressure (PEEP for the mechanical ventilation of small animals is frequently obtained with water seals or by using ventilators developed for human use. An alternative mechanism is the use of an on-off expiratory valve closing at the moment when the alveolar pressure is equal to the target PEEP. In this paper, a novel PEEP controller (PEEP-new and the PEEP system of a commercial small-animal ventilator, both based on switching an on-off valve, are evaluated. Methods The proposed PEEP controller is a discrete integrator monitoring the error between the target PEEP and the airways opening pressure prior to the onset of an inspiratory cycle. In vitro as well as in vivo experiments with rats were carried out and the PEEP accuracy, settling time and under/overshoot were considered as a measure of performance. Results The commercial PEEP controller did not pass the tests since it ignores the airways resistive pressure drop, resulting in a PEEP 5 cmH2O greater than the target in most conditions. The PEEP-new presented steady-state errors smaller than 0.5 cmH2O, with settling times below 10 s and under/overshoot smaller than 2 cmH2O. Conclusion The PEEP-new presented acceptable performance, considering accuracy and temporal response. This novel PEEP generator may prove useful in many applications for small animal ventilators.

An advanced expiratory circuit for the recovery of perfluorocarbon liquid from non-saturated perfluorocarbon vapour during partial liquid ventilation: an experimental model

Directory of Open Access Journals (Sweden)

Davies Mark W

2006-02-01

Full Text Available Abstract Background The loss of perfluorocarbon (PFC vapour in the expired gases during partial liquid ventilation should be minimized both to prevent perfluorocarbon vapour entering the atmosphere and to re-use the recovered PFC liquid. Using a substantially modified design of our previously described condenser, we aimed to determine how much perfluorocarbon liquid could be recovered from gases containing PFC and water vapour, at concentrations found during partial liquid ventilation, and to determine if the amount recovered differed with background flow rate (at flow rates suitable for use in neonates. Methods The expiratory line of a standard ventilator circuit set-up was mimicked, with the addition of two condensers. Perfluorocarbon (30 mL of FC-77 and water vapour, at concentrations found during partial liquid ventilation, were passed through the circuit at a number of flow rates and the percentage recovery of the liquids measured. Results From 14.2 mL (47% to 27.3 mL (91% of the infused 30 mL of FC-77 was recovered at the flow rates studied. Significantly higher FC-77 recovery was obtained at lower flow rates (ANOVA with Bonferroni's multiple comparison test, p -1 (ANOVA with Bonferroni's multiple comparison test, p -1, respectively. Conclusion Using two condensers in series 47% to 91% of perfluorocarbon liquid can be recovered, from gases containing perfluorocarbon and water vapour, at concentrations found during partial liquid ventilation.

Clinical evidence on high flow oxygen therapy and active humidification in adults.

Science.gov (United States)

Gotera, C; Díaz Lobato, S; Pinto, T; Winck, J C

2013-01-01

Recently there has been growing interest in an alternative to conventional oxygen therapy: the heated, humidified high flow nasal cannula oxygen therapy (HFNC). A number of physiological effects have been described with HFNC: pharyngeal dead space washout, reduction of nasopharyngeal resistance, a positive expiratory pressure effect, an alveolar recruitment, greater humidification, more comfort and better tolerance by the patient, better control of FiO2 and mucociliary clearance. There is limited experience of HFNC in adults. There are no established guidelines or decision-making pathways to guide use of the HFNC therapy for adults. In this article we review the existing evidence of HFNC oxygen therapy in adult patients, its advantages, limitations and the current literature on clinical applications. Further research is required to determine the long-term effect of this therapy and identify the adult patient population to whom it is most beneficial. Copyright © 2013 Sociedade Portuguesa de Pneumologia. Published by Elsevier España. All rights reserved.

Peak flow variation in childhood asthma : Relationship to symptoms, atopy, airways obstruction and hyperresponsiveness

NARCIS (Netherlands)

Brand, PLP; Duiverman, EJ; Postma, DS; Waalkens, HJ; Kerrebijn, KF; vanEssenZandvliet, EEM; Quanjer, PH; Sluiter, HJ; Pouw, EM; Schoonbrood, DFME; Roos, CM; Jansen, HM; DeGooijer, A; Kerstjens, HAM; vanderMark, TW; Koeter, GH; deJong, PM; Sterk, PJ; Weaver, AMJ; Dijkman, JH; Dekhuijzen, PNR; Folgering, HTM; vanHerwaarden, CLA; Overbeek, SE; Bogaard, JM; Hilvering, C; Gans, SJ; Mengelers, HJJ; vanderBruggenBogaarts, BAHA; Kreukniet, J; Kouwenberg, JM; Prinsen, JE; Gerritsen, J; Knol, K; deMonchy, JGR; Dekker, FW; Kaptein, AA; Merkus, PJFM; Pocock, SJ; Hughes, MD; Robinson, NJ; Bleecker, ER; Meyers, DA

Although home recording of peak expiratory flow (PEF) is considered useful in managing asthma, little is known about the relationship of PEF variation to other indicators of disease activity, We examined the relationship of PEF variation, expressed in various ways, to symptoms, atopy, level of lung

Impediment in upper airway stabilizing forces assessed by phrenic nerve stimulation in sleep apnea patients

Directory of Open Access Journals (Sweden)

Vérin E

2005-09-01

Full Text Available Abstract Background The forces developed during inspiration play a key role in determining upper airway stability and the occurrence of nocturnal breathing disorders. Phrenic nerve stimulation applied during wakefulness is a unique tool to assess Upper airway dynamic properties and to measure the overall mechanical effects of the inspiratory process on UA stability. Objectives To compare the flow/pressure responses to inspiratory and expiratory twitches between sleep apnea subjects and normal subjects. Methods Inspiratory and expiratory twitches using magnetic nerve stimulation completed in eleven untreated sleep apnea subjects and ten normal subjects. Results In both groups, higher flow and pressure were reached during inspiratory twitches. The two groups showed no differences in expiratory twitch parameters. During inspiration, the pressure at which flow-limitation occurred was more negative in normals than in apneic subjects, but not reaching significance (p = 0.07. The relationship between pharyngeal pressure and flow adequately fitted with a polynomial regression model providing a measurement of upper airway critical pressure during twitch. This pressure significantly decreased in normals from expiratory to inspiratory twitches (-11.1 ± 1.6 and -15.7 ± 1.0 cm H2O respectively, 95% CI 1.6–7.6, p Conclusion Inspiratory-related upper airway dilating forces are impeded in sleep apnea patients.

Countercurrent flow limitation model for RELAP5/MOD3

International Nuclear Information System (INIS)

Riemke, R.A.

1991-01-01

This paper reports on a countercurrent flow limitation model incorporated into the RELAP5/MOD3 system transient analysis code. The model is implemented in a manner similar to the RELAP5 chocking model. Simulations using air/water flooding test problem demonstrate the ability of the code to significantly improve its comparison to data when a flooding correlation is used

Heating limits of boiling downward two-phase flow in parallel channels

International Nuclear Information System (INIS)

Fukuda, Kenji; Kondoh, Tetsuya; Hasegawa, Shu; Sakai, Takaaki.

1989-01-01

Flow characteristics and heating limits of downward two-phase flow in single or parallel multi-channels are investigated experimentally and analytically. The heating section used is made of glass tube, in which the heater tube is inserted, and the flow regime inside it is observed. In single channel experiments with low flow rate conditions, it is found that, initially, gas phase which flows upward against the downward liquid phase flow condenses and diminishes as it flows up being cooled by inflowing liquid. However, as the heating power is increased, some portion of the gas phase reaches the top and accumulates to form an liquid level, which eventually causes the dryout. On the other hand, for high flow rate condition, the flooding at the bottom of the heated section is the cause of the dryout. In parallel multi-channels experiments, reversed (upward) flow which leads to the dryout is observed in some of these channels for low flow rate conditions, while the situation is the same to the single channel case for high flow rate conditions. Analyses are carried out to predict the onset of dryout in single channel using the drift flux model as well as the Wallis' flooding correlation. Above-mentioned two types of the dryout and their boundary are predicted which agree well with the experimental results. (author)

Clinical assessment of auto-positive end-expiratory pressure by diaphragmatic electrical activity during pressure support and neurally adjusted ventilatory assist.

Science.gov (United States)

Bellani, Giacomo; Coppadoro, Andrea; Patroniti, Nicolò; Turella, Marta; Arrigoni Marocco, Stefano; Grasselli, Giacomo; Mauri, Tommaso; Pesenti, Antonio

2014-09-01

Auto-positive end-expiratory pressure (auto-PEEP) may substantially increase the inspiratory effort during assisted mechanical ventilation. Purpose of this study was to assess whether the electrical activity of the diaphragm (EAdi) signal can be reliably used to estimate auto-PEEP in patients undergoing pressure support ventilation and neurally adjusted ventilatory assist (NAVA) and whether NAVA was beneficial in comparison with pressure support ventilation in patients affected by auto-PEEP. In 10 patients with a clinical suspicion of auto-PEEP, the authors simultaneously recorded EAdi, airway, esophageal pressure, and flow during pressure support and NAVA, whereas external PEEP was increased from 2 to 14 cm H2O. Tracings were analyzed to measure apparent "dynamic" auto-PEEP (decrease in esophageal pressure to generate inspiratory flow), auto-EAdi (EAdi value at the onset of inspiratory flow), and IDEAdi (inspiratory delay between the onset of EAdi and the inspiratory flow). The pressure necessary to overcome auto-PEEP, auto-EAdi, and IDEAdi was significantly lower in NAVA as compared with pressure support ventilation, decreased with increase in external PEEP, although the effect of external PEEP was less pronounced in NAVA. Both auto-EAdi and IDEAdi were tightly correlated with auto-PEEP (r = 0.94 and r = 0.75, respectively). In the presence of auto-PEEP at lower external PEEP levels, NAVA was characterized by a characteristic shape of the airway pressure. In patients with auto-PEEP, NAVA, compared with pressure support ventilation, led to a decrease in the pressure necessary to overcome auto-PEEP, which could be reliably monitored by the electrical activity of the diaphragm before inspiratory flow onset (auto-EAdi).

Acute effects of particulate matter and black carbon from seasonal fires on peak expiratory flow of schoolchildren in the Brazilian Amazon.

Directory of Open Access Journals (Sweden)

Ludmilla da Silva Viana Jacobson

Full Text Available BACKGROUND: Panel studies have shown adverse effects of air pollution from biomass burning on children's health. This study estimated the effect of current levels of outdoor air pollution in the Amazonian dry season on peak expiratory flow (PEF. METHODS: A panel study with 234 schoolchildren from 6 to 15 years old living in the municipality of Tangará da Serra, Brazil was conducted. PEF was measured daily in the dry season in 2008. Mixed-effects models and unified modelling repeated for every child were applied. Time trends, temperature, humidity, and subject characteristics were regarded. Inhalable particulate matter (PM10, fine particulate matter (PM2.5, and black carbon (BC effects were evaluated based on 24-hour exposure lagged by 1 to 5 days and the averages of 2 or 3 days. Polynomial distributed lag models (PDLM were also applied. RESULTS: The analyses revealed reductions in PEF for PM10 and PM2.5 increases of 10 µg/m(3 and 1 µg/m(3 for BC. For PM10, the reductions varied from 0.15 (confidence interval (CI95%: -0.29; -0.01 to 0.25 l/min (CI95%: -0.40; -0.10. For PM2.5, they ranged from 0.46 (CI95%: -0.86 to -0.06 to 0.54 l/min (CI95%:-0.95; -0.14. As for BC, the reduction was approximately 1.40 l/min. In relation to PDLM, adverse effects were noticed in models based on the exposure on the current day through the previous 3 days (PDLM 0-3 and on the current day through the previous 5 days (PDLM 0-5, specially for PM10. For all children, for PDLM 0-5 the global effect was important for PM10, with PEF reduction of 0.31 l/min (CI95%: -0.56; -0.05. Also, reductions in lags 3 and 4 were observed. These associations were stronger for children between 6 and 8 years old. CONCLUSION: Reductions in PEF were associated with air pollution, mainly for lagged exposures of 3 to 5 days and for younger children.

The limit of the Yang-Mills-Higgs flow on Higgs bundles

OpenAIRE

Li, Jiayu; Zhang, Xi

2014-01-01

In this paper, we consider the gradient flow of the Yang-Mills-Higgs functional for Higgs pairs on a Hermitian vector bundle $(E, H_{0})$ over a compact K\\"ahler manifold $(M, \\omega )$. We study the asymptotic behavior of the Yang-Mills-Higgs flow for Higgs pairs at infinity, and show that the limiting Higgs sheaf is isomorphic to the double dual of the graded Higgs sheaves associated to the Harder-Narasimhan-Seshadri filtration of the initial Higgs bundle.

The need for standardisation of peak flow charts

OpenAIRE

Reddel, H; Vincent, S; Civitico, J

2005-01-01

Peak expiratory flow (PEF) monitoring is recommended in asthma guidelines as a tool for assessing severity, monitoring response to treatment, detecting exacerbations, identifying triggers, and providing objective justification for treatment to the patient, but some clinicians have expressed concerns about its relevance in the management of asthma. We have identified a sevenfold variation in the scale of existing PEF charts, with resulting wide variation in the appearance of the same PEF date ...

Dead space and slope indices from the expiratory carbon dioxide tension-volume curve

OpenAIRE

Kars, Alice; Bogaard, Jan; Stijnen, Theo; Vries, J.; Verbraak, Anton; Hilvering, C.

1997-01-01

textabstractThe slope of phase 3 and three noninvasively determined dead space estimates derived from the expiratory carbon dioxide tension (PCO2) versus volume curve, including the Bohr dead space (VD,Bohr), the Fowler dead space (VD,Fowler) and pre-interface expirate (PIE), were investigated in 28 healthy control subjects, 12 asthma and 29 emphysema patients (20 severely obstructed and nine moderately obstructed) with the aim to establish diagnostic value. Because breath volume and frequenc...

Wasserstein gradient flows from large deviations of many-particle limits

NARCIS (Netherlands)

Duong, M.H.; Laschos, V.; Renger, D.R.M.

2013-01-01

We study the Fokker–Planck equation as the many-particle limit of a stochastic particle system on one hand and as a Wasserstein gradient flow on the other. We write the path-space rate functional, which characterises the large deviations from the expected trajectories, in such a way that the free

TU-CD-BRA-11: Application of Bone Suppression Technique to Inspiratory/expiratory Chest Radiography

Energy Technology Data Exchange (ETDEWEB)

Tanaka, R; Sanada, S [Kanazawa University, Kanazawa, Ishikawa (Japan); Sakuta, K; Kawashima, H [Kanazawa University Hospital, Kanazawa, Ishikawa (Japan); Kishitani, Y [TOYO Corporation, Chuoh-ku, Tokyo (Japan)

2015-06-15

Purpose: The bone suppression technique based on advanced image processing can suppress the conspicuity of bones on chest radiographs, creating soft tissue images normally obtained by the dual-energy subtraction technique. This study was performed to investigate the usefulness of bone suppression technique in quantitative analysis of pulmonary function in inspiratory/expiratory chest radiography. Methods: Commercial bone suppression image processing software (ClearRead; Riverain Technologies) was applied to paired inspiratory/expiratory chest radiographs of 107 patients (normal, 33; abnormal, 74) to create corresponding bone suppression images. The abnormal subjects had been diagnosed with pulmonary diseases, such as pneumothorax, pneumonia, emphysema, asthma, and lung cancer. After recognition of the lung area, the vectors of respiratory displacement were measured in all local lung areas using a cross-correlation technique. The measured displacement in each area was visualized as displacement color maps. The distribution pattern of respiratory displacement was assessed by comparison with the findings of lung scintigraphy. Results: Respiratory displacement of pulmonary markings (soft tissues) was able to be quantified separately from the rib movements on bone suppression images. The resulting displacement map showed a left-right symmetric distribution increasing from the lung apex to the bottom region of the lung in many cases. However, patients with ventilatory impairments showed a nonuniform distribution caused by decreased displacement of pulmonary markings, which were confirmed to correspond to area with ventilatory impairments found on the lung scintigrams. Conclusion: The bone suppression technique was useful for quantitative analysis of respiratory displacement of pulmonary markings without any interruption of the rib shadows. Abnormal areas could be detected as decreased displacement of pulmonary markings. Inspiratory/expiratory chest radiography combined

RELATIONSHIP OF AIRWAY HYPERRESPONSIVENESS TO RESPIRATORY SYMPTOMS AND DIURNAL PEAK FLOW VARIATION IN PATIENTS WITH OBSTRUCTIVE LUNG-DISEASE

NARCIS (Netherlands)

BRAND, PLP; POSTMA, DS; KERSTJENS, HAM; KOETER, GH

This study reports on the relationship of airway hyperresponsiveness (AH) with respiratory symptoms and diurnal peak flow expiratory (PEF) variation in 221 hyperresponsive patients with moderately severe airways obstruction. The disease was in a stable phase in all patients. Closely adhering to the

Deep breathing exercises with positive expiratory pressure in patients with multiple sclerosis - a randomized controlled trial.

Science.gov (United States)

Westerdahl, Elisabeth; Wittrin, Anna; Kånåhols, Margareta; Gunnarsson, Martin; Nilsagård, Ylva

2016-11-01

Breathing exercises with positive expiratory pressure are often recommended to patients with advanced neurological deficits, but the potential benefit in multiple sclerosis (MS) patients with mild and moderate symptoms has not yet been investigated in randomized controlled trials. To study the effects of 2 months of home-based breathing exercises for patients with mild to moderate MS on respiratory muscle strength, lung function, and subjective breathing and health status outcomes. Forty-eight patients with MS according to the revised McDonald criteria were enrolled in a randomized controlled trial. Patients performing breathing exercises (n = 23) were compared with a control group (n = 25) performing no breathing exercises. The breathing exercises were performed with a positive expiratory pressure device (10-15 cmH 2 O) and consisted of 30 slow deep breaths performed twice a day for 2 months. Respiratory muscle strength (maximal inspiratory and expiratory pressure at the mouth), spirometry, oxygenation, thoracic excursion, subjective perceptions of breathing and self-reported health status were evaluated before and after the intervention period. Following the intervention, there was a significant difference between the breathing group and the control group regarding the relative change in lung function, favoring the breathing group (vital capacity: P < 0.043; forced vital capacity: P < 0.025). There were no other significant differences between the groups. Breathing exercises may be beneficial in patients with mild to moderate stages of MS. However, the clinical significance needs to be clarified, and it remains to be seen whether a sustainable effect in delaying the development of respiratory dysfunction in MS can be obtained. © 2015 The Authors. The Clinical Respiratory Journal published by John Wiley & Sons Ltd.

The stationary flow in a heterogeneous compliant vessel network

International Nuclear Information System (INIS)

Filoche, Marcel; Florens, Magali

2011-01-01

We introduce a mathematical model of the hydrodynamic transport into systems consisting in a network of connected flexible pipes. In each pipe of the network, the flow is assumed to be steady and one-dimensional. The fluid-structure interaction is described through tube laws which relate the pipe diameter to the pressure difference across the pipe wall. We show that the resulting one-dimensional differential equation describing the flow in the pipe can be exactly integrated if one is able to estimate averages of the Reynolds number along the pipe. The differential equation is then transformed into a non linear scalar equation relating pressures at both ends of the pipe and the flow rate in the pipe. These equations are coupled throughout the network with mass conservation equations for the flow and zero pressure losses at the branching points of the network. This allows us to derive a general model for the computation of the flow into very large inhomogeneous networks consisting of several thousands of flexible pipes. This model is then applied to perform numerical simulations of the human lung airway system at exhalation. The topology of the system and the tube laws are taken from morphometric and physiological data in the literature. We find good qualitative and quantitative agreement between the simulation results and flow-volume loops measured in real patients. In particular, expiratory flow limitation which is an essential characteristic of forced expiration is found to be well reproduced by our simulations. Finally, a mathematical model of a pathology (Chronic Obstructive Pulmonary Disease) is introduced which allows us to quantitatively assess the influence of a moderate or severe alteration of the airway compliances.

Mechanism of falling water limitation in two-phase counter flow through single hole vertical channel

International Nuclear Information System (INIS)

Sudo, Yukio; Ohnuki, Akira

1983-01-01

In the safety evaluation at the time of loss coolant accident, which is a credible accident in LWRs, recently main effort has been concentrated to the optimum evaluation calculation, and the grasp of vapor-liquid two-phase flow phenomena has become important. As one of the important phenomena, there is the limitation of falling water in two-phase counter flow through a vertical channel. This phenomenon is divided into the limitation of falling water stored in an upper plenum to a core through an upper core-supporting plate and a tie plate at the time of reflooding, and the limitation of falling emergency core-cooling water in downcomer channels at the time of reflooding in PWRs, under the presence of rising steam flow. In both cases, the evaluation of the quantity of falling water is important, because it contributes directly to core cooling. In this research, in order to clarify the mechanism of limitation of falling water in two-phase vertical counter flow, first, two-phase flow of air-water system through a single-hole vertical channel was taken up, and the effect of main parameters was experimentally studied. At the same time, the theoretical investigation was performed, and the comparison with the experimental results obtained so far was carried out. The different mechanisms for short and long channels gave the good results. (Kako, I.)

Numerical study on modeling of liquid film flow under countercurrent flow limitation in volume of fluid method

Energy Technology Data Exchange (ETDEWEB)

Watanabe, Taro, E-mail: watanabe_t@qe.see.eng.osaka-u.ac.jp [Graduate School of Engineering, Osaka University, 2-1, Yamadaoka, Suita-shi, Osaka 565-7895 (Japan); Takata, Takashi, E-mail: takata.takashi@jaea.go.jp [Japan Atomic Energy Agency, 4002 Narita-chou, Oarai-machi, Higashi-Ibaraki-gun, Ibaraki 331-1393 (Japan); Yamaguchi, Akira, E-mail: yamaguchi@n.t.u-tokyo.ac.jp [Graduate School of Engineering, The University of Tokyo, 2-22 Shirakata-Shirane, Tokai-mura, Naka-gun, Ibaraki 319-1188 (Japan)

2017-03-15

Highlights: • Thin liquid film flow under CCFL was modeled and coupled with the VOF method. • The difference of the liquid flow rate in experiments of CCFL was evaluated. • The proposed VOF method can quantitatively predict CCFL with low computational cost. - Abstract: Countercurrent flow limitation (CCFL) in a heat transfer tube at a steam generator (SG) of pressurized water reactor (PWR) is one of the important issues on the core cooling under a loss of coolant accident (LOCA). In order to improve the prediction accuracy of the CCFL characteristics in numerical simulations using the volume of fluid (VOF) method with less computational cost, a thin liquid film flow in a countercurrent flow is modeled independently and is coupled with the VOF method. The CCFL characteristics is evaluated analytically in condition of a maximizing down-flow rate as a function of a void fraction or a liquid film thickness considering a critical thickness. Then, we have carried out numerical simulations of a countercurrent flow in a vertical tube so as to investigate the CCFL characteristics and compare them with the previous experimental results. As a result, it has been concluded that the effect of liquid film entrainment by upward gas flux will cause the difference in the experiments.

Flow over an obstruction with the generation of nonlinear waves on the free surface: Limiting regimes

International Nuclear Information System (INIS)

Maklakov, D.V.

1995-01-01

A numerical-analytic method of calculating a subcritical flow over an obstruction is proposed. This method is based on the identification of the asymptotics of the behavior of a wave train in unknown functions. The method makes it possible to calculate both steep and long waves. The effectiveness of the method is demonstrated for the problem of flow over a vortex. The concept of the limiting flow regime as a regime with the maximum value of the perturbation parameter for which steady flow still persists is introduced. Various types of the limiting regimes obtained in the calculations are analyzed

Experimental Study of Dispersion and Deposition of Expiratory Aerosols in Aircraft Cabins and Impact on Infectious Disease Transmission

DEFF Research Database (Denmark)

To, G.N.S.; Wan, M.P.; Chao, C.Y.H.

2009-01-01

The dispersion and deposition characteristics of polydispersed expiratory aerosols were investigated in an aircraft cabin mockup to study the transmission of infectious diseases. The airflow was characterized by particle image velocimetry (PIV) measurements. Aerosol dispersionwas measured...

Intrinsic positive end-expiratory pressure during one-lung ventilation of patients with pulmonary hyperinflation. Influence of low respiratory rate with unchanged minute volume.

Science.gov (United States)

Szegedi, L L; Barvais, L; Sokolow, Y; Yernault, J C; d'Hollander, A A

2002-01-01

We measured lung mechanics and gas exchange during one-lung ventilation (OLV) of patients with chronic obstructive pulmonary disease, using three respiratory rates (RR) and unchanged minute volume. We studied 15 patients about to undergo lung surgery, during anaesthesia, and placed in the lateral position. Ventilation was with constant minute volume, inspiratory flow and FIO2. For periods of 15 min, RR of 5, 10, and 15 bpm were applied in a random sequence and recordings were made of lung mechanics and an arterial blood gas sample was taken. Data were analysed with the repeated measures ANOVA and paired t-test with Bonferroni correction. PaO2 changes were not significant. At the lowest RR, PaCO2 decreased (from 42 (SD 4) mm Hg at RR 15-41 (4) mm Hg at RR 10 and 39 (4) mm Hg at RR 5, P<0.01), and end-tidal carbon dioxide increased (from 33 (5) mm Hg at RR 15 to 35 (5) mm Hg at RR 10 and 36 (6) mm Hg at RR 5, P<0.01). Intrinsic positive end-expiratory pressure (PEEPi) was reduced even with larger tidal volumes (from 6 (4) cm H2O at RR 15-5 (4) cm H2O at RR 10, and 3 (3) cm H2O at RR 5, P<0.01), most probably caused by increased expiratory time at the lowest RR. A reduction in RR reduces PEEPi and hypercapnia during OLV in anaesthetized patients with chronic obstructive lung disease.

Lattice Boltzmann methods for complex micro-flows: applicability and limitations for practical applications

Energy Technology Data Exchange (ETDEWEB)

Suga, K, E-mail: suga@me.osakafu-u.ac.jp [Department of Mechanical Engineering, Osaka Prefecture University, 1-1 Gakuen-cho, Naka-ku, Sakai, Osaka 599-8531 (Japan)

2013-06-15

The extensive evaluation studies of the lattice Boltzmann method for micro-scale flows ({mu}-flow LBM) by the author's group are summarized. For the two-dimensional test cases, force-driven Poiseuille flows, Couette flows, a combined nanochannel flow, and flows in a nanochannel with a square- or triangular cylinder are discussed. The three-dimensional (3D) test cases are nano-mesh flows and a flow between 3D bumpy walls. The reference data for the complex test flow geometries are from the molecular dynamics simulations of the Lennard-Jones fluid by the author's group. The focused flows are mainly in the slip and a part of the transitional flow regimes at Kn < 1. The evaluated schemes of the {mu}-flow LBMs are the lattice Bhatnagar-Gross-Krook and the multiple-relaxation time LBMs with several boundary conditions and discrete velocity models. The effects of the discrete velocity models, the wall boundary conditions, the near-wall correction models of the molecular mean free path and the regularization process are discussed to confirm the applicability and the limitations of the {mu}-flow LBMs for complex flow geometries. (invited review)

Lattice Boltzmann methods for complex micro-flows: applicability and limitations for practical applications

International Nuclear Information System (INIS)

Suga, K

2013-01-01

The extensive evaluation studies of the lattice Boltzmann method for micro-scale flows (μ-flow LBM) by the author's group are summarized. For the two-dimensional test cases, force-driven Poiseuille flows, Couette flows, a combined nanochannel flow, and flows in a nanochannel with a square- or triangular cylinder are discussed. The three-dimensional (3D) test cases are nano-mesh flows and a flow between 3D bumpy walls. The reference data for the complex test flow geometries are from the molecular dynamics simulations of the Lennard-Jones fluid by the author's group. The focused flows are mainly in the slip and a part of the transitional flow regimes at Kn < 1. The evaluated schemes of the μ-flow LBMs are the lattice Bhatnagar–Gross–Krook and the multiple-relaxation time LBMs with several boundary conditions and discrete velocity models. The effects of the discrete velocity models, the wall boundary conditions, the near-wall correction models of the molecular mean free path and the regularization process are discussed to confirm the applicability and the limitations of the μ-flow LBMs for complex flow geometries. (invited review)

Changes in Cross-Sectional Area and Transverse Diameter of the Heart on Inspiratory and Expiratory Chest CT: Correlation with Changes in Lung Size and Influence on Cardiothoracic Ratio Measurement.

Directory of Open Access Journals (Sweden)

Hayato Tomita

Full Text Available The aim of this study was to investigate physiological changes in cardiac area and diameters between inspiratory and expiratory chest computed tomography (CT, and to assess their correlation with lung size change and influence on cardiothoracic ratio (CTR measurements.The institutional review board of our institution approved this study, and informed consent was waived. Forty-three subjects underwent inspiratory and expiratory chest CT as part of routine clinical care. On both inspiratory and expiratory scans, lung volumes and maximum lung diameters (transverse and vertical directions were measured. The maximum cardiac cross-sectional area (CSA and the maximum transverse cardiac diameter were measured on both scans, and the CT-based CTR was calculated. Changes in the lung and cardiac measurements were expressed as the expiratory/inspiratory (E/I ratios. Comparisons between inspiratory and expiratory measurements were made by the Wilcoxon signed-rank test. Correlations between the E/I ratios of lung and heart measurements were evaluated by Spearman's rank correlation analysis.Cardiac CSA and transverse cardiac diameter was significantly larger on expiratory than on inspiratory CT (p < 0.0001. Significant negative correlations were found between the E/I ratios of these cardiac measurements and the E/I ratios of lung volume and vertical lung diameter (p < 0.01. CT-based CTR was significantly larger on expiration than on inspiration (p < 0.0001.Heart size on chest CT depends on the phase of ventilation, and is correlated with changes in lung volume and craniocaudal lung diameter. The CTR is also significantly influenced by ventilation.

Pediatric Sepsis Guidelines: Summary for resource-limited countries

Science.gov (United States)

Khilnani, Praveen; Singhi, Sunit; Lodha, Rakesh; Santhanam, Indumathi; Sachdev, Anil; Chugh, Krishan; Jaishree, M.; Ranjit, Suchitra; Ramachandran, Bala; Ali, Uma; Udani, Soonu; Uttam, Rajiv; Deopujari, Satish

2010-01-01

Justification: Pediatric sepsis is a commonly encountered global issue. Existing guidelines for sepsis seem to be applicable to the developed countries, and only few articles are published regarding application of these guidelines in the developing countries, especially in resource-limited countries such as India and Africa. Process: An expert representative panel drawn from all over India, under aegis of Intensive Care Chapter of Indian Academy of Pediatrics (IAP) met to discuss and draw guidelines for clinical practice and feasibility of delivery of care in the early hours in pediatric patient with sepsis, keeping in view unique patient population and limited availability of equipment and resources. Discussion included issues such as sepsis definitions, rapid cardiopulmonary assessment, feasibility of early aggressive fluid therapy, inotropic support, corticosteriod therapy, early endotracheal intubation and use of positive end expiratory pressure/mechanical ventilation, initial empirical antibiotic therapy, glycemic control, and role of immunoglobulin, blood, and blood products. Objective: To achieve a reasonable evidence-based consensus on the basis of published literature and expert opinion to formulating clinical practice guidelines applicable to resource-limited countries such as India. Recommendations: Pediatric sepsis guidelines are presented in text and flow chart format keeping resource limitations in mind for countries such as India and Africa. Levels of evidence are indicated wherever applicable. It is anticipated that once the guidelines are used and outcomes data evaluated, further modifications will be necessary. It is planned to periodically review and revise these guidelines every 3–5 years as new body of evidence accumulates. PMID:20606908

Nebulized hypertonic saline via positive expiratory pressure versus via jet nebulizer in patients with severe cystic fibrosis.

LENUS (Irish Health Repository)

O'Connell, Oisin J

2011-06-01

Nebulized hypertonic saline is a highly effective therapy for patients with cystic fibrosis (CF), yet 10% of patients are intolerant of hypertonic saline administered via jet nebulizer. Positive expiratory pressure (PEP) nebulizers splint open the airways and offers a more controlled rate of nebulization.

Calculation of Wind Power Limit adjusting the Continuation Power Flow

International Nuclear Information System (INIS)

Santos Fuentefria, Ariel; Castro Fernández, Miguel; Martínez García, Antonio

2012-01-01

The wind power insertion in the power system is an important issue and can create some instability problems in voltage and system frequency due to stochastic origin of wind. Know the Wind Power Limit is a very important matter. Existing in bibliography a few methods for calculation of wind power limit. The calculation is based in static constrains, dynamic constraints or both. In this paper is developed a method for the calculation of wind power limit using some adjust in the continuation power flow, and having into account the static constrains. The method is complemented with Minimal Power Production Criterion. The method is proved in the Isla de la Juventud Electric System. The software used in the simulations was the Power System Analysis Toolbox (PSAT). (author)

Positive expiratory pressure in patients with chronic obstructive pulmonary disease--a systematic review.

Science.gov (United States)

Fagevik Olsén, Monika; Westerdahl, Elisabeth

2009-01-01

Breathing exercises against a resistance during expiration are often used as treatment for patients with chronic obstructive pulmonary disease (COPD). Controversy still exists regarding the clinical application and efficacy. The aim of this systematic review was to determine the effects of chest physiotherapy techniques with positive expiratory pressure (PEP) for the prevention and treatment of pulmonary impairment in adults with COPD. The review was conducted on randomised, controlled clinical trials in which breathing exercises with positive expiratory pressure were compared with other chest physical therapy techniques or with no treatment, in adult patients with COPD. A computer-assisted literature search of available databases from 1970 to January 2008 was performed. Two reviewers extracted data independently and assessed the trials systematically with an instrument for measuring methodological quality. In total, 11 trials met the inclusion criteria, of which 5 reached an adequate level of internal validity. Several kinds of PEP techniques with a diversity of intensities and durations of treatment have been evaluated with different outcome measures and follow-up periods. Benefits of PEP were found in isolated outcome measures in separate studies with a follow-up period <1 month. Concerning long-term effects, the results are contradictory. Prior to widespread prescription of long-term PEP treatment, more research is required to establish the benefit of the technique in patients with COPD. (c) 2008 S. Karger AG, Basel.

Effects of Ramadan Fasting on Spirometric Values and Clinical Symptoms in Asthmatic Patients

Directory of Open Access Journals (Sweden)

Abdolreza Norouzy

2013-07-01

Full Text Available Introduction: Ramadan is the 9th Islamic lunar month during which Muslims avoid eating and drinking from sunrise to sunset. The effect of Ramadan intermittent fasting on asthma control is controversial. The aim of this study was to investigate the effects of Ramadan fasting on the spirometric variables and clinical symptoms on well-controlled asthmatic patients during Ramadan. Material and Methods: a cohort study was conducted in Mashhad, Khorasan Razavi, Iran. Twenty-nine (19 females and 10 males well-controlled asthmatic patients aged 47 (12 years completed the study. The average duration of fasting was 26.5 days. Assessment of spirometric variables (daily peak expiratory flow, peak expiratory flow variability, peak expiratory flow home monitoring as well as asthma clinical symptoms including dyspnea, cough, wheezing, and chest tightness were carried out. Results: No significant changes in clinical symptoms were reported in asthmatic patients at the end of Ramadan fasting. Among spirometric variables, only peak expiratory flow improved after Ramadan (p <0.05. There was a reduction in the mean peak expiratory flow variability from 13% at the first week of fasting to 10% at the fourth week (p <0.05. Conclusion: In well-controlled asthmatic patients, Ramadan fasting resulted in improvement in peak expiratory flow and peak expiratory flow variability.

Axial-Flow Turbine Rotor Discharge-Flow Overexpansion and Limit-Loading Condition, Part I: Computational Fluid Dynamics (CFD) Investigation

Science.gov (United States)

Chen, Shu-Cheng S.

2017-01-01

A Computational Fluid Dynamic (CFD) investigation is conducted over a two-dimensional axial-flow turbine rotor blade row to study the phenomena of turbine rotor discharge flow overexpansion at subcritical, critical, and supercritical conditions. Quantitative data of the mean-flow Mach numbers, mean-flow angles, the tangential blade pressure forces, the mean-flow mass flux, and the flow-path total pressure loss coefficients, averaged or integrated across the two-dimensional computational domain encompassing two blade-passages, are obtained over a series of 14 inlet-total to exit-static pressure ratios, from 1.5 (un-choked; subcritical condition) to 10.0 (supercritical with excessively high pressure ratio.) Detailed flow features over the full domain-of-computation, such as the streamline patterns, Mach contours, pressure contours, blade surface pressure distributions, etc. are collected and displayed in this paper. A formal, quantitative definition of the limit loading condition based on the channel flow theory is proposed and explained. Contrary to the comments made in the historical works performed on this subject, about the deficiency of the theoretical methods applied in analyzing this phenomena, using modern CFD method for the study of this subject appears to be quite adequate and successful. This paper describes the CFD work and its findings.

The effect of flow limitation on the cardiorespiratory response to arousal from sleep under controlled conditions of chemostimulation in healthy older adults.

Science.gov (United States)

Goff, Elizabeth A; Nicholas, Christian L; Kleiman, Jan; Spear, Owen; Morrell, Mary J; Trinder, John

2012-12-01

The influence of flow limitation on the magnitude of the cardiorespiratory response to arousal from sleep is of interest in older people, because they experience considerable flow limitation and frequent arousals from sleep. We studied older flow-limiting subjects, testing the hypothesis that the cardiorespiratory activation response would be larger when arousal occurred during flow limitation, compared to no flow limitation, and chemical stimuli were controlled. In 11 older adults [mean ± standard deviation (SD) age: 68 ± 5 years] ventilation was stabilized using continuous positive airway pressure, and flow limitation was induced by dialling down the pressure. Partial pressure of end-tidal carbon dioxide (PetCO(2)) was maintained by titration of the inspired CO(2) and hyperoxia was maintained using 40% O(2) balanced with nitrogen. Flow limitation at the time of arousal did not augment cardiovascular activation response (heart rate P = 0.7; systolic blood pressure P = 0.6; diastolic blood pressure P = 0.3), whereas ventilation was greater following arousals during flow limitation compared to no flow limitation (P sleep is not influenced by flow limitation at the time of arousal, when chemical stimuli are controlled in older adults. This finding may contribute to the decreased cardiovascular burden associated with sleep-disordered breathing reported in older adults, although our data do not exclude the possibility that flow limitation in the presence of mild hypoxic hypercapnia could increase the cardiovascular response to arousal. © 2012 European Sleep Research Society.

Characteristics of steady-state plasma flow in the tokamak limiter scrape-off layer

International Nuclear Information System (INIS)

Petrov, V.G.

1984-01-01

Steady state plasma flow in the scrape-off layer of a toroidal limiter is discussed. The force balance along the torus minor radius is taken into account, from which follows that the plasma pressure gradient is balanced by the ponderomotive force (1/c) j-vectorxB-vector, which arises in the presence of a current density component perpendicular to the magnetic field. The limiter has an important effect on the electric current flow in the scrape-off layer. It is shown that the electric potential and plasma density values differ from one side of the limiter to the other; this leads to plasma drift along the minor radius. The characteristic length of change in the plasma density is found to be of the order of the ion cyclotron radius calculated for a poloidal magnetic field. (author)

Effects of recruitment maneuver and positive end-expiratory pressure on respiratory mechanics and transpulmonary pressure during laparoscopic surgery.

Science.gov (United States)

Cinnella, Gilda; Grasso, Salvatore; Spadaro, Savino; Rauseo, Michela; Mirabella, Lucia; Salatto, Potito; De Capraris, Antonella; Nappi, Luigi; Greco, Pantaleo; Dambrosio, Michele

2013-01-01

The authors tested the hypothesis that during laparoscopic surgery, Trendelenburg position and pneumoperitoneum may worsen chest wall elastance, concomitantly decreasing transpulmonary pressure, and that a protective ventilator strategy applied after pneumoperitoneum induction, by increasing transpulmonary pressure, would result in alveolar recruitment and improvement in respiratory mechanics and gas exchange. In 29 consecutive patients, a recruiting maneuver followed by positive end-expiratory pressure 5 cm H(2)O maintained until the end of surgery was applied after pneumoperitoneum induction. Respiratory mechanics, gas exchange, blood pressure, and cardiac index were measured before (T(BSL)) and after pneumoperitoneum with zero positive end-expiratory pressure (T(preOLS)), after recruitment with positive end-expiratory pressure (T(postOLS)), and after peritoneum desufflation with positive end-expiratory pressure (T(end)). Esophageal pressure was used for partitioning respiratory mechanics between lung and chest wall (data are mean ± SD): on T(preOLS), chest wall elastance (E(cw)) and elastance of the lung (E(L)) increased (8.2 ± 0.9 vs. 6.2 ± 1.2 cm H(2)O/L, respectively, on T(BSL); P = 0.00016; and 11.69 ± 1.68 vs. 9.61 ± 1.52 cm H(2)O/L on T(BSL); P = 0.0007). On T(postOLS), both chest wall elastance and E(L) decreased (5.2 ± 1.2 and 8.62 ± 1.03 cm H(2)O/L, respectively; P = 0.00015 vs. T(preOLS)), and Pao(2)/inspiratory oxygen fraction improved (491 ± 107 vs. 425 ± 97 on T(preOLS); P = 0.008) remaining stable thereafter. Recruited volume (the difference in lung volume for the same static airway pressure) was 194 ± 80 ml. Pplat(RS) remained stable while inspiratory transpulmonary pressure increased (11.65 + 1.37 cm H(2)O vs. 9.21 + 2.03 on T(preOLS); P = 0.007). All respiratory mechanics parameters remained stable after abdominal desufflation. Hemodynamic parameters remained stable throughout the study. In patients submitted to laparoscopic surgery in

Blow-out limits of nonpremixed turbulent jet flames in a cross flow at atmospheric and sub-atmospheric pressures

KAUST Repository

Wang, Qiang

2015-07-22

The blow-out limits of nonpremixed turbulent jet flames in cross flows were studied, especially concerning the effect of ambient pressure, by conducting experiments at atmospheric and sub-atmospheric pressures. The combined effects of air flow and pressure were investigated by a series of experiments conducted in an especially built wind tunnel in Lhasa, a city on the Tibetan plateau where the altitude is 3650 m and the atmospheric pressure condition is naturally low (64 kPa). These results were compared with results obtained from a wind tunnel at standard atmospheric pressure (100 kPa) in Hefei city (altitude 50 m). The size of the fuel nozzles used in the experiments ranged from 3 to 8 mm in diameter and propane was used as the fuel. It was found that the blow-out limit of the air speed of the cross flow first increased (“cross flow dominant” regime) and then decreased (“fuel jet dominant” regime) as the fuel jet velocity increased in both pressures; however, the blow-out limit of the air speed of the cross flow was much lower at sub-atmospheric pressure than that at standard atmospheric pressure whereas the domain of the blow-out limit curve (in a plot of the air speed of the cross flow versus the fuel jet velocity) shrank as the pressure decreased. A theoretical model was developed to characterize the blow-out limit of nonpremixed jet flames in a cross flow based on a Damköhler number, defined as the ratio between the mixing time and the characteristic reaction time. A satisfactory correlation was obtained at relative strong cross flow conditions (“cross flow dominant” regime) that included the effects of the air speed of the cross flow, fuel jet velocity, nozzle diameter and pressure.

Sports-related flow limitations in the iliac arteries in endurance athletes : aetiology, diagnosis, treatment and future developments

NARCIS (Netherlands)

Bender, M.H.M.; Schep, G.; Vries, de W.R.; Hoogeveen, A.R.; Wijn, P.F.F.

2004-01-01

Approximately one in five top-level cyclists will develop sports-related flow limitations in the iliac arteries. These flow limitations may be caused by a vascular lumen narrowing due to endofibrotic thickening of the intima and/or by kinking of the vessels. In some athletes, extreme vessel length

Space-charge-limited ion flow through an ionizing neutral layer

International Nuclear Information System (INIS)

Duvall, R.E.; Litwin, C.; Maron, Y.

1993-01-01

Space-charge-limited ion flow through an ionizing layer of neutral atoms is studied. The ion flow is between two parallel conducting plates (anode and cathode) with an externally applied voltage between them. An expanding layer of neutral atoms is adjacent to the anode surface, extending a finite distance into the anode--cathode gap. All ions originate either from the anode surface or from the ionization of neutrals; electrons originate only from ionization. Electrons are strongly magnetized by an externally applied, time-independent direct current (dc) magnetic field directed across the ion flow. The ions are unmagnetized, all motion being perpendicular to the conducting plates. Two different models of the anode layer were used to analyze this problem: a multifluid steady-state model and a single fluid time-dependent model. From both models it was found that the anode surface becomes shielded after the ion flux from the ionizing layer becomes larger than the space-charge-limited flux of the reduced gap between the neutral layer and cathode. Comparison was made between the time-dependent model and results from magnetically insulated ion beam diode (MID) experiments. Using an initial areal density of neutral hydrogen and carbon equal to the final observed electron areal density, comparison was made between calculated plasma shielding times and upper bounds on the shielding time observed in experiments. It was found that a layer of neutral hydrogen must contain a minimum of 15% carbon (by number density) to explain the rapid electric field screening observed in experiments

Value and limitations of transpulmonary pressure calculations during intra-abdominal hypertension.

Science.gov (United States)

Cortes-Puentes, Gustavo A; Gard, Kenneth E; Adams, Alexander B; Faltesek, Katherine A; Anderson, Christopher P; Dries, David J; Marini, John J

2013-08-01

To clarify the effect of progressively increasing intra-abdominal pressure on esophageal pressure, transpulmonary pressure, and functional residual capacity. Controlled application of increased intra-abdominal pressure at two positive end-expiratory pressure levels (1 and 10 cm H2O) in an anesthetized porcine model of controlled ventilation. Large animal laboratory of a university-affiliated hospital. Eleven deeply anesthetized swine (weight 46.2 ± 6.2 kg). Air-regulated intra-abdominal hypertension (0-25 mm Hg). Esophageal pressure, tidal compliance, bladder pressure, and end-expiratory lung aeration by gas dilution. Functional residual capacity was significantly reduced by increasing intra-abdominal pressure at both positive end-expiratory pressure levels (p ≤ 0.0001) without corresponding changes of end-expiratory esophageal pressure. Above intra-abdominal pressure 5 mm Hg, plateau airway pressure increased linearly by ~ 50% of the applied intra-abdominal pressure value, associated with commensurate changes of esophageal pressure. With tidal volume held constant, negligible changes occurred in transpulmonary pressure due to intra-abdominal pressure. Driving pressures calculated from airway pressures alone (plateau airway pressure--positive end-expiratory pressure) did not equate to those computed from transpulmonary pressure (tidal changes in transpulmonary pressure). Increasing positive end-expiratory pressure shifted the predominantly negative end-expiratory transpulmonary pressure at positive end-expiratory pressure 1 cm H2O (mean -3.5 ± 0.4 cm H2O) into the positive range at positive end-expiratory pressure 10 cm H2O (mean 0.58 ± 1.2 cm H2O). Despite its insensitivity to changes in functional residual capacity, measuring transpulmonary pressure may be helpful in explaining how different levels of positive end-expiratory pressure influence recruitment and collapse during tidal ventilation in the presence of increased intra-abdominal pressure and in

Effects of brief smoking cessation education with expiratory carbon monoxide measurement on level of motivation to quit smoking.

Science.gov (United States)

Choi, Won-Young; Kim, Cheol-Hwan; Lee, Ok-Gyu

2013-05-01

Smoking rates among Korean adult males is still high despite multifaceted efforts to reduce it. In Korea, there have been several studies on the effectiveness of smoking cessation education for inpatients, health check-ups, and smoking cessation clinics. However, there haven't been any studies on the effectiveness of smoking cessation education conducted outside the hospital. This study investigated effectiveness of brief education on smoking cessation with an expiratory carbon monoxide (CO) measurement outside the hospital among adult male office-workers in Korea. From April 1st to May 10th, 2012, we conducted a controlled trial among 95 adult male office workers over the age of 19 who smoke outside, in a public place in Seoul by cluster sampling. For the education group, we provided smoking cessation education for about 5 to 10 minutes, measured the expiratory CO level, and made the subjects complete questionnaires, while only self-help materials on quitting smoking were given to the control group. After 4 weeks, we evaluated the change in the level of motivation or success to quit smoking in both groups via e-mail or mobile phone. In the education group, the level of motivation to quit smoking was improved significantly. A multiple logistic regression analysis showed that the odds ratio of improved motivation to quit smoking in the education group was 28.10 times higher than that of the control group. Brief education on smoking cessation with expiratory CO measurement conducted outside the hospital could enhance the level of motivation to quit smoking.

The respiratory drive to thoracic motoneurones in the cat and its relation to the connections from expiratory bulbospinal neurones

DEFF Research Database (Denmark)

Saywell, S A; Anissimova, N P; Ford, T W

2007-01-01

of connection revealed were related to the presence and size of central respiratory drive potentials in the same motoneurones. Intracellular recordings were made from motoneurones in segments T5-T9 of the spinal cord of anaesthetized cats. Spike-triggered averaging from expiratory bulbospinal neurones...... in the caudal medulla revealed monosynaptic EPSPs in all groups of motoneurones, with the strongest connections to expiratory motoneurones with axons in the internal intercostal nerve. In the latter, connection strength was similar irrespective of the target muscle (e.g. external abdominal oblique or internal...... intercostal) and the EPSP amplitude was positively correlated with the amplitude of the central respiratory drive potential of the motoneurone. For this group, EPSPs were found in 45/83 bulbospinal neurone/motoneurone pairs, with a mean amplitude of 40.5 microV. The overall strength of the connection supports...

Relationship of end-expiratory pressure, lung volume, and /sup 99m/Tc-DTPA clearance

International Nuclear Information System (INIS)

Cooper, J.A.; van der Zee, H.; Line, B.R.; Malik, A.B.

1987-01-01

We investigated the dose-response effect of positive end-expiratory pressure (PEEP) and increased lung volume on the pulmonary clearance rate of aerosolized technetium-99m-labeled diethylenetriaminepentaacetic acid (99mTc-DTPA). Clearance of lung radioactivity was expressed as percent decrease per minute. Base-line clearance was measured while anesthetized sheep (n = 20) were ventilated with 0 cmH 2 O end-expiratory pressure. Clearance was remeasured during ventilation at 2.5, 5, 10, 15, or 20 cmH 2 O PEEP. Further studies showed stepwise increases in functional residual capacity (FRC) (P less than 0.05) measured at 0, 2.5, 5, 10, 15, and 20 cmH 2 O PEEP. At 2.5 cmH 2 O PEEP, the clearance rate was not different from that at base line (P less than 0.05), although FRC was increased from base line. Clearance rate increased progressively with increasing PEEP at 5, 10, and 15 cmH 2 O (P less than 0.05). Between 15 and 20 cmH 2 O PEEP, clearance rate was again unchanged, despite an increase in FRC. The pulmonary clearance of aerosolized /sup 99m/Tc-DTPA shows a sigmoidal response to increasing FRC and PEEP, having both threshold and maximal effects. This relationship is most consistent with the hypothesis that alveolar epithelial permeability is increased by lung inflation

Peak-counts blood flow model-errors and limitations

International Nuclear Information System (INIS)

Mullani, N.A.; Marani, S.K.; Ekas, R.D.; Gould, K.L.

1984-01-01

The peak-counts model has several advantages, but its use may be limited due to the condition that the venous egress may not be negligible at the time of peak-counts. Consequently, blood flow measurements by the peak-counts model will depend on the bolus size, bolus duration, and the minimum transit time of the bolus through the region of interest. The effect of bolus size on the measurement of extraction fraction and blood flow was evaluated by injecting 1 to 30ml of rubidium chloride in the femoral vein of a dog and measuring the myocardial activity with a beta probe over the heart. Regional blood flow measurements were not found to vary with bolus sizes up to 30ml. The effect of bolus duration was studied by injecting a 10cc bolus of tracer at different speeds in the femoral vein of a dog. All intravenous injections undergo a broadening of the bolus duration due to the transit time of the tracer through the lungs and the heart. This transit time was found to range from 4-6 second FWHM and dominates the duration of the bolus to the myocardium for up to 3 second injections. A computer simulation has been carried out in which the different parameters of delay time, extraction fraction, and bolus duration can be changed to assess the errors in the peak-counts model. The results of the simulations show that the error will be greatest for short transit time delays and for low extraction fractions

Boundary layers and the vanishing viscosity limit for incompressible 2D flow

OpenAIRE

Filho, Milton C. Lopes

2007-01-01

This manuscript is a survey on results related to boundary layers and the vanishing viscosity limit for incompressible flow. It is the lecture notes for a 10 hour minicourse given at the Morningside Center, Academia Sinica, Beijing, PRC from 11/28 to 12/07, 2007. The main topics covered are: a derivation of Prandtl's boundary layer equation; an outline of the rigorous theory of Prandtl's equation, without proofs; Kato's criterion for the vanishing viscosity limit; the vanishing viscosity limi...

Effect of the radiofrequency volumetric tissue reduction of inferior turbinate on expiratory nasal sound frequency.

Science.gov (United States)

Seren, Erdal

2009-01-01

We sought to evaluate the short-term efficacy of radiofrequency volumetric tissue reduction (RFVTR) in treatment of inferior turbinate hypertrophy (TH) as measured by expiratory nasal sound spectra. In our study, we aimed to investigate the Odiosoft-rhino (OR) as a new diagnostic method to evaluate the nasal airflow of patients before and after RFVTR. In this study, we have analyzed and recorded the expiratory nasal sound in patients with inferior TH before and after RFVTR. This analysis includes the time expanded waveform, the spectral analysis with time averaged fast Fourier transform (FFT), and the waveform analysis of nasal sound. We found an increase in sound intensity at high frequency (Hf) in the sound analyses of the patients before RFVTR and a decrease in sound intensity at Hf was found in patients after RFVTR. This study indicates that RFVTR is an effective procedure to improve nasal airflow in the patients with nasal obstruction with inferior TH. We found significant decreases in the sound intensity level at Hf in the sound spectra after RFVTR. The OR results from the 2000- to 4000-Hz frequency (Hf) interval may be more useful in assessing patients with nasal obstruction than other frequency intervals. OR may be used as a noninvasive diagnostic tool to evaluate the nasal airflow.

Fundamental uncertainty limit of optical flow velocimetry according to Heisenberg's uncertainty principle.

Science.gov (United States)

Fischer, Andreas

2016-11-01

Optical flow velocity measurements are important for understanding the complex behavior of flows. Although a huge variety of methods exist, they are either based on a Doppler or a time-of-flight measurement principle. Doppler velocimetry evaluates the velocity-dependent frequency shift of light scattered at a moving particle, whereas time-of-flight velocimetry evaluates the traveled distance of a scattering particle per time interval. Regarding the aim of achieving a minimal measurement uncertainty, it is unclear if one principle allows to achieve lower uncertainties or if both principles can achieve equal uncertainties. For this reason, the natural, fundamental uncertainty limit according to Heisenberg's uncertainty principle is derived for Doppler and time-of-flight measurement principles, respectively. The obtained limits of the velocity uncertainty are qualitatively identical showing, e.g., a direct proportionality for the absolute value of the velocity to the power of 32 and an indirect proportionality to the square root of the scattered light power. Hence, both measurement principles have identical potentials regarding the fundamental uncertainty limit due to the quantum mechanical behavior of photons. This fundamental limit can be attained (at least asymptotically) in reality either with Doppler or time-of-flight methods, because the respective Cramér-Rao bounds for dominating photon shot noise, which is modeled as white Poissonian noise, are identical with the conclusions from Heisenberg's uncertainty principle.

Positive end-expiratory pressure improves survival in a rodent model of cardiopulmonary resuscitation using high-dose epinephrine.

LENUS (Irish Health Repository)

McCaul, Conán

2009-10-01

Multiple interventions have been tested in models of cardiopulmonary resuscitation (CPR) to optimize drug use, chest compressions, and ventilation. None has studied the effects of positive end-expiratory pressure (PEEP) on outcome. We hypothesized that because PEEP can reverse pulmonary atelectasis, lower pulmonary vascular resistance, and potentially improve cardiac output, its use during CPR would increase survival.

Peak flow meter with a questionnaire and mini-spirometer to help detect asthma and COPD in real-life clinical practice: a cross-sectional study.

Science.gov (United States)

Thorat, Yogesh T; Salvi, Sundeep S; Kodgule, Rahul R

2017-05-09

Peak flow meter with questionnaire and mini-spirometer are considered as alternative tools to spirometry for screening of asthma and chronic obstructive pulmonary disease. However, the accuracy of these tools together, in clinical settings for disease diagnosis, has not been studied. Two hundred consecutive patients with respiratory complaints answered a short symptom questionnaire and performed peak expiratory flow measurements, standard spirometry with Koko spirometer and mini-spirometry (COPD-6). Spirometry was repeated after bronchodilation. Physician made a final diagnosis of asthma, chronic obstructive pulmonary disease and others. One eighty nine patients (78 females) with age 51 ± 17 years with asthma (115), chronic obstructive pulmonary disease (33) and others (41) completed the study. "Breathlessness > 6months" and "cough > 6months" were important symptoms to detect obstructive airways disease. "Asymptomatic period > 2 weeks" had the best sensitivity (Sn) and specificity (Sp) to differentiate asthma and chronic obstructive pulmonary disease. A peak expiratory flow of meter with few symptom questions can be effectively used in clinical practice for objective detection of asthma and chronic obstructive pulmonary disease, in the absence of good quality spirometry. Mini-spirometers are useful in detection of obstructive airways diseases but FEV 1 measured is inaccurate. DIFFERENTIATING CONDITIONS IN POORLY-EQUIPPED SETTINGS: A simple questionnaire and peak flow meter measurements can help doctors differentiate between asthma and chronic lung disease. In clinical settings where access to specialist equipment and knowledge is limited, it can be challenging for doctors to tell the difference between asthma and chronic obstructive pulmonary disease (COPD). To determine a viable alternative method for differentiating between these diseases, Rahul Kodgule and colleagues at the Chest Research Foundation in Pune, India, trialed a simplified version

Methods for the determination of skeletal muscle blood flow: development, strengths and limitations

DEFF Research Database (Denmark)

Gliemann, Lasse; Mortensen, Stefan P.; Hellsten, Ylva

2018-01-01

Since the first measurements of limb blood flow at rest and during nerve stimulation were conducted in the late 1800s, a number of methods have been developed for the determination of limb and skeletal muscle blood flow in humans. The methods, which have been applied in the study of aspects...... such as blood flow regulation, oxygen uptake and metabolism, differ in terms of strengths and degree of limitations but most have advantages for specific settings. The purpose of this review is to describe the origin and the basic principles of the methods, important aspects and requirements of the procedures....... One of the earliest methods, venous occlusion plethysmography, is a noninvasive method which still is extensively used and which provides similar values as other more direct blood flow methods such as ultrasound Doppler. The constant infusion thermodilution method remains the most appropriate...

Effects of equipment and technique on peak flow measurements

Directory of Open Access Journals (Sweden)

O'Driscoll B Ronan

2006-06-01

Full Text Available Abstract Background Different lung function equipment and different respiratory manoeuvres may produce different Peak Expiratory Flow (PEF results. Although the PEF is the most common lung function test, there have been few studies of these effects and no previous study has evaluated both factors in a single group of patients. Methods We studied 36 subjects (PEF range 80–570 l/min. All patients recorded PEF measurements using a short rapid expiration following maximal inspiration (PEF technique or a forced maximal expiration to residual volume (FVC technique. Measurements were made using a Wright's peak flow meter, a turbine spirometer and a Fleisch pneumotachograph spirometer. Results The mean PEF was 8.7% higher when the PEF technique was used (compared with FVC technique, p Conclusion Peak flow measurements are affected by the instruction given and by the device and Peak Flow scale used. Patient management decisions should not be based on PEF measurement made on different instruments.

Numerical model for swirl flow cooling in high-heat-flux particle beam targets and the design of a swirl-flow-based plasma limiter

International Nuclear Information System (INIS)

Milora, S.L.; Combs, S.K.; Foster, C.A.

1984-11-01

An unsteady, two-dimensional heat conduction code has been used to study the performance of swirl-flow-based neutral particle beam targets. The model includes the effects of two-phase heat transfer and asymmetric heating of tubular elements. The calorimeter installed in the Medium Energy Test Facility, which has been subjected to 30-s neutral beam pulses with incident heat flux intensities of greater than or equal to 5 kW/cm 2 , has been modeled. The numerical results indicate that local heat fluxes in excess of 7 kW/cm 2 occur at the water-cooled surface on the side exposed to the beam. This exceeds critical heat flux limits for uniformly heated tubes wih straight flow by approximately a factor of 5. The design of a plasma limiter based on swirl flow heat transfer is presented

Amplified fragment length polymorphism fingerprints support limited gene flow among social spider populations

NARCIS (Netherlands)

Smith, Deborah; van Rijn, Sander; Henschel, Joh; Bilde, Trine; Lubin, Yael

We used DNA fingerprints to determine whether the population structure and colony composition of the cooperative social spider Stegodyphus dumicola are compatible with requirements of interdemic ('group') selection: differential proliferation of demes or groups and limited gene flow among groups. To

Countercurrent flow-limiting characteristics of a Savannah River Plant control rod septifoil

International Nuclear Information System (INIS)

Anderson, J.L.

1992-07-01

Experiments were performed at the Idaho National Engineering Laboratory to investigate the counter-current flow limiting characteristics of a Savannah River Plant control rod septifoil assembly. These experiments were unheated, using air and water as the working fluids. Results are presented in terms of the Wallis flooding correlation for several different control rod configurations. Flooding was observed to occur in the vicinity of the inlet slots/holes of the septifoil, rather than within the rod bundle at the location of the minimum flow area. Nearly identical flooding characteristics of the septifoil were observed for configurations with zero, three, and four rods inserted, but significantly different results occurred with 5 rods inserted

On singular limits arising in the scale analysis of stratified fluid flows

Czech Academy of Sciences Publication Activity Database

Feireisl, Eduard; Klein, R.; Novotný, A.; Zatorska, E.

2016-01-01

Roč. 26, č. 3 (2016), s. 419-443 ISSN 0218-2025 Grant - others:European Research Council(XE) MATHEF(320078) Institutional support: RVO:67985840 Keywords : isentropic fluid flow * strong stratification * singular limit * anelastic approximation Subject RIV: BA - General Mathematics Impact factor: 2.860, year: 2016 http://www.worldscientific.com/doi/10.1142/S021820251650007X

Effects of Inhaled Fenoterol and Positive End-Expiratory Pressure on the Respiratory Mechanics of Patients with Chronic Obstructive Pulmonary Disease

Directory of Open Access Journals (Sweden)

Claude Guerin

2005-01-01

Full Text Available BACKGROUND: During acute ventilatory failure in patients with chronic obstructive pulmonary disease (COPD, applying external positive end-expiratory pressure (PEEPe will reopen small airways and, thus, may enhance peripheral deposition as well as the physiological effects of inhaled beta-2 agonists.

Exercise-induced asthma in a group of South African schoolchildren ...

African Journals Online (AJOL)

They were tested with a peak flow meter for peak expiratory flow rate (PEFR) and with a flow-volume curve for forced expiratory flow in 1 second (FEV1) before and 10 minutes after a self-paced free running test during physical education classes. Testing was undertaken by teachers using the peak flow meter and by a ...

Lung recruitability is better estimated according to the Berlin definition of acute respiratory distress syndrome at standard 5 cm H2O rather than higher positive end-expiratory pressure: a retrospective cohort study.

Science.gov (United States)

Caironi, Pietro; Carlesso, Eleonora; Cressoni, Massimo; Chiumello, Davide; Moerer, Onner; Chiurazzi, Chiara; Brioni, Matteo; Bottino, Nicola; Lazzerini, Marco; Bugedo, Guillermo; Quintel, Michael; Ranieri, V Marco; Gattinoni, Luciano

2015-04-01

The Berlin definition of acute respiratory distress syndrome has introduced three classes of severity according to PaO2/FIO2 thresholds. The level of positive end-expiratory pressure applied may greatly affect PaO2/FIO2, thereby masking acute respiratory distress syndrome severity, which should reflect the underlying lung injury (lung edema and recruitability). We hypothesized that the assessment of acute respiratory distress syndrome severity at standardized low positive end-expiratory pressure may improve the association between the underlying lung injury, as detected by CT, and PaO2/FIO2-derived severity. Retrospective analysis. Four university hospitals (Italy, Germany, and Chile). One hundred forty-eight patients with acute lung injury or acute respiratory distress syndrome according to the American-European Consensus Conference criteria. Patients underwent a three-step ventilator protocol (at clinical, 5 cm H2O, or 15 cm H2O positive end-expiratory pressure). Whole-lung CT scans were obtained at 5 and 45 cm H2O airway pressure. Nine patients did not fulfill acute respiratory distress syndrome criteria of the novel Berlin definition. Patients were then classified according to PaO2/FIO2 assessed at clinical, 5 cm H2O, or 15 cm H2O positive end-expiratory pressure. At clinical positive end-expiratory pressure (11±3 cm H2O), patients with severe acute respiratory distress syndrome had a greater lung tissue weight and recruitability than patients with mild or moderate acute respiratory distress syndrome (pBerlin definition of acute respiratory distress syndrome assessed at 5 cm H2O allows a better evaluation of lung recruitability and edema than at higher positive end-expiratory pressure clinically set.

Characteristics, predictors and prospects of lung function among ...

African Journals Online (AJOL)

Background: Cigarette smoking is a major risk factor for airflow limitation in addition to its other multi-systemic deleterious effects. Peak expiratory flow (PEF) measurement offers an opportunity to assess ventilatory function abnormalities in cigarette smokers. Objective: The objective of this study is to determine ventilatory ...

Prediction equations for spirometry in four- to six-year-old children.

Science.gov (United States)

França, Danielle Corrêa; Camargos, Paulo Augusto Moreira; Jones, Marcus Herbert; Martins, Jocimar Avelar; Vieira, Bruna da Silva Pinto Pinheiro; Colosimo, Enrico Antônio; de Mendonça, Karla Morganna Pereira Pinto; Borja, Raíssa de Oliveira; Britto, Raquel Rodrigues; Parreira, Verônica Franco

2016-01-01

To generate prediction equations for spirometry in 4- to 6-year-old children. Forced vital capacity, forced expiratory volume in 0.5s, forced expiratory volume in one second, peak expiratory flow, and forced expiratory flow at 25-75% of the forced vital capacity were assessed in 195 healthy children residing in the town of Sete Lagoas, state of Minas Gerais, Southeastern Brazil. The least mean squares method was used to derive the prediction equations. The level of significance was established as p<0.05. Overall, 85% of the children succeeded in performing the spirometric maneuvers. In the prediction equation, height was the single predictor of the spirometric variables as follows: forced vital capacity=exponential [(-2.255)+(0.022×height)], forced expiratory volume in 0.5s=exponential [(-2.288)+(0.019×height)], forced expiratory volume in one second=exponential [(-2.767)+(0.026×height)], peak expiratory flow=exponential [(-2.908)+(0.019×height)], and forced expiratory flow at 25-75% of the forced vital capacity=exponential [(-1.404)+(0.016×height)]. Neither age nor weight influenced the regression equations. No significant differences in the predicted values for boys and girls were observed. The predicted values obtained in the present study are comparable to those reported for preschoolers from both Brazil and other countries. Copyright © 2016 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

Airway wall thickness associated with forced expiratory volume in 1 second decline and development of airflow limitation

NARCIS (Netherlands)

Hoesein, Firdaus A. A. Mohamed; de Jong, Pim A.; Lammers, Jan-Willem J.; Mali, Willem P. T. M.; Schmidt, Michael; de Koning, Harry J.; van der Aalst, Carlijn; Oudkerk, Matthijs; Vliegenthart, Rozemarijn; Groen, Harry J. M.; van Ginneken, Bram; van Rikxoort, Eva M.; Zanen, Pieter

Airway wall thickness and emphysema contribute to airflow limitation. We examined their association with lung function decline and development of airflow limitation in 2021 male smokers with and without airflow limitation. Airway wall thickness and emphysema were quantified on chest computed

Lung hyperinflation in COPD: the impact of pharmacotherapy

Directory of Open Access Journals (Sweden)

D. E. O'Donnell

2006-12-01

Full Text Available Improvement in airway function in response to bronchodilator therapy is generally confirmed by simple spirometry. However, improvements in maximal expiratory flow rates have been shown to correlate poorly with important patient-centred outcomes, such as reduced exertional dyspnoea and improved exercise performance. Recent studies have suggested that attendant reductions in end-expiratory lung volume as a result of bronchodilator-induced improvements in lung emptying may be more closely associated with symptom relief and increased exercise capacity than traditional spirometric indices. To the extent that chronic lung hyperinflation and the superimposition of acute dynamic hyperinflation (in response to increased ventilation or expiratory flow limitation result in excessive loading and weakening of the inspiratory muscles, then pharmacological lung volume reduction should have important mechanical and sensory benefits for the patient. The present article will examine the mechanisms of lung deflation following short-term bronchodilator therapy. The physiological links between reduced hyperinflation, improved dyspnoea and exercise endurance will be examined, and the emerging evidence for the additive effects of combining various modern pharmacological therapies will be reviewed.

Comparison of pulmonary function in patients with COPD, asthma-COPD overlap syndrome, and asthma with airflow limitation.

Science.gov (United States)

Kitaguchi, Yoshiaki; Yasuo, Masanori; Hanaoka, Masayuki

2016-01-01

This study was conducted in order to investigate the differences in the respiratory physiology of patients with chronic obstructive pulmonary disease (COPD), asthma-COPD overlap syndrome (ACOS), and asthma with airflow limitation (asthma FL(+)). The medical records for a series of all stable patients with persistent airflow limitation due to COPD, ACOS, or asthma were retrospectively reviewed and divided into the COPD group (n=118), the ACOS group (n=32), and the asthma FL(+) group (n=27). All the patients underwent chest high-resolution computed tomography (HRCT) and pulmonary function tests, including respiratory impedance. The low attenuation area score on chest HRCT was significantly higher in the COPD group than in the ACOS group (9.52±0.76 vs 5.09±1.16, Pbronchial wall thickening on chest HRCT was significantly higher in the asthma FL(+) group than in the COPD group (55.6% vs 25.0%, P<0.01). In pulmonary function, forced expiratory volume in 1 second (FEV1) and peak expiratory flow rate were significantly higher in the asthma FL(+) group than in the ACOS group (76.28%±2.54% predicted vs 63.43%±3.22% predicted, P<0.05 and 74.40%±3.16% predicted vs 61.08%±3.54% predicted, P<0.05, respectively). Although residual volume was significantly lower in the asthma FL(+) group than in the COPD group (112.05%±4.34% predicted vs 137.38%±3.43% predicted, P<0.01) and the ACOS group (112.05%±4.34% predicted vs148.46%±6.25% predicted, P<0.01), there were no significant differences in functional residual capacity or total lung capacity. The increase in FEV1 in response to short-acting β2-agonists was significantly greater in the ACOS group than in the COPD group (229±29 mL vs 72±10 mL, P<0.01) and the asthma FL(+) group (229±29 mL vs 153±21 mL, P<0.05). Regarding respiratory impedance, resistance at 5 Hz and resistance at 20 Hz, which are oscillatory parameters of respiratory resistance, were significantly higher in the asthma FL(+) group than in the COPD group

Blow-out limits of nonpremixed turbulent jet flames in a cross flow at atmospheric and sub-atmospheric pressures

KAUST Repository

Wang, Qiang; Hu, Longhua; Yoon, Sung Hwan; Lu, Shouxiang; Delichatsios, Michael; Chung, Suk-Ho

2015-01-01

The blow-out limits of nonpremixed turbulent jet flames in cross flows were studied, especially concerning the effect of ambient pressure, by conducting experiments at atmospheric and sub-atmospheric pressures. The combined effects of air flow

Lung-protective ventilation in intensive care unit and operation room : Tidal volume size, level of positive end-expiratory pressure and driving pressure

NARCIS (Netherlands)

Serpa Neto, A.

2017-01-01

Several investigations have shown independent associations between three ventilator settings – tidal volume size, positive end–expiratory pressure (PEEP) and driving pressure – and outcomes in patients with the acute respiratory distress syndrome (ARDS). There is an increasing notion that similar

A probabilistic method for determining effluent temperature limits for flow instability for SRS reactors

International Nuclear Information System (INIS)

Hardy, B.J.; White, A.M.

1990-06-01

This manual describes the uncertainty analysis used to determine the effluent temperature limits for a Mark 22 charge in the Savannah River Site production reactors. The postulated accident scenario is a DEGB/LOCA resulting from a coolant pipe break at the plenum inlet accompanied by the safety rod failure described in the previous chapter. The analysis described in this manual is used to calculate the limits for the flow instability phase of the accident. For this phase of the accident, the limits criterion is that the Stanton number does not exceed 0.00455 [1]. The limits are determined for a specified 84% probability that the Stanton number will not exceed 0.00455 in any assembly in the core

A probabilistic method for determining effluent temperature limits for flow instability for SRS reactors

Energy Technology Data Exchange (ETDEWEB)

Hardy, B.J.; White, A.M.

1990-06-01

This manual describes the uncertainty analysis used to determine the effluent temperature limits for a Mark 22 charge in the Savannah River Site production reactors. The postulated accident scenario is a DEGB/LOCA resulting from a coolant pipe break at the plenum inlet accompanied by the safety rod failure described in the previous chapter. The analysis described in this manual is used to calculate the limits for the flow instability phase of the accident. For this phase of the accident, the limits criterion is that the Stanton number does not exceed 0.00455 [1]. The limits are determined for a specified 84% probability that the Stanton number will not exceed 0.00455 in any assembly in the core.

Upper-airway flow limitation and transcutaneous carbon dioxide during sleep in normal pregnancy.

Science.gov (United States)

Rimpilä, Ville; Jernman, Riina; Lassila, Katariina; Uotila, Jukka; Huhtala, Heini; Mäenpää, Johanna; Polo, Olli

2017-08-01

Sleep during pregnancy involves a physiological challenge to provide sufficient gas exchange to the fetus. Enhanced ventilatory responses to hypercapnia and hypoxia may protect from deficient gas exchange, but sleep-disordered breathing (SDB) may predispose to adverse events. The aim of this study was to analyze sleep and breathing in healthy pregnant women compared to non-pregnant controls, with a focus on CO 2 changes and upper-airway flow limitation. Healthy women in the third trimester and healthy non-pregnant women with normal body mass index (BMI) were recruited for polysomnography. Conventional analysis of sleep and breathing was performed. Transcutaneous carbon dioxide (TcCO 2 ) was determined for each sleep stage. Flow-limitation was analyzed using the flattening index and TcCO 2 values were recorded for every inspiration. Eighteen pregnant women and 12 controls were studied. Pregnancy was associated with shorter sleep duration and more superficial sleep. Apnea-hypopnea index, arterial oxyhemoglobin desaturation, flow-limitation, snoring or periodic leg movements were similar in the two groups. Mean SaO 2 and minimum SaO 2 were lower and average heart rate was higher in the pregnant group. TcCO 2 levels did not differ between groups but variance of TcCO 2 was smaller in pregnant women during non-rapid eye movement (NREM). TcCO 2 profiles showed transient TcCO 2 peaks, which seem specific to pregnancy. Healthy pregnancy does not predispose to SDB. Enhanced ventilatory control manifests as narrowing threshold of TcCO 2 between wakefulness and sleep. Pregnant women have a tendency for rapid CO 2 increases during sleep which might have harmful consequences if not properly compensated. Copyright © 2017 Elsevier B.V. All rights reserved.

Technical aspects and limitations of fractional flow reserve measurement.

Science.gov (United States)

Jerabek, Stepan; Kovarnik, Tomas

2018-02-27

The only indication for coronary revascularization is elimination of ischaemia. Invasive hemodynamic methods (fractional flow reserve - FFR and instantaneous wave-free ratio (iFR) are superior to coronary angiography in detection of lesions causing myocardial ischaemia. Current European guidelines for myocardial revascularization recommend using of FFR for detection of functional assessment of lesions severity in category IA and number of these procedures increases. However, routine usage of these methods requires knowledge of technical requirements and limitations. The aim of the study is to summarise good clinical practice for FFR and iFR measurements with explanation of possible technical challenges, that are necessary for increasing of measurement accuracy. Authors describe frequent technical mistakes and malpractice during invasive assessment of lesion severity in coronary arteries.

Key considerations on nebulization of antimicrobial agents to mechanically ventilated patients.

Science.gov (United States)

Rello, J; Rouby, J J; Sole-Lleonart, C; Chastre, J; Blot, S; Luyt, C E; Riera, J; Vos, M C; Monsel, A; Dhanani, J; Roberts, J A

2017-09-01

Nebulized antibiotics have an established role in patients with cystic fibrosis or bronchiectasis. Their potential benefit to treat respiratory infections in mechanically ventilated patients is receiving increasing interest. In this consensus statement of the European Society of Clinical Microbiology and Infectious Diseases, the body of evidence of the therapeutic utility of aerosolized antibiotics in mechanically ventilated patients was reviewed and resulted in the following recommendations: Vibrating-mesh nebulizers should be preferred to jet or ultrasonic nebulizers. To decrease turbulence and limit circuit and tracheobronchial deposition, we recommend: (a) the use of specifically designed respiratory circuits avoiding sharp angles and characterized by smooth inner surfaces, (b) the use of specific ventilator settings during nebulization including use of a volume controlled mode using constant inspiratory flow, tidal volume 8 mL/kg, respiratory frequency 12 to 15 bpm, inspiratory:expiratory ratio 50%, inspiratory pause 20% and positive end-expiratory pressure 5 to 10 cm H 2 O and (c) the administration of a short-acting sedative agent if coordination between the patient and the ventilator is not obtained, to avoid patient's flow triggering and episodes of peak decelerating inspiratory flow. A filter should be inserted on the expiratory limb to protect the ventilator flow device and changed between each nebulization to avoid expiratory flow obstruction. A heat and moisture exchanger and/or conventional heated humidifier should be stopped during the nebulization period to avoid a massive loss of aerosolized particles through trapping and condensation. If these technical requirements are not followed, there is a high risk of treatment failure and adverse events in mechanically ventilated patients receiving nebulized antibiotics for pneumonia. Copyright © 2017 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights

Pulmonary functions in air conditioner users.

Science.gov (United States)

Khaliq, Farah; Sharma, Sameer; Tandon, O P

2006-01-01

Air conditioning may affect human health since it has profound effect on our environment, than just lowering temperature. The present study was planned to assess the effect of air conditioners (AC) on pulmonary functions in young healthy non-smoker males. The study group comprised of ten subjects who were using AC's in their cars for at least 1 hr daily since last 6 months. While ten subjects who did not use AC at all served as controls. The pulmonary functions were assessed using PK Morgan 232 spirometer in a closed room. The peak expiratory flow rate (PEFR) and Forced expiratory flow between 25-75% of vital capacity (FEF25-75) were significantly reduced in subjects using car AC's. Inspiratory flow rates also showed a trend towards decline in AC users but could not reach the level of significance. The lung volumes and capacities were not significantly different in the two groups except for forced expiratory volume in 0.5 sec (FEV 0.5 sec), which also decreased in AC users. The airway resistance and lung compliance did not show significant change. In the presence of normal FEV1, reduced FEF25-75% which is the flow rate over the middle half of vital capacity, is an evidence of mild airflow limitation. The result is suggestive of predisposition of AC users towards respiratory disorders in form of mild airflow restriction.

Equivalent linearization method for limit cycle flutter analysis of plate-type structure in axial flow

International Nuclear Information System (INIS)

Lu Li; Yang Yiren

2009-01-01

The responses and limit cycle flutter of a plate-type structure with cubic stiffness in viscous flow were studied. The continuous system was dispersed by utilizing Galerkin Method. The equivalent linearization concept was performed to predict the ranges of limit cycle flutter velocities. The coupled map of flutter amplitude-equivalent linear stiffness-critical velocity was used to analyze the stability of limit cycle flutter. The theoretical results agree well with the results of numerical integration, which indicates that the equivalent linearization concept is available to the analysis of limit cycle flutter of plate-type structure. (authors)

Breath-by-breath analysis of expiratory gas concentration in chickens.

Science.gov (United States)

Itabisashi, T

1981-01-01

Expiratory oxygen and carbon-dioxide concentration were analysed breath by breath in order to examine their wave forms in adult awake hens restrained in various postural positions, including supine, prone and sitting positions. Expired gas was collected at the nostril in almost all the hens. In the sitting position free from vocalization, feeding, drinking, panting, and restlessness, hens showed various forms of stable pattern of oxygen-gas curves. These forms were classified into three types, or the ascending, flat and descending types, with respect to the plateau inclination. The waves of carbon-dioxide were not always a mirror image of those of oxygen. The rate of occurrence of each type varied with the hen's postural position. The wave form was altered with the experimental body-rotation of the hen. When placed between the deflections of stable pattern, the episodes of wave deformation resembling that seen at the time of uneven pulmonary ventilation in mammals could frequently be observed in any hen's posture examined. Cardiogenic oscillation appeared on the plateau of expired-gas curves.

Effect of Flow Direction on the Extinction Limit for Flame Spread over Wire Insulation in Microgravity

DEFF Research Database (Denmark)

Nagachi, Masashi; Mitsui, Fumiya; Citerne, Jean-Marie

Experiments to determine the Limiting Oxygen Concentration (LOC) of a flame spread over electric wire insulation were carried out in microgravity provided by parabolic flights. The difference between the LOC in opposed and concurrent flows was evidenced. Polyethylene insulated Copper (Cu) wires...... and polyethylene insulated Nickel-Chrome (NiCr) wires with inner core diameter of 0.50 mm and insulation thickness of 0.30 mm were examined with external flow velocities ranging from 50mm/s to 200mm/s. The results for the Copper wires show that with increasing external flow velocity, the LOC monotonically...... decreased for the concurrent flow conditions and the LOC first decreased and then increased (“U” trend) for the opposed flow conditions. Similar trends were found in the experiments with NiCr wires. Also, in terms of the minimum LOC value, the minimum LOC was comparable for both wire types in both flow...

Numerical study on flow rate limitation of open capillary channel flow through a wedge

Directory of Open Access Journals (Sweden)

Ting-Ting Zhang

2016-04-01

Full Text Available The flow characteristics of slender-column flow in wedge-shaped channel under microgravity condition are investigated in this work. The one-dimensional theoretical model is applied to predict the critical flow rate and surface contour of stable flow. However, the one-dimensional model overestimates the critical flow rate for not considering the extra pressure loss. Then, we develop a three-dimensional simulation method with OpenFOAM, a computational fluid dynamics tool, to simulate various phenomena in wedge channels with different lengths. The numerical results are verified with the capillary channel flow experimental data on the International Space Station. We find that the three-dimensional simulation perfectly predicts the critical flow rates and surface contours under various flow conditions. Meanwhile, the general behaviors in subcritical, critical, and supercritical flow are studied in three-dimensional simulation considering variations of flow rate and open channel length. The numerical techniques for three-dimensional simulation is validated for a wide range of configurations and is hopeful to provide valuable guidance for capillary channel flow experiment and efficient liquid management in space.

The Economic Role and Limitations of Cooperatives: An Investment Cash Flow Derivation

OpenAIRE

Peterson, H. Christopher

1992-01-01

The economic role and limitations of cooperatives are derived using an approach based on investment cash flows and net present value. Cooperatives are viewed as an option for member investment as well as an option for member patronage. The investment approach yields results similar to the traditional paradigms that focus on patronage. In addition, the approach makes more explicit the impact of member investment on cooperative existence, valuation, performance measurement, and strategy options.

Modeling the Fate of Expiratory Aerosols and the Associated Infection Risk in an Aircraft Cabin Environment

DEFF Research Database (Denmark)

Wan, M.P.; To, G.N.S.; Chao, C.Y.H.

2009-01-01

to estimate the risk of infection by contact. The environmental control system (ECS) in a cabin creates air circulation mainly in the lateral direction, making lateral dispersions of aerosols much faster than longitudinal dispersions. Aerosols with initial sizes under 28 m in diameter can stay airborne......The transport and deposition of polydispersed expiratory aerosols in an aircraft cabin were simulated using a Lagrangian-based model validated by experiments conducted in an aircraft cabin mockup. Infection risk by inhalation was estimated using the aerosol dispersion data and a model was developed...

Low blood flow at onset of moderate-intensity exercise does not limit muscle oxygen uptake

DEFF Research Database (Denmark)

Nyberg, Michael Permin; Mortensen, Stefan P; Saltin, Bengt

2010-01-01

The effect of low blood flow at onset of moderate-intensity exercise on the rate of rise in muscle oxygen uptake was examined. Seven male subjects performed a 3.5-min one-legged knee-extensor exercise bout (24 +/- 1 W, mean +/- SD) without (Con) and with (double blockade; DB) arterial infusion...... of inhibitors of nitric oxide synthase (N(G)-monomethyl-l-arginine) and cyclooxygenase (indomethacin) to inhibit the synthesis of nitric oxide and prostanoids, respectively. Leg blood flow and leg oxygen delivery throughout exercise was 25-50% lower (P ... +/- 12 vs. 262 +/- 39 ml/min). The present data demonstrate that muscle blood flow and oxygen delivery can be markedly reduced without affecting muscle oxygen uptake in the initial phase of moderate-intensity exercise, suggesting that blood flow does not limit muscle oxygen uptake at the onset...

Setting individualized positive end-expiratory pressure level with a positive end-expiratory pressure decrement trial after a recruitment maneuver improves oxygenation and lung mechanics during one-lung ventilation.

Science.gov (United States)

Ferrando, Carlos; Mugarra, Ana; Gutierrez, Andrea; Carbonell, Jose Antonio; García, Marisa; Soro, Marina; Tusman, Gerardo; Belda, Francisco Javier

2014-03-01

We investigated whether individualized positive end-expiratory pressure (PEEP) improves oxygenation, ventilation, and lung mechanics during one-lung ventilation compared with standardized PEEP. Thirty patients undergoing thoracic surgery were randomly allocated to the study or control group. Both groups received an alveolar recruitment maneuver at the beginning and end of one-lung ventilation. After the alveolar recruitment maneuver, the control group had their lungs ventilated with a 5 cm·H2O PEEP, while the study group had their lungs ventilated with an individualized PEEP level determined by a PEEP decrement trial. Arterial blood samples, lung mechanics, and volumetric capnography were recorded at multiple timepoints throughout the procedure. The individualized PEEP values in study group were higher than the standardized PEEP values (10 ± 2 vs 5 cm·H2O; P decrement trial than with a standardized 5 cm·H2O of PEEP.

The effect of habitual waterpipe tobacco smoking on pulmonary function and exercise capacity in young healthy males: A pilot study.

Science.gov (United States)

Hawari, F I; Obeidat, N A; Ghonimat, I M; Ayub, H S; Dawahreh, S S

2017-01-01

Evidence regarding the health effects of habitual waterpipe smoking is limited, particularly in young smokers. Respiratory health and cardiopulmonary exercise tests were compared in young male habitual waterpipe smokers (WPS) versus non-smokers. 69 WPS (≥3 times/week for three years) and 69 non-smokers were studied. Respiratory health was assessed through the American Thoracic Society and the Division of Lung Diseases (ATS-DLD-78) adult questionnaire. Pulmonary function and cardiopulmonary exercise tests were performed. Self-reported respiratory symptoms, forced expiratory volume in first second (FEV 1 ), forced vital capacity (FVC), FEV 1 /FVC ratio, forced expiratory flow between 25 and 75% of FVC (FEF 25-75% ), peak expiratory flow (PEF), exercise time, peak end-tidal CO 2 tension (PetCO 2 ), subject-reported leg fatigue and dyspnea; peak O 2 uptake (VO 2 max), and end-expiratory lung volume (EELV) change from baseline (at peak exercise) were measured. WPS were more likely than non-smokers to report respiratory symptoms. WPS also demonstrated: shorter exercise time; lower peak VO 2 ; higher perceived dyspnea at mid-exercise; lower values of the following: FEV 1 , FVC, PEF, and EELV change. Habitual waterpipe tobacco smoking in young seemingly healthy individuals is associated with a greater burden of respiratory symptoms and impaired exercise capacity. Copyright © 2016 Elsevier Ltd. All rights reserved.

Reference values for spirometry in preschool children.

Science.gov (United States)

Burity, Edjane F; Pereira, Carlos A C; Rizzo, José A; Brito, Murilo C A; Sarinho, Emanuel S C

2013-01-01

Reference values for lung function tests differ in samples from different countries, including values for preschoolers. The main objective of this study was to derive reference values in this population. A prospective study was conducted through a questionnaire applied to 425 preschool children aged 3 to 6 years, from schools and day-care centers in a metropolitan city in Brazil. Children were selected by simple random sampling from the aforementioned schools. Peak expiratory flow (PEF), forced vital capacity (FVC), forced expiratory volumes (FEV1, FEV0.50), forced expiratory flow (FEF25-75) and FEV1/FVC, FEV0.5/FVC and FEF25-75/FVC ratios were evaluated. Of the 425 children enrolled, 321 (75.6%) underwent the tests. Of these, 135 (42.0%) showed acceptable results with full expiratory curves and thus were included in the regression analysis to define the reference values. Height and gender significantly influenced FVC values through linear and logarithmic regression analysis. In males, R(2) increased with the logarithmic model for FVC and FEV1, but the linear model was retained for its simplicity. The lower limits were calculated by measuring the fifth percentile residues. Full expiratory curves are more difficult to obtain in preschoolers. In addition to height, gender also influences the measures of FVC and FEV1. Reference values were defined for spirometry in preschool children in this population, which are applicable to similar populations. Copyright © 2013 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

Influence of Changing the Diameter of the Bubble Generator Bottle and Expiratory Limb on Bubble CPAP: An in vitro Study

Directory of Open Access Journals (Sweden)

Chun-Shan Wu

2012-12-01

Conclusion: The size and submergence depth of an expiratory limb of a CPAP circuit, the diameter of the bubble generator bottle, and the compliance of the model lung all influence the magnitude and frequency of the transmitted pressure waveform. Therefore, these factors may affect lung volume recruitment and breathing efficiency in bubble CPAP.

Effect of a mixture of pyridostigmine and atropine on forced expiratory volume (FEV1), and serum cholinesterase activity in normal subjects

DEFF Research Database (Denmark)

Feldt-Rasmussen, B F; Gefke, Kaj; Mosbech, H

1985-01-01

injection with a decrease to 27 +/- 5% (mean +/- SEM) of the original activity. Forced expiratory volume in the first 1s (FEV1) was measured at fixed time intervals for 90 min. No decrease in FEV1 was observed; on the contrary, there was a small increase. We conclude that atropine effectively antagonizes...

A Comprehensive Prediction Model of Hydraulic Extended-Reach Limit Considering the Allowable Range of Drilling Fluid Flow Rate in Horizontal Drilling.

Science.gov (United States)

Li, Xin; Gao, Deli; Chen, Xuyue

2017-06-08

Hydraulic extended-reach limit (HERL) model of horizontal extended-reach well (ERW) can predict the maximum measured depth (MMD) of the horizontal ERW. The HERL refers to the well's MMD when drilling fluid cannot be normally circulated by drilling pump. Previous model analyzed the following two constraint conditions, drilling pump rated pressure and rated power. However, effects of the allowable range of drilling fluid flow rate (Q min  ≤ Q ≤ Q max ) were not considered. In this study, three cases of HERL model are proposed according to the relationship between allowable range of drilling fluid flow rate and rated flow rate of drilling pump (Q r ). A horizontal ERW is analyzed to predict its HERL, especially its horizontal-section limit (L h ). Results show that when Q min  ≤ Q r  ≤ Q max (Case I), L h depends both on horizontal-section limit based on rated pump pressure (L h1 ) and horizontal-section limit based on rated pump power (L h2 ); when Q min  drilling fluid flow rate, while L h2 keeps decreasing as the drilling fluid flow rate increases. The comprehensive model provides a more accurate prediction on HERL.

Lattice Boltzmann methods for thermal flows: Continuum limit and applications to compressible Rayleigh Taylor systems

NARCIS (Netherlands)

Scagliarini, Andrea; Biferale, L.; Sbragaglia, M.; Sugiyama, K.; Toschi, F.

2010-01-01

We compute the continuum thermohydrodynamical limit of a new formulation of lattice kinetic equations for thermal compressible flows, recently proposed by Sbragaglia et al. [J. Fluid Mech. 628, 299 (2009)] . We show that the hydrodynamical manifold is given by the correct compressible

Effect of 1,6-hexamethylene diisocyanate exposure on peak flowmetry in automobile paint shop workers in Iran.

Science.gov (United States)

Pourabedian, Siyamak; Barkhordari, Abdullah; Habibi, Ehsanallah; Rismanchiyan, Masoud; Zare, Mohsen

2010-06-01

The aim of this study was to investigate the effects of occupational exposure to 1,6-hexamethylene diisocyanate (HDI) on peak flowmetry in automobile body paint shop workers in Iran. We studied a population of 43 car painters exposed to HDI at their workplaces. Peak expiratory flow was tested for one working week, from the start to the end of each shift. Air was sampled and HDI analysed in parallel, according to the OSHA 42 method. Daily and weekly HDI exposure averages were (0.42+/-0.1) mg m(-3) and (0.13+/-0.05) mg m(-3), respectively. On painting days, 72 % of workers showed more than a 10 % variation in peak expiratory flow. Inhalation exposure exceeded the threshold limit value (TLV) ten times over. This strongly suggests that HDI affected the peak flowmetry in the studied workers.

Two-phase flow experiments on Counter-Current Flow Limitation in a model of the hot leg of a pressurized water reactor (2015 test series)

Energy Technology Data Exchange (ETDEWEB)

Beyer, Matthias; Lucas, Dirk; Pietruske, Heiko; Szalinski, Lutz

2016-12-15

Counter-Current Flow Limitation (CCFL) is of importance for PWR safety analyses in several accident scenarios connected with loss of coolant. Basing on the experiences obtained during a first series of hot leg tests now new experiments on counter-current flow limitation were conducted in the TOPFLOW pressure vessel. The test series comprises air-water tests at 1 and 2 bar as well as steam-water tests at 10, 25 and 50 bar. During the experiments the flow structure was observed along the hot leg model using a high-speed camera and web-cams. In addition pressure was measured at several positions along the horizontal part and the water levels in the reactor-simulator and steam-generator-simulator tanks were determined. This report documents the experimental setup including the description of operational and special measuring techniques, the experimental procedure and the data obtained. From these data flooding curves were obtained basing on the Wallis parameter. The results show a slight shift of the curves in dependency of the pressure. In addition a slight decrease of the slope was found with increasing pressure. Additional investigations concern the effects of hysteresis and the frequencies of liquid slugs. The latter ones show a dependency on pressure and the mass flow rate of the injected water. The data are available for CFD-model development and validation.

Two-phase flow experiments on Counter-Current Flow Limitation in a model of the hot leg of a pressurized water reactor (2015 test series)

International Nuclear Information System (INIS)

Beyer, Matthias; Lucas, Dirk; Pietruske, Heiko; Szalinski, Lutz

2016-12-01

Counter-Current Flow Limitation (CCFL) is of importance for PWR safety analyses in several accident scenarios connected with loss of coolant. Basing on the experiences obtained during a first series of hot leg tests now new experiments on counter-current flow limitation were conducted in the TOPFLOW pressure vessel. The test series comprises air-water tests at 1 and 2 bar as well as steam-water tests at 10, 25 and 50 bar. During the experiments the flow structure was observed along the hot leg model using a high-speed camera and web-cams. In addition pressure was measured at several positions along the horizontal part and the water levels in the reactor-simulator and steam-generator-simulator tanks were determined. This report documents the experimental setup including the description of operational and special measuring techniques, the experimental procedure and the data obtained. From these data flooding curves were obtained basing on the Wallis parameter. The results show a slight shift of the curves in dependency of the pressure. In addition a slight decrease of the slope was found with increasing pressure. Additional investigations concern the effects of hysteresis and the frequencies of liquid slugs. The latter ones show a dependency on pressure and the mass flow rate of the injected water. The data are available for CFD-model development and validation.

The Neopuff's PEEP valve is flow sensitive.

LENUS (Irish Health Repository)

Hawkes, Colin Patrick

2012-01-31

AIM: The current recommendation in setting up the Neopuff is to use a gas flow of 5-15 L\\/min. We investigated if the sensitivity of the positive end expiratory pressure (PEEP) valve varies at different flow rates within this range. METHODS: Five Neopuffs were set up to provide a PEEP of 5 cm H(2) O. The number of clockwise revolutions to complete occlusion of the PEEP valve and the mean and range of pressures at each quarter clockwise revolution were recorded at gas flow rates between 5 and 15 L\\/min. Results: At 5, 10 and 15 L\\/min, 0.5, 1.7 and 3.4 full clockwise rotations were required to completely occlude the PEEP valve, and pressures rose from 5 to 11.4, 18.4 and 21.5 cm H(2) O, respectively. At a flow rate of 5 L\\/min, half a rotation of the PEEP dial resulted in a rise in PEEP from 5 to 11.4cm H(2) O. At 10 L\\/min, half a rotation resulted in a rise from 5 to 7.7cm H(2) O, and at 15 L\\/min PEEP rose from 5 to 6.8cm H(2) O. CONCLUSION: Users of the Neopuff should be aware that the PEEP valve is more sensitive at lower flow rates and that half a rotation of the dial at 5 L\\/min gas flow can more than double the PEEP.

CHANGES IN LUNG FUNCTION IN THE TREATMENT OF PATIENTS WITH EXOGENOUS ALLERGIC ALVEOLITIS

OpenAIRE

V. B. Nefedov; L. A. Popova; E. A. Shergina; N. N. Makaryants

2014-01-01

Total lung capacity (TLC), lung capacity (LC), forced LC (FLC), intrathoracic volume (ITV), pulmonary residual volume (PRV), forced expiratory volume in one second (FEV1 ), (FEV1 )/LC%, peak expiratory flow (PEF), maximum expiratory flow rate (MEFR)25, MEFR50, MEFR75, Raw, Rin, Rex, DLCO-SB, DLCO-SB/VА, РаО2 , and РаСО2 were determined in 43 patients with exogenous allergic alveolitis (EAA) before, during, and after treatment with glucocorticosteroids, hemapheresis, ambroxol, and fluimucil. L...

Experimental study of falling water limitation under counter-current flow in the vertical rectangular channel

International Nuclear Information System (INIS)

Usui, Tohru; Kaminaga, Masanori; Sudo, Yukio.

1988-07-01

Quantitative understanding of critical heat flux (CHF) in the narrow vertical rectangular channel is required for the thermo-hydroulic design and the safety analysis of research reactors in which flat-plate-type fuel is adopted. Especially, critical heat flux under low downward velocity has a close relation with falling water limitation under counter-current flow. Accordingly, CCFL (Counter-current Flow Limitation) experiments were carried out for both vertical rectangular channels and vertical circular tubes varried in their size and configuration of their cross sections, to make clear CCFL characteristics in the vertical rectangular channels. In the experiments, l/de of the rectangular channel was changed from 3.5 to 180. As the results, it was clear that different equivalent hydraulic diameter de, namely width or water gap of channel, gave different CCFL characteristics of rectangular channel. But the influence of channel length l on CCFL characteristics was not observed. Besides, a dimensionless correlation to estimate a relation between upward air velocity and downward water velocity was proposed based on the present experimental results. The difference of CCFL characteristics between rectangular channels and circular tubes was also investigated. Especially for the rectangular channels, dry-patches appearing condition was made clear as a flow-map. (author)

Sensitivity and specificity of hypopnoea detection using nasal pressure in the presence of a nasal expiratory resistive device (Provent®)

International Nuclear Information System (INIS)

Milne, Stephen; Amis, Terence C; Wheatley, John R; Kairaitis, Kristina

2014-01-01

Nasal expiratory resistive valves (Provent ® ) have been proposed as novel therapy for obstructive sleep apnea. We compared pressure measurements from a standard nasal pressure catheter used to assess nasal airflow during sleep with those from nasal expiratory resistive device with attached proprietary nasal pressure cannula. Nasal pressure cannula or Provent ® + proprietary nasal pressure cannula were attached to a bench model of human anterior nares and nasal passages, and pressure measured (P). Respiratory airflows generated by a subject breathing were applied to rear of model and airflow ( V-dot ) measured via pneumotachograph. Airflow amplitude (Δ V-dot ) was plotted against pressure amplitude (ΔP). Hypopnoea detection (<50% Δ V-dot ) sensitivity and specificity was tested by expressing ΔP in terms of two reference breaths: reference breath 1, Δ V-dot 0.55 L s −1  = 100%; and reference breath 2, Δ V-dot 0.45 L s −1  = 100%. ΔP/Δ V-dot relationships were linear for Δ V-dot  ≤ 0.55 L s −1 ; ΔP = 0.37ΔV + 0.16 (nasal pressure cannula), ΔP = 2.7ΔV + 0.12 (Provent ® + proprietary nasal pressure cannula); both R 2  > 0.65, p < 0.0001; p < 0.0001 for between slope difference). For nasal pressure cannula, specificity of hypopnoea detection differed between reference breaths one and two (80.2% and 40.0%, respectively), and Provent ® + proprietary nasal pressure cannula (30.3% and 74.2%, respectively). Quantification of airflow obstruction in the presence of Provent ® + proprietary nasal pressure cannula is greatly influenced by the reference breath chosen to determine a reduction in nasal airflow. Reported variability in therapeutic response to nasal expiratory resistive devices may relate to differences in measurement technique specificity used to quantify the severity of sleep disordered breathing. (paper)

Implicit high-order discontinuous Galerkin method with HWENO type limiters for steady viscous flow simulations

Science.gov (United States)

Jiang, Zhen-Hua; Yan, Chao; Yu, Jian

2013-08-01

Two types of implicit algorithms have been improved for high order discontinuous Galerkin (DG) method to solve compressible Navier-Stokes (NS) equations on triangular grids. A block lower-upper symmetric Gauss-Seidel (BLU-SGS) approach is implemented as a nonlinear iterative scheme. And a modified LU-SGS (LLU-SGS) approach is suggested to reduce the memory requirements while retain the good convergence performance of the original LU-SGS approach. Both implicit schemes have the significant advantage that only the diagonal block matrix is stored. The resulting implicit high-order DG methods are applied, in combination with Hermite weighted essentially non-oscillatory (HWENO) limiters, to solve viscous flow problems. Numerical results demonstrate that the present implicit methods are able to achieve significant efficiency improvements over explicit counterparts and for viscous flows with shocks, and the HWENO limiters can be used to achieve the desired essentially non-oscillatory shock transition and the designed high-order accuracy simultaneously.

Sources of variability of resting cerebral blood flow in healthy subjects

DEFF Research Database (Denmark)

Henriksen, Otto Mølby; Kruuse, Christina Rostrup; Olesen, Jes

2013-01-01

Measurements of cerebral blood flow (CBF) show large variability among healthy subjects. The aim of the present study was to investigate the relative effect of established factors influencing CBF on the variability of resting CBF. We retrospectively analyzed spontaneous variability in 430 CBF...... measurements acquired in 152 healthy, young subjects using (133)Xe single-photon emission computed tomography. Cerebral blood flow was correlated positively with both end-tidal expiratory PCO2 (PETCO2) and female gender and inversely with hematocrit (Hct). Between- and within-subject CO2 reactivity...... when Hct was also accounted for. The present study confirms large between-subject variability in CBF measurements and that gender, Hct, and PETCO2 explain only a small part of this variability. This implies that a large fraction of CBF variability may be due to unknown factors such as differences...

Pulmonary function studies in healthy Filipino adults residing in the United States.

Science.gov (United States)

Lin, F L; Kelso, J M

1999-08-01

Differences in lung volumes among various ethnic groups are known to occur; however, this has not been studied in Filipinos. We sought to assess pulmonary function in healthy, nonsmoking Filipinos residing in the United States compared with standards for white subjects. Healthy adult Filipinos, age 18 years or greater, were recruited. All subjects were screened with health questionnaires to exclude those with cardiopulmonary disease. Pulmonary function tests were performed by using forced expiratory maneuvers. Values for FEV(1 ), forced vital capacity (FVC), FEV(1 )/FVC, forced expiratory flow from 25% to 75% of FVC, and peak expiratory flow rate were compared with predicted values for white subjects (ie, without a racial adjustment). Two hundred twenty-four healthy subjects (121 men and 103 women) completed the study. The group means (as a percentage of the predicted standard for white subjects) were as follows: FEV(1 ), 86%; FVC, 84%; FEV(1 )/FVC, 103%; forced expiratory flow from 25% to 75% of FVC, 96%; and peak expiratory flow rate, 107%. These findings are very similar to those for African Americans and other Asians. We conclude that it is appropriate to use an 85% racial adjustment for FEV(1 ) and FVC when interpreting pulmonary function test results in Filipinos.

Limits to gene flow in a cosmopolitan marine planktonic diatom.

Science.gov (United States)

Casteleyn, Griet; Leliaert, Frederik; Backeljau, Thierry; Debeer, Ann-Eline; Kotaki, Yuichi; Rhodes, Lesley; Lundholm, Nina; Sabbe, Koen; Vyverman, Wim

2010-07-20

The role of geographic isolation in marine microbial speciation is hotly debated because of the high dispersal potential and large population sizes of planktonic microorganisms and the apparent lack of strong dispersal barriers in the open sea. Here, we show that gene flow between distant populations of the globally distributed, bloom-forming diatom species Pseudo-nitzschia pungens (clade I) is limited and follows a strong isolation by distance pattern. Furthermore, phylogenetic analysis implies that under appropriate geographic and environmental circumstances, like the pronounced climatic changes in the Pleistocene, population structuring may lead to speciation and hence may play an important role in diversification of marine planktonic microorganisms. A better understanding of the factors that control population structuring is thus essential to reveal the role of allopatric speciation in marine microorganisms.

Large-N limit of the gradient flow in the 2D O(N) nonlinear sigma model

International Nuclear Information System (INIS)

Makino, Hiroki; Sugino, Fumihiko; Suzuki, Hiroshi

2015-01-01

The gradient flow equation in the 2D O(N) nonlinear sigma model with lattice regularization is solved in the leading order of the 1/N expansion. By using this solution, we analytically compute the thermal expectation value of a lattice energy–momentum tensor defined through the gradient flow. The expectation value reproduces thermodynamic quantities obtained by the standard large-N method. This analysis confirms that the above lattice energy–momentum tensor restores the correct normalization automatically in the continuum limit, in a system with a non-perturbative mass gap

Improved oxygenation during standing performance of deep breathing exercises with positive expiratory pressure after cardiac surgery: A randomized controlled trial.

Science.gov (United States)

Pettersson, Henrik; Faager, Gun; Westerdahl, Elisabeth

2015-09-01

Breathing exercises after cardiac surgery are often performed in a sitting position. It is unknown whether oxygenation would be better in the standing position. The aim of this study was to evaluate oxygenation and subjective breathing ability during sitting vs standing performance of deep breathing exercises on the second day after cardiac surgery. Patients undergoing coronary artery bypass grafting (n = 189) were randomized to sitting (controls) or standing. Both groups performed 3 × 10 deep breaths with a positive expiratory pressure device. Peripheral oxygen saturation was measured before, directly after, and 15 min after the intervention. Subjective breathing ability, blood pressure, heart rate, and pain were assessed. Oxygenation improved significantly in the standing group compared with controls directly after the breathing exercises (p < 0.001) and after 15 min rest (p = 0.027). The standing group reported better deep breathing ability compared with controls (p = 0.004). A slightly increased heart rate was found in the standing group (p = 0.047). After cardiac surgery, breathing exercises with positive expiratory pressure, performed in a standing position, significantly improved oxygenation and subjective breathing ability compared with sitting performance. Performance of breathing exercises in the standing position is feasible and could be a valuable treatment for patients with postoperative hypoxaemia.

Effects of Ramadan fasting on spirometric values and clinical symptoms in asthmatic patients

Directory of Open Access Journals (Sweden)

Abdolreza Norouzy

2013-03-01

Full Text Available Introduction: Ramadan is the 9th  Islamic lunar month during which Muslims avoid eating and drinking from sunrise to sunset.  The effect of Ramadan intermittent fasting on asthma control is controversial.  The aim of this study was to investigate the effects of Ramadan fasting on the spirometric variables and clinical symptoms on well-controlled asthmatic patients during Ramadan. Material and Methods: a cohort study was conducted in Mashhad, Khorasan Razavi, Iran. Twenty-nine (19 females and 10 males well-controlled asthmatic patients aged 47 (12 years completed the study.  The average duration of fasting was 26.5 days. Assessment of spirometric variables (daily peak expiratory flow, peak expiratory flow variability, peak expiratory flow home monitoring as well as asthma clinical symptoms including dyspnea, cough, wheezing, and chest tightness were carried out. Results: No significant changes in clinical symptoms were reported in asthmatic patients at the end of Ramadan fasting.  Among spirometric variables, only peak expiratory flow improved after Ramadan (p

The usefulness of computed tomography in distinguishing between asthma with irreversible air-flow limitation and pulmonary emphysema

International Nuclear Information System (INIS)

Taniguchi, Hiroyuki; Ogawa, Kenji; Nakajima, Yoko; Amano, Masao; Kondo, Yasuhiro; Matsumoto, Kohei; Yokoyama, Sigeki; Matsubara, Kazuhito

1988-01-01

Chronic asthma may develop irreversible air-flow limitation and in this circumstance, it is clinically difficult to distinguish between asthma and pulmonary emphysema. Recently, it has been reported that computed tomography (CT) may assist in detecting changes in the lung specific for emphysema. We examined patients who suffered from asthma before the age of 45 which led to irreversible air-flow limitation (BA group; n = 17, mean age = 65.9) and patients with pulmonary emphysema (CPE group; n = 19, mean age = 69.8). Pulmonary function testing and CT were performed on all patients. In assessment of CT, areas of low attenuation and vascular disruption were considered to be suggestive of emphysema, and the Emphysema Score (ES) was calculated according to the method of Bergin et al. There was no significant difference in FEV1.0, % FEV1.0, % FEV1.0/FVC, % RV and RV/TLC between the BA group and the CPE group. In contrast, there was a significant decrease in the % DLco in CPE group compared with that of the BA group (p < 0.001). The ES in total lung was 54.9 ± 18.6 % in the CPE group and 7.8 ± 11.0 % in BA group (p < 0.001). There was a significant correlation between the % DLco and the ES in the CPE group (p < 0.01). We conclude that the CT is useful in distinguishing between asthma with irreversible air-flow limitation and pulmonary emphysema. (author)

Inspiratory and expiratory HRCT findings in Behcet's disease and correlation with pulmonary function tests

Energy Technology Data Exchange (ETDEWEB)

Oezer, Caner [Department of Radiology, Mersin University, Faculty of Medicine, Mersin (Turkey)]. E-mail: cozer@mersin.edu.tr; Duce, Meltem Nass [Department of Radiology, Mersin University, Faculty of Medicine, Mersin (Turkey); Ulubas, Bahar [Department of Respiratory Disease, Mersin University, Faculty of Medicine, Mersin (Turkey); Bicer, Ali [Department of Physical Medicine and Rehabilitation, Mersin University, Faculty of Medicine, Mersin (Turkey); Tuersen, Uemit [Department of Dermatology, Mersin University, Faculty of Medicine, Mersin (Turkey); Apaydin, F. Demir [Department of Radiology, Mersin University, Faculty of Medicine, Mersin (Turkey); Yildiz, Altan [Department of Radiology, Mersin University, Faculty of Medicine, Mersin (Turkey); Camdeviren, Handan [Department of Biostatistics, Mersin University, Faculty of Medicine, Mersin (Turkey)

2005-10-01

Purpose: The purpose of our study was to describe the pulmonary parenchymal changes of Behcet's disease using high-resolution computed tomography and to correlate them with pulmonary function tests. Materials and methods: Thirty-four patients with Behcet's disease (18 men, 16 women), 3 of whom were symptomatic, were included as the study group. Four of 34 patients were smokers. Twenty asymptomatic volunteers (12 men, 8 women), 4 of whom were smokers, constituted the control group. The pulmonary function tests and high-resolution computed tomography were performed for both groups. Results: Inspiratory high-resolution computed tomography findings were abnormal in nine patients (26.5%) of the study group. In eight patients, there were multiple abnormalities, whereas one patient had only one abnormality. Pleural thickening and irregularities, major fissure thickening, emphysematous changes, bronchiectasis, parenchymal bands, and irregular densities, and parenchymal nodules were the encountered abnormalities. Inspiratory high-resolution computed tomography scans were normal in the control group. On expiratory scans, there was statistically significant difference between study group and control group when air trapping, especially grades 3 and 4, was compared (P < 0.01). Pulmonary function tests of both the study and the control groups were in normal ranges, and there was no statistically significant difference between the two groups according to pulmonary function tests (P > 0.05). Discussion and conclusion: High-resolution computed tomography is sensitive in the demonstration of pulmonary changes in patients with Behcet's disease. End-expiratory high-resolution computed tomography examination is very useful and necessary to show the presence of air trapping, thus the presence of small airway disease, even if the patient is asymptomatic or has normal pulmonary function tests.

A single photon emission computed tomograph based on a limited dumber of detectors for fluid flow visualization

International Nuclear Information System (INIS)

Legoupil, S.

1999-01-01

We present in this work a method for fluid flow visualization in a system using radioactive tracers. The method is based on single photon emission computed tomography techniques, applied to a limited number of discrete detectors. We propose in this work a method for the estimation of the transport matrix of photons, associated to the acquisition system. This method is based on the modelization of profiles acquired for a set of point sources located in the imaged volume. Monte Carlo simulations allow to separate scattered photons from those directly collected by the system. The influence of the energy tracer is exposed. The reconstruction method is based on the maximum likelihood - expectation maximization algorithm. An experimental device, based on 36 detectors was realised for the visualization of water circulation in a vessel. A video monitoring allows to visualize the dye water tracer. Dye and radioactive tracers are injected simultaneously in a water flow circulating in the vessel. Reconstructed and video images are compared. Quantitative and qualitative analysis show that fluid flow visualization is feasible with a limited number of detectors. This method can be applied for system involving circulations of fluids. (author)

Associations between positive end-expiratory pressure and outcome of patients without ARDS at onset of ventilation: a systematic review and meta-analysis of randomized controlled trials

NARCIS (Netherlands)

Serpa Neto, Ary; Filho, Roberto Rabello; Cherpanath, Thomas; Determann, Rogier; Dongelmans, Dave A.; Paulus, Frederique; Tuinman, Pieter Roel; Pelosi, Paolo; de Abreu, Marcelo Gama; Schultz, Marcus J.

2016-01-01

The aim of this investigation was to compare ventilation at different levels of positive end-expiratory pressure (PEEP) with regard to clinical important outcomes of intensive care unit (ICU) patients without acute respiratory distress syndrome (ARDS) at onset of ventilation. Meta-analysis of

Discrete particle swarm optimization to solve multi-objective limited-wait hybrid flow shop scheduling problem

Science.gov (United States)

Santosa, B.; Siswanto, N.; Fiqihesa

2018-04-01

This paper proposes a discrete Particle Swam Optimization (PSO) to solve limited-wait hybrid flowshop scheduing problem with multi objectives. Flow shop schedulimg represents the condition when several machines are arranged in series and each job must be processed at each machine with same sequence. The objective functions are minimizing completion time (makespan), total tardiness time, and total machine idle time. Flow shop scheduling model always grows to cope with the real production system accurately. Since flow shop scheduling is a NP-Hard problem then the most suitable method to solve is metaheuristics. One of metaheuristics algorithm is Particle Swarm Optimization (PSO), an algorithm which is based on the behavior of a swarm. Originally, PSO was intended to solve continuous optimization problems. Since flow shop scheduling is a discrete optimization problem, then, we need to modify PSO to fit the problem. The modification is done by using probability transition matrix mechanism. While to handle multi objectives problem, we use Pareto Optimal (MPSO). The results of MPSO is better than the PSO because the MPSO solution set produced higher probability to find the optimal solution. Besides the MPSO solution set is closer to the optimal solution

Alternative model of space-charge-limited thermionic current flow through a plasma

Science.gov (United States)

Campanell, M. D.

2018-04-01

It is widely assumed that thermionic current flow through a plasma is limited by a "space-charge-limited" (SCL) cathode sheath that consumes the hot cathode's negative bias and accelerates upstream ions into the cathode. Here, we formulate a fundamentally different current-limited mode. In the "inverse" mode, the potentials of both electrodes are above the plasma potential, so that the plasma ions are confined. The bias is consumed by the anode sheath. There is no potential gradient in the neutral plasma region from resistivity or presheath. The inverse cathode sheath pulls some thermoelectrons back to the cathode, thereby limiting the circuit current. Thermoelectrons entering the zero-field plasma region that undergo collisions may also be sent back to the cathode, further attenuating the circuit current. In planar geometry, the plasma density is shown to vary linearly across the electrode gap. A continuum kinetic planar plasma diode simulation model is set up to compare the properties of current modes with classical, conventional SCL, and inverse cathode sheaths. SCL modes can exist only if charge-exchange collisions are turned off in the potential well of the virtual cathode to prevent ion trapping. With the collisions, the current-limited equilibrium must be inverse. Inverse operating modes should therefore be present or possible in many plasma devices that rely on hot cathodes. Evidence from past experiments is discussed. The inverse mode may offer opportunities to minimize sputtering and power consumption that were not previously explored due to the common assumption of SCL sheaths.

Development and implementation of flowing liquid lithium limiter control system for EAST

Energy Technology Data Exchange (ETDEWEB)

Yuan, XiaoLin [Institute of Plasma Physics, Chinese Academy of Sciences, Hefei 230031 (China); University of Science and Technology of China, Hefei 230031 (China); Chen, Yue [Institute of Plasma Physics, Chinese Academy of Sciences, Hefei 230031 (China); Hu, JianSheng, E-mail: hujs@ipp.ac.cn [Institute of Plasma Physics, Chinese Academy of Sciences, Hefei 230031 (China); Li, JianGang; Zuo, GuiZhong; Ren, Jun; Zhou, Yue; Li, ChangZheng; Sun, Zheng; Xu, Wei; Meng, XianCai; Huang, Ming; Zheng, XingWei; Yao, Xingjia [Institute of Plasma Physics, Chinese Academy of Sciences, Hefei 230031 (China)

2016-11-15

Highlights: • Development of a FLiLi remote control system for EAST. • Intelligent instruments are used to realize FLiLi remote control. • Good operating results of the control system were obtained in the EAST campaign. - Abstract: A control system of a flowing liquid lithium (FLiLi) limiter for the Experimental Advanced Superconducting Tokamak (EAST) was developed and implemented. The control system is not only able to control the direct current (DC) electromagnetic pump and heating power but can also set scanning parameters, receive the shot number, acquire the temperature, etc. The system consists of multifunctional LAN eXtensions for Instrumentation (LXI) instrument, temperature-acquisition module, programmable DC power supply, and programmable logic controller (PLC). The multi-range DC power supply is programmed to meet the operational requirements of the DC electromagnetic pump. The LXI instrument and temperature-acquisition module are used to obtain temperature data. The PLC is adopted to control the temperature of the FLiLi limiter. A safety interlock and protection function was developed for the FLiLi limiter control system. The software was designed by using LabVIEW to achieve data interaction between multiple protocols. The FLiLi limiter control system can acquire experimental data at a speed of 100 S/s and store it for later analysis. The control system was successfully applied to a FLiLi limiter to study the interaction between plasma and a fixed wall in the EAST campaign. This paper presents the framework, the implementation details, and results of the control system.

The effect of statin treatment on the prevention of stent mediated flow limited edge dissections during PCI in patients with stable angina.

Science.gov (United States)

Oksuz, Fatih; Yarlioglues, Mikail; Yayla, Cagrı; Canpolat, Ugur; Murat, Sani Namık; Aydogdu, Sinan

2016-10-01

The effect of statin therapy before PCI with direct stenting may reduce the development of flow limited edge dissections (ED) in patients with stable angina. Flow limited ED after PCI is associated with an increased risk of major adverse cardiovascular events. Statin therapy induces important changes in the plaque composition which have been previously identified as strong predictors of ED. 100 patients complicated with flow limited ED and 100 control patients with successful procedure were enrolled into the study. EDs were described as the 5-mm regions that were immediately adjacent to the stent borders, both distally and proximally on the coronary angiography. Rate of statin use and duration of statin use were significantly higher in patients with non-ED group (63%) versus ED group (25%) (p<0.001). In addition, patients in ED group had significantly higher levels of C-reactive protein (CRP) at admission (9.9mg/dL (5.89-16.45) vs. 4.40mg/dL (3.5-7.09), respectively, p=0.014). Our findings suggested that maintenance statin treatment before PCI with direct stenting may reduce the development of flow limited ED in patients with stable angina. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Comparison of pulmonary function in patients with COPD, asthma-COPD overlap syndrome, and asthma with airflow limitation

Directory of Open Access Journals (Sweden)

Kitaguchi Y

2016-05-01

Full Text Available Yoshiaki Kitaguchi, Masanori Yasuo, Masayuki Hanaoka First Department of Internal Medicine, Shinshu University School of Medicine, Matsumoto, Japan Background: This study was conducted in order to investigate the differences in the respiratory physiology of patients with chronic obstructive pulmonary disease (COPD, asthma-COPD overlap syndrome (ACOS, and asthma with airflow limitation (asthma FL+. Methods: The medical records for a series of all stable patients with persistent airflow limitation due to COPD, ACOS, or asthma were retrospectively reviewed and divided into the COPD group (n=118, the ACOS group (n=32, and the asthma FL+ group (n=27. All the patients underwent chest high-resolution computed tomography (HRCT and pulmonary function tests, including respiratory impedance. Results: The low attenuation area score on chest HRCT was significantly higher in the COPD group than in the ACOS group (9.52±0.76 vs 5.09±1.16, P<0.01. The prevalence of bronchial wall thickening on chest HRCT was significantly higher in the asthma FL+ group than in the COPD group (55.6% vs 25.0%, P<0.01. In pulmonary function, forced expiratory volume in 1 second (FEV1 and peak expiratory flow rate were significantly higher in the asthma FL+ group than in the ACOS group (76.28%±2.54% predicted vs 63.43%±3.22% predicted, P<0.05 and 74.40%±3.16% predicted vs 61.08%±3.54% predicted, P<0.05, respectively. Although residual volume was significantly lower in the asthma FL+ group than in the COPD group (112.05%±4.34% predicted vs 137.38%±3.43% predicted, P<0.01 and the ACOS group (112.05%±4.34% predicted vs148.46%±6.25% predicted, P<0.01, there were no significant differences in functional residual capacity or total lung capacity. The increase in FEV1 in response to short-acting ß2-agonists was significantly greater in the ACOS group than in the COPD group (229±29 mL vs 72±10 mL, P<0.01 and the asthma FL+ group (229±29 mL vs 153±21 mL, P<0.05. Regarding

Angle β of greater than 80° at the start of spirometry may identify high-quality flow volume curves.

Science.gov (United States)

Lian, Ningfang; Li, Li; Ren, Weiying; Jiang, Zhilong; Zhu, Lei

2017-04-01

The American Thoracic Society (ATS) and European Respiratory Society (ERS) emphasize a satisfactory start in maximal expiratory flow-volume (MEFV) curves and highlight subjective parameters: performance without hesitation and expiration with maximum force. We described a new parameter, angle β for characterization of the start to the MEFV curve. Subjects completed the MEFV curve at least three times and at least two curves met ATS/ERS quality. Subjects were divided into normal, restrictive and obstructive groups according to pulmonary function test results. The tangent line was drawn at the start of the MEFV curve's ascending limb to the x-axis and the angle β between the tangent line and x-axis was obtained. The relationships between tangent of β, pulmonary function parameters (PFPs) and anthropometric data were assessed. The MEFV curves with insufficient explosion at the start were considered as poor-quality MEFV curves. In 998 subjects with high-quality spirometry, although PFP varied in relation to the three aspects: the angle β and its tangent were similar (P > 0.05), the tangent of β did not correlate with PFP or anthropometric measurements (P > 0.05) and the lower limit of normal (LLN) of the angle β was 80° in the group with high-quality spirometry (P < 0.05). Angle β derived from poor-quality MEFV curves was smaller than that from good quality one (P < 0.05). Angle β may function as a parameter to assess the expiratory efforts, which can be used to assess the quality of the MEFV curve start. © 2016 Asian Pacific Society of Respirology.

Is increased positive end-expiratory pressure the culprit? Autoresuscitation in a 44-year-old man after prolonged cardiopulmonary resuscitation: a case report

OpenAIRE

Hagmann, Henning; Oelmann, Katrin; Stangl, Robert; Michels, Guido

2016-01-01

Background The phenomenon of autoresuscitation is rare, yet it is known to most emergency physicians. However, the pathophysiology of the delayed return of spontaneous circulation remains enigmatic. Among other causes hyperinflation of the lungs and excessively high positive end-expiratory pressure have been suggested, but reports including cardiopulmonary monitoring during cardiopulmonary resuscitation are scarce to support this hypothesis. Case presentation We report a case of autoresuscita...

The use of high-flow nasal oxygen in COPD patients

Directory of Open Access Journals (Sweden)

Silva Santos P

2016-09-01

Full Text Available Pedro Silva Santos,1 Antonio M Esquinas21Pulmonology Unit, Centro Hospitalar e Universitário de Coimbra – Hospitais da Universidade de Coimbra, Coimbra, Portugal; 2Internsive Care Unit, Hospital Morales Meseguer, Múrcia, SpainHigh-flow nasal cannula (HFNC oxygen therapy is an innovative and useful mode for the treatment of patients with respiratory failure.1–3 It delivers heated and humidified air providing higher and more expected gas flow rates and fraction inspired oxygen (FiO2 than traditional oxygen therapy.2     We read the article by Bräunlich et al1 carefully and congratulate the authors on their study about the use of nasal high-flow therapy in COPD patients. There are, however, some limitations to the study that need to be considered.    First, this study has a small number of patients, particularly in groups A and B, which in our opinion will affect the comparison of data with the group C that contains a greater variety of patients with more severe outcomes, including forced expiratory volume in 1 second and forced vital capacity. Second, as a study on mean airway pressure, it would be interesting to evaluate partial pressure of CO2 with higher flows.    Third, one of the aims of this study was to characterize changes in hypercapnia, so it is not correct to include nonhypercapnic patients. Fourth, it would be interesting to know the FiO2 that was given and whether the patients had domiciliary oxygen or noninvasive ventilation, as most of them are hypercapnic patients. Finally, regarding comfort and dyspnea scale, HFNC showed better results, which may increase its use when intolerant to noninvasive ventilation.    In short, HFNC is an interesting mode for the future treatment of COPD patients with respiratory failure, which may lead to larger and randomized trials to confirm this indication.View original paper by Bräunlich et al.

The benefits and limitations of electrolyte mixing in vanadium flow batteries

International Nuclear Information System (INIS)

Zhang, Yunong; Liu, Le; Xi, Jingyu; Wu, Zenghua; Qiu, Xinping

2017-01-01

Highlights: •The benefits and limitations of electrolyte mixing method are studied in this work. •Different current densities and mix times are studied. •The VFB cycle number increases from 145 to 598 at 160 mA cm −2 by mixing the electrolytes. -- Abstract: Cycle life prolongation and discharge capacity regeneration have drawn enormous attention in the field of vanadium flow batteries (VFBs). Among all the methods, mixing the positive and negative electrolytes is the most efficient, but the study about the proper time and the effect of the mix method is relatively deficient. In this study, different mix times and current densities are chosen to explore the benefits and limitations of the mix method, also the mechanism of discharge capacity behavior is discussed. Through the mix method, not only the cycle number has been extended significantly, but also the voltage and energy efficiencies are recovered. Although the contribution of the mix method is restrained by the average valence of the mixed electrolytes, it can be alleviated by electrolysis. The mix method is economic, uncomplicated and can be employed in industrial applications.

Improved pulmonary function in working divers breathing nitrox at shallow depths

Science.gov (United States)

Fitzpatrick, Daniel T.; Conkin, Johnny

2003-01-01

INTRODUCTION: There is limited data about the long-term pulmonary effects of nitrox use in divers at shallow depths. This study examined changes in pulmonary function in a cohort of working divers breathing a 46% oxygen enriched mixture while diving at depths less than 12 m. METHODS: A total of 43 working divers from the Neutral Buoyancy Laboratory (NBL), NASA-Johnson Space Center completed a questionnaire providing information on diving history prior to NBL employment, diving history outside the NBL since employment, and smoking history. Cumulative dive hours were obtained from the NBL dive-time database. Medical records were reviewed to obtain the diver's height, weight, and pulmonary function measurements from initial pre-dive, first year and third year annual medical examinations. RESULTS: The initial forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV1) were greater than predicted, 104% and 102%, respectively. After 3 yr of diving at the NBL, both the FVC and FEV1 showed a significant (p < 0.01) increase of 6.3% and 5.5%, respectively. There were no significant changes in peak expiratory flow (PEF), forced mid-expiratory flow rate (FEF(25-75%)), and forced expiratory flow rates at 25%, 50%, and 75% of FVC expired (FEF25%, FEF50%, FEF75%). Cumulative NBL dive hours was the only contributing variable found to be significantly associated with both FVC and FEV1 at 1 and 3 yr. CONCLUSIONS: NBL divers initially belong to a select group with larger than predicted lung volumes. Regular diving with nitrox at shallow depths over a 3-yr period did not impair pulmonary function. Improvements in FVC and FEV1 were primarily due to a training effect.

Quantitative assessment of cross-sectional area of small pulmonary vessels in patients with COPD using inspiratory and expiratory MDCT

International Nuclear Information System (INIS)

Matsuura, Yukiko; Kawata, Naoko; Yanagawa, Noriyuki; Sugiura, Toshihiko; Sakurai, Yoriko; Sato, Misuzu; Iesato, Ken; Terada, Jiro; Sakao, Seiichiro; Tada, Yuji; Tanabe, Nobuhiro; Suzuki, Yoichi; Tatsumi, Koichiro

2013-01-01

Objectives: Structural and functional changes in pulmonary vessels are prevalent at the initial stages of chronic obstructive pulmonary disease (COPD). These vascular alterations can be assessed using cross-sectional area (CSA) of small pulmonary vessels. However, neither in non-COPD smokers nor in COPD patients it has been defined whether the structural changes of pulmonary vessels detected by paired inspiratory and expiratory CT scans are associated with emphysematous changes. We quantified the CSA and low attenuation area (LAA) and evaluated the changes in these parameters in the inspiratory and expiratory phases. Materials and methods: Fifty consecutive non-COPD smokers and COPD patients were subjected to multi detector-row CT and the percentage of vessels with a CSA less than 5 mm 2 as well as the percentage LAA for total lung area (%CSA < 5, %LAA, respectively) were calculated. Results: The %CSA < 5 correlated negatively with %LAA. The %CSA < 5 was lower in COPD patients with emphysema as compared with non-COPD smokers and COPD patients with or without mild emphysema. In addition, the %CSA < 5 was lower in the no/mild emphysema subgroup as compared with non-COPD smokers. The respiratory phase change of %CSA < 5 in COPD patients was greater than that in non-COPD smokers. Conclusion: The percentage of small pulmonary vessels decreased as emphysematous changes increase, and this decrease was observed even in patients with no/mild emphysema. Furthermore, respiratory phase changes in CSA were higher in COPD patients than in non-COPD smokers

A state of the art on the flooding phenomena and countercurrent flow limiting modeling

Energy Technology Data Exchange (ETDEWEB)

Jeong, Young Jong; Chang, Won Pyo [Korea Atomic Energy Research Institute, Taejon (Korea, Republic of)

1996-07-01

Countercurrent flow limiting phenomenon and its modeling for vertical and nearly horizontal pipes has been reviewed in two phase flow. A number of analytical and empirical model have been developed for flooding in the vertical pipes and annulars. These may be classified as stability theory, envelope theory, static equilibrium theory, slug formation theory, Wallis correlation, and Kutateladze correlation. The theories and empirical correlations are reviewed and comparison with the various experimental data. The scatter of the experimental data is large because of the different flooding condition and because of the influence of the experimental conditions. Application of flooding for PWR best estimate system codes is reviewed. The codes provide the user options to implement CCFL correlation for the specific geometry. The codes can accommodate generally Wallis, Kutateladze, or Bankoff correlation. 4 tabs., 36 figs., 52 refs. (Author).

A state of the art on the flooding phenomena and countercurrent flow limiting modeling

International Nuclear Information System (INIS)

Jeong, Young Jong; Chang, Won Pyo

1996-07-01

Countercurrent flow limiting phenomenon and its modeling for vertical and nearly horizontal pipes has been reviewed in two phase flow. A number of analytical and empirical model have been developed for flooding in the vertical pipes and annulars. These may be classified as stability theory, envelope theory, static equilibrium theory, slug formation theory, Wallis correlation, and Kutateladze correlation. The theories and empirical correlations are reviewed and comparison with the various experimental data. The scatter of the experimental data is large because of the different flooding condition and because of the influence of the experimental conditions. Application of flooding for PWR best estimate system codes is reviewed. The codes provide the user options to implement CCFL correlation for the specific geometry. The codes can accommodate generally Wallis, Kutateladze, or Bankoff correlation. 4 tabs., 36 figs., 52 refs. (Author)

Be-limiter experiment on ISX

International Nuclear Information System (INIS)

Mioduszewski, P.K.

1984-01-01

The relevance of this experiment to the JET experiment is described. Data on the following issues are given: (1) thermo-mechanical properties of the Be-limiter; (2) particle flow to limiter; (3) heat flow to the limiter; (4) limiter-plasma-wall interaction; (5) plasma properties/operation; (6) active control of plasma-limiter operation; and (7) fault conditions

Transport of expiratory droplets in an aircraft cabin.

Science.gov (United States)

Gupta, Jitendra K; Lin, Chao-Hsin; Chen, Qingyan

2011-02-01

The droplets exhaled by an index patient with infectious disease such as influenza or tuberculosis may be the carriers of contagious agents. Indoor environments such as the airliner cabins may be susceptible to infection from such airborne contagious agents. The present investigation computed the transport of the droplets exhaled by the index patient seated in the middle of a seven-row, twin-aisle, fully occupied cabin using the CFD simulations. The droplets exhaled were from a single cough, a single breath, and a 15-s talk of the index patient. The expiratory droplets were tracked by using Lagrangian method, and their evaporation was modeled. It was found that the bulk airflow pattern in the cabin played the most important role on the droplet transport. The droplets were contained in the row before, at, and after the index patient within 30 s and dispersed uniformly to all the seven rows in 4 minutes. The total airborne droplet fraction reduced to 48, 32, 20, and 12% after they entered the cabin for 1, 2, 3, and 4 min, respectively, because of the ventilation from the environmental control system. It is critical to predict the risk of airborne infection to take appropriate measures to control and mitigate the risk. Most of the studies in past either assume a homogenous distribution of contaminants or use steady-state conditions. The present study instead provides information on the transient movement of the droplets exhaled by an index passenger in an aircraft cabin. These droplets may contain active contagious agents and can be potent enough to cause infection. The findings can be used by medical professionals to estimate the spatial and temporal distribution of risk of infection to various passengers in the cabin. © 2010 John Wiley & Sons A/S.

Reduced-order aeroelastic model for limit-cycle oscillations in vortex-dominated unsteady airfoil flows

Science.gov (United States)

Suresh Babu, Arun Vishnu; Ramesh, Kiran; Gopalarathnam, Ashok

2017-11-01

In previous research, Ramesh et al. (JFM,2014) developed a low-order discrete vortex method for modeling unsteady airfoil flows with intermittent leading edge vortex (LEV) shedding using a leading edge suction parameter (LESP). LEV shedding is initiated using discrete vortices (DVs) whenever the Leading Edge Suction Parameter (LESP) exceeds a critical value. In subsequent research, the method was successfully employed by Ramesh et al. (JFS, 2015) to predict aeroelastic limit-cycle oscillations in airfoil flows dominated by intermittent LEV shedding. When applied to flows that require large number of time steps, the computational cost increases due to the increasing vortex count. In this research, we apply an amalgamation strategy to actively control the DV count, and thereby reduce simulation time. A pair each of LEVs and TEVs are amalgamated at every time step. The ideal pairs for amalgamation are identified based on the requirement that the flowfield in the vicinity of the airfoil is least affected (Spalart, 1988). Instead of placing the amalgamated vortex at the centroid, we place it at an optimal location to ensure that the leading-edge suction and the airfoil bound circulation are conserved. Results of the initial study are promising.

Comparison of forced expiratory spirometric flow changes following ...

African Journals Online (AJOL)

Group B received intrathecal anaesthesia 15 mgs of bupivacaine with 0.5 ml of normal saline and Group BF received 15 mgs of bupivacaine with 0.5 ml of fentanyl (25 μg) intrathecally. The patients were instructed about the performance of the spirometry on the previous evening of the surgery. Forced vital capacity, forced ...

Reference population equations using peak expiratory flow meters ...

African Journals Online (AJOL)

Many formulae for predicting lung function values for Nigerians have been produced by a lot of investigators. The same principle but different statistical methods were adopted by different authors in generating these equations, hence the variability observed among these formulae. Most equations in current use are based on ...

Empirical analysis of gross vehicle weight and free flow speed and consideration on its relation with differential speed limit.

Science.gov (United States)

Saifizul, Ahmad Abdullah; Yamanaka, Hideo; Karim, Mohamed Rehan

2011-05-01

Most highly motorized countries in the world have implemented different speed limits for light weight and heavy weight vehicles. The heavy vehicle speed limit is usually chosen to be lower than that of passenger cars due to the difficulty for the drivers to safely maneuver the heavy vehicle at high speed and greater impact during a crash. However, in many cases, the speed limit for heavy vehicle is set by only considering the vehicle size or category, mostly due to simplicity in enforcement. In this study, traffic and vehicular data for all vehicle types were collected using a weigh-in-motion system installed at Federal Route 54 in Malaysia. The first finding from the data showed that the weight variation for each vehicle category is considerable. Therefore, the effect of gross vehicle weight (GVW) and category of heavy vehicle on free flow speed and their interaction were analyzed using statistical techniques. Empirical analysis results showed that statistically for each type of heavy vehicle, there was a significant relationship between free flow speed of a heavy vehicle and GVW. Specifically, the results suggest that the mean and variance of free flow speed decrease with an increase GVW by the amount unrelated to size and shape for all GVW range. Then, based on the 85th percentile principle, the study proposed a new concept for setting the speed limit for heavy vehicle by incorporating GVW where a different speed limit is imposed to the heavy vehicle, not only based on vehicle classification, but also according to its GVW. Copyright © 2010 Elsevier Ltd. All rights reserved.

Comparison of Flow and Volume Incentive Spirometry on Pulmonary Function and Exercise Tolerance in Open Abdominal Surgery: A Randomized Clinical Trial

Science.gov (United States)

Kumar, Amaravadi Sampath; Augustine, Alfred Joseph; Pazhyaottayil, Zulfeequer Chundaanveetil; Ramakrishna, Anand; Krishnakumar, Shyam Krishnan

2016-01-01

Introduction Surgical procedures in abdominal area lead to changes in pulmonary function, respiratory mechanics and impaired physical capacity leading to postoperative pulmonary complications, which can affect up to 80% of upper abdominal surgery. Aim To evaluate the effects of flow and volume incentive spirometry on pulmonary function and exercise tolerance in patients undergoing open abdominal surgery. Materials and Methods A randomized clinical trial was conducted in a hospital of Mangalore city in Southern India. Thirty-seven males and thirteen females who were undergoing abdominal surgeries were included and allocated into flow and volume incentive spirometry groups by block randomization. All subjects underwent evaluations of pulmonary function with measurement of Forced Vital Capacity (FVC), Forced Expiratory Volume in the first second (FEV1), Peak Expiratory Flow (PEF). Preoperative and postoperative measurements were taken up to day 5 for both groups. Exercise tolerance measured by Six- Minute Walk Test during preoperative period and measured again at the time of discharge for both groups. Pulmonary function was analysed by post-hoc analysis and carried out using Bonferroni’s ‘t’-test. Exercise tolerance was analysed by Paired ‘T’-test. Results Pulmonary function (FVC, FEV1, and PEFR) was found to be significantly decreased in 1st, 2nd and 3rd postoperative day when compared with preoperative day. On 4th and 5th postoperative day the pulmonary function (FVC, FEV1, and PEFR) was found to be better preserved in both flow and volume incentive spirometry groups. The Six-Minute Walk Test showed a statistically significant improvement in pulmonary function on the day of discharge than in the preoperative period. In terms of distance covered, the volume- incentive spirometry group showed a greater statistically significant improvement from the preoperative period to the time of discharge than was exhibited by the flow incentive spirometry group

[Characteristics of tidal breathing pulmonary function in children with tracheobronchomalacia].

Science.gov (United States)

Li, Lan; Chen, Qaing; Zhang, Fan; Zhu, Shuang-Gui; Hu, Ci-Lang; Wu, Ai-Min

2017-12-01

To investigate the characteristics of tidal breathing pulmonary function in children with tracheobronchomalacia (TBM). In this study, 30 children who were diagnosed with TBM using electronic bronchoscopy were enrolled in the observation group; 30 healthy children were recruited in the normal control group. For individuals in each group, the assessment of tidal breath pulmonary function was performed at diagnosis and 3, 6, 9, and 12 months after diagnosis. There were no significant differences in tidal volume, inspiratory time, expiratory time, and inspiratory to expiratory ratio between the two groups (P>0.05). Compared with the control group, the observation group had a significantly higher respiratory rate and significantly lower ratio of time to peak tidal expiratory flow to total expiratory time (TPTEF/TE) and ratio of volume to peak tidal expiratory flow to total expiratory volume (VPTEF/VE). There was a time-dependent increase in TPTEF/TE and VPTEF/VE for TBM children from the time of initial diagnosis to 12 months after diagnosis. Tidal breathing pulmonary function has characteristic changes in children with TBM. Tidal breathing pulmonary function tends to be recovered with increased age in children with TBM.

Mechanical ventilation with lower tidal volumes and positive end-expiratory pressure prevents pulmonary inflammation in patients without preexisting lung injury.

Science.gov (United States)

Wolthuis, Esther K; Choi, Goda; Dessing, Mark C; Bresser, Paul; Lutter, Rene; Dzoljic, Misa; van der Poll, Tom; Vroom, Margreeth B; Hollmann, Markus; Schultz, Marcus J

2008-01-01

Mechanical ventilation with high tidal volumes aggravates lung injury in patients with acute lung injury or acute respiratory distress syndrome. The authors sought to determine the effects of short-term mechanical ventilation on local inflammatory responses in patients without preexisting lung injury. Patients scheduled to undergo an elective surgical procedure (lasting > or = 5 h) were randomly assigned to mechanical ventilation with either higher tidal volumes of 12 ml/kg ideal body weight and no positive end-expiratory pressure (PEEP) or lower tidal volumes of 6 ml/kg and 10 cm H2O PEEP. After induction of anesthesia and 5 h thereafter, bronchoalveolar lavage fluid and/or blood was investigated for polymorphonuclear cell influx, changes in levels of inflammatory markers, and nucleosomes. Mechanical ventilation with lower tidal volumes and PEEP (n = 21) attenuated the increase of pulmonary levels of interleukin (IL)-8, myeloperoxidase, and elastase as seen with higher tidal volumes and no PEEP (n = 19). Only for myeloperoxidase, a difference was found between the two ventilation strategies after 5 h of mechanical ventilation (P volumes and PEEP may limit pulmonary inflammation in mechanically ventilated patients without preexisting lung injury. The specific contribution of both lower tidal volumes and PEEP on the protective effects of the lung should be further investigated.

Overweight and obesity may lead to under-diagnosis of airflow limitation

DEFF Research Database (Denmark)

Çolak, Yunus; Marott, Jacob Louis; Vestbo, Jørgen

2015-01-01

BACKGROUND: The prevalence of obesity has increased during the last decades and varies from 10-20% in most European countries to approximately 32% in the United States. However, data on how obesity affects the presence of airflow limitation (AFL) defined as a reduced ratio between forced expiratory...... volume in 1 second (FEV1) and forced vital capacity (FVC) are scarce. METHODS: Data was derived from the third examination of the Copenhagen City Heart Study from 1991 until 1994 (n = 10,135). We examine the impact of different adiposity markers (weight, body mass index (BMI), waist circumference, waist......-diagnosis and under-treatment of COPD among individuals with overweight and obesity....

Variable speed limit strategies analysis with mesoscopic traffic flow model based on complex networks

Science.gov (United States)

Li, Shu-Bin; Cao, Dan-Ni; Dang, Wen-Xiu; Zhang, Lin

As a new cross-discipline, the complexity science has penetrated into every field of economy and society. With the arrival of big data, the research of the complexity science has reached its summit again. In recent years, it offers a new perspective for traffic control by using complex networks theory. The interaction course of various kinds of information in traffic system forms a huge complex system. A new mesoscopic traffic flow model is improved with variable speed limit (VSL), and the simulation process is designed, which is based on the complex networks theory combined with the proposed model. This paper studies effect of VSL on the dynamic traffic flow, and then analyzes the optimal control strategy of VSL in different network topologies. The conclusion of this research is meaningful to put forward some reasonable transportation plan and develop effective traffic management and control measures to help the department of traffic management.

[Clinical research of using optimal compliance to determine positive end-expiratory pressure].

Science.gov (United States)

Xu, Lei; Feng, Quan-sheng; Lian, Fu; Shao, Xin-hua; Li, Zhi-bo; Wang, Zhi-yong; Li, Jun

2012-07-01

To observe the availability and security of optimal compliance strategy to titrate the optimal positive end-expiratory pressure (PEEP), compared with quasi-static pressure-volume curve (P-V curve) traced by low-flow method. Fourteen patients received mechanical ventilation with acute respiratory distress syndrome (ARDS) admitted in intensive care unit (ICU) of Tianjin Third Central Hospital from November 2009 to December 2010 were divided into two groups(n = 7). The quasi-static P-V curve method and the optimal compliance titration were used to set the optimal PEEP respectively, repeated 3 times in a row. The optimal PEEP and the consistency of repeated experiments were compared between groups. The hemodynamic parameters, oxygenation index (OI), lung compliance (C), cytokines and pulmonary surfactant-associated protein D (SP-D) concentration in plasma before and 2, 4, and 6 hours after the experiment were observed in each group. (1) There were no significant differences in gender, age and severity of disease between two groups. (2)The optimal PEEP [cm H(2)O, 1 cm H(2)O=0.098 kPa] had no significant difference between quasi-static P-V curve method group and the optimal compliance titration group (11.53 ± 2.07 vs. 10.57 ± 0.87, P>0.05). The consistency of repeated experiments in quasi-static P-V curve method group was poor, the slope of the quasi-static P-V curve in repeated experiments showed downward tendency. The optimal PEEP was increasing in each measure. There was significant difference between the first and the third time (10.00 ± 1.58 vs. 12.80 ± 1.92, P vs. 93.71 ± 5.38, temperature: 38.05 ± 0.73 vs. 36.99 ± 1.02, IL-6: 144.84 ± 23.89 vs. 94.73 ± 5.91, TNF-α: 151.46 ± 46.00 vs. 89.86 ± 13.13, SP-D: 33.65 ± 8.66 vs. 16.63 ± 5.61, MAP: 85.47 ± 9.24 vs. 102.43 ± 8.38, CCI: 3.00 ± 0.48 vs. 3.81 ± 0.81, OI: 62.00 ± 21.45 vs. 103.40 ± 37.27, C: 32.10 ± 2.92 vs. 49.57 ± 7.18, all P safety and usability.

Theoretical study of inspiratory flow waveforms during mechanical ventilation on pulmonary blood flow and gas exchange.

Science.gov (United States)

Niranjan, S C; Bidani, A; Ghorbel, F; Zwischenberger, J B; Clark, J W

1999-08-01

A lumped two-compartment mathematical model of respiratory mechanics incorporating gas exchange and pulmonary circulation is utilized to analyze the effects of square, descending and ascending inspiratory flow waveforms during mechanical ventilation. The effects on alveolar volume variation, alveolar pressure, airway pressure, gas exchange rate, and expired gas species concentration are evaluated. Advantages in ventilation employing a certain inspiratory flow profile are offset by corresponding reduction in perfusion rates, leading to marginal effects on net gas exchange rates. The descending profile provides better CO2 exchange, whereas the ascending profile is more advantageous for O2 exchange. Regional disparities in airway/lung properties create maldistribution of ventilation and a concomitant inequality in regional alveolar gas composition and gas exchange rates. When minute ventilation is maintained constant, for identical time constant disparities, inequalities in compliance yield pronounced effects on net gas exchange rates at low frequencies, whereas the adverse effects of inequalities in resistance are more pronounced at higher frequencies. Reduction in expiratory air flow (via increased airway resistance) reduces the magnitude of upstroke slope of capnogram and oxigram time courses without significantly affecting end-tidal expired gas compositions, whereas alterations in mechanical factors that result in increased gas exchanges rates yield increases in CO2 and decreases in O2 end-tidal composition values. The model provides a template for assessing the dynamics of cardiopulmonary interactions during mechanical ventilation by combining concurrent descriptions of ventilation, capillary perfusion, and gas exchange. Copyright 1999 Academic Press.

Intraoperative and postoperative evaluation of low tidal volume combined with low-level positive end-expiratory pressure ventilation in laparoscopic surgery in elderly patients

Directory of Open Access Journals (Sweden)

Ye-Qiu Li

2016-01-01

Full Text Available Objective: To evaluate intraoperative and postoperative condition of low tidal volume combined with low-level positive end-expiratory pressure ventilation in laparoscopic surgery in elderly patients. Methods: A total of 176 cases of elderly patients (more than 60 years old receiving laparoscopic surgery in our hospital from July 2013 to July 2015 were selected as research subjects and randomly divided into observation group and control group, each group included 88 cases, control group received conventional ventilation strategy, observation group received low tidal volume combined with low-level positive end-expiratory pressure ventilation strategy, and then levels of hemodynamic indexes, respiratory mechanical indexes, serology indexes and cerebral vessel related indexes, etc of two groups were compared. Results: Intraoperative and postoperative heart rate and mean arterial pressure levels of observation group were lower than those of control group, arterial partial pressure of oxygen and oxygenation index levels were higher than those of control group and differences had statistical significance (P<0.05; intraoperative APIP and Pplat values of observation group were lower than those of control group, Cs value was higher than that of control group and differences had statistical significance (P<0.05; intraoperative and postoperative serum IL-8 and TNF-α levels of observation group were lower than those of control group, IL-10 level was higher than that of control group and differences had statistical significance (P<0.05; intraoperative and postoperative PjvO2, SjvO2 and CjvO2 levels of observation group were higher than those of control group, Da-jvO2 level was lower than that of control group and differences had statistical significance (P<0.05. Conclusions: When elderly patients receive laparoscopic surgery, the use of low tidal volume combined with low-level positive end-expiratory pressure ventilation strategy can stabilize hemodynamic

Evaluation of image quality and patient safety: paired inspiratory and expiratory MDCT assessment of tracheobronchomalacia in paediatric patients under general anaesthesia with breath-hold technique

International Nuclear Information System (INIS)

Lee, Edward Y.; Bastos, Maria d' Almeida; Stark, Cynthia; Carrier, Maureen; Zurakowski, David; Mason, Keira P.

2012-01-01

The purpose of our investigation was to evaluate image quality and patient safety in infants and young children who required general anaesthesia with breath-hold technique for paired inspiratory and expiratory multidetector CT (MDCT) assessment of tracheobronchomalacia (TBM). Our hospital's institutional review board approved the review of radiological and clinical data of a consecutive series of 20 paediatric patients who underwent MDCT under general anaesthesia with breath-hold technique for evaluation of TBM from May 2006 to December 2008. For each MDCT study, two fellowship-trained paediatric radiologists reviewed the inspiratory and expiratory MDCT images in an independent, randomised and blinded fashion for the presence of motion artefact at three anatomic levels (upper, middle and lower central airways). The clinical history and anaesthesia outcome, including the occurrence of any adverse events during or following the MDCT examinations until discharge, were also reviewed and recorded. The study population consisted of 20 infants and young children (13 boys/seven girls, mean age 1.7 ± 1.4 years, age range 11 days to 4 years). The imaging quality of all 20 MDCT studies was diagnostic with no motion artefact in 16 studies (80%) and minimal motion artefact in the remaining four studies (20%). Minor adverse events occurred in three patients (15%) that included one patient (5%) with a brief (<60 s) oxygen desaturation during MDCT study, which resolved with oxygen, and two patients (5%) with either a brief (<60 s) oxygen desaturation (n = 1, 5%) or cough (n = 1, 5%) during recovery period, which were completely resolved with oxygen and dexamethasone, respectively. Diagnostic quality paired inspiratory and expiratory MDCT imaging with breath-hold technique can be safely performed in infants and young children under general anaesthesia for evaluation of TBM.

Quantitative assessment of cross-sectional area of small pulmonary vessels in patients with COPD using inspiratory and expiratory MDCT

Energy Technology Data Exchange (ETDEWEB)

Matsuura, Yukiko, E-mail: matsuyuki_future@yahoo.co.jp [Department of Respirology, Graduate School of Medicine, Chiba University, Chiba 260-8670 Japan (Japan); Kawata, Naoko, E-mail: chumito_03@yahoo.co.jp [Department of Respirology, Graduate School of Medicine, Chiba University, Chiba 260-8670 Japan (Japan); Yanagawa, Noriyuki, E-mail: yanagawa@ho.chiba-u.ac.jp [Department of Respirology, Graduate School of Medicine, Chiba University, Chiba 260-8670 Japan (Japan); Sugiura, Toshihiko, E-mail: sugiura@js3.so-net.ne.jp [Department of Respirology, Graduate School of Medicine, Chiba University, Chiba 260-8670 Japan (Japan); Sakurai, Yoriko, E-mail: yoliri@nifty.com [Department of Respirology, Graduate School of Medicine, Chiba University, Chiba 260-8670 Japan (Japan); Sato, Misuzu, E-mail: mis_misuzu@yahoo.co.jp [Department of Respirology, Graduate School of Medicine, Chiba University, Chiba 260-8670 Japan (Japan); Iesato, Ken, E-mail: iesato_k@yahoo.co.jp [Department of Respirology, Graduate School of Medicine, Chiba University, Chiba 260-8670 Japan (Japan); Terada, Jiro, E-mail: jirotera@chiba-u.jp [Department of Respirology, Graduate School of Medicine, Chiba University, Chiba 260-8670 Japan (Japan); Sakao, Seiichiro, E-mail: sakao@faculty.chiba-u.jp [Department of Respirology, Graduate School of Medicine, Chiba University, Chiba 260-8670 Japan (Japan); Tada, Yuji, E-mail: ytada@faculty.chiba-u.jp [Department of Respirology, Graduate School of Medicine, Chiba University, Chiba 260-8670 Japan (Japan); Tanabe, Nobuhiro, E-mail: ntanabe@faculty.chiba-u.jp [Department of Respirology, Graduate School of Medicine, Chiba University, Chiba 260-8670 Japan (Japan); Suzuki, Yoichi, E-mail: ysuzuki@faculty.chiba-u.jp [Department of public Health, Graduate School of Medicine, Chiba University, Chiba 260-8670 Japan (Japan); Tatsumi, Koichiro, E-mail: tatsumi@faculty.chiba-u.jp [Department of Respirology, Graduate School of Medicine, Chiba University, Chiba 260-8670 Japan (Japan)

2013-10-01

Objectives: Structural and functional changes in pulmonary vessels are prevalent at the initial stages of chronic obstructive pulmonary disease (COPD). These vascular alterations can be assessed using cross-sectional area (CSA) of small pulmonary vessels. However, neither in non-COPD smokers nor in COPD patients it has been defined whether the structural changes of pulmonary vessels detected by paired inspiratory and expiratory CT scans are associated with emphysematous changes. We quantified the CSA and low attenuation area (LAA) and evaluated the changes in these parameters in the inspiratory and expiratory phases. Materials and methods: Fifty consecutive non-COPD smokers and COPD patients were subjected to multi detector-row CT and the percentage of vessels with a CSA less than 5 mm{sup 2} as well as the percentage LAA for total lung area (%CSA < 5, %LAA, respectively) were calculated. Results: The %CSA < 5 correlated negatively with %LAA. The %CSA < 5 was lower in COPD patients with emphysema as compared with non-COPD smokers and COPD patients with or without mild emphysema. In addition, the %CSA < 5 was lower in the no/mild emphysema subgroup as compared with non-COPD smokers. The respiratory phase change of %CSA < 5 in COPD patients was greater than that in non-COPD smokers. Conclusion: The percentage of small pulmonary vessels decreased as emphysematous changes increase, and this decrease was observed even in patients with no/mild emphysema. Furthermore, respiratory phase changes in CSA were higher in COPD patients than in non-COPD smokers.

Possibilities and Limitations of CFD Simulation for Flashing Flow Scenarios in Nuclear Applications

Directory of Open Access Journals (Sweden)

Yixiang Liao

2017-01-01

Full Text Available The flashing phenomenon is relevant to nuclear safety analysis, for example by a loss of coolant accident and safety release scenarios. It has been studied intensively by means of experiments and simulations with system codes, but computational fluid dynamics (CFD simulation is still at the embryonic stage. Rapid increasing computer speed makes it possible to apply the CFD technology in such complex flow situations. Nevertheless, a thorough evaluation on the limitations and restrictions is still missing, which is however indispensable for reliable application, as well as further development. In the present work, the commonly-used two-fluid model with different mono-disperse assumptions is used to simulate various flashing scenarios. With the help of available experimental data, the results are evaluated, and the limitations are discussed. A poly-disperse method is found necessary for a reliable prediction of mean bubble size and phase distribution. The first attempts to trace the evolution of the bubble size distribution by means of poly-disperse simulations are made.

Current flow and pair creation at low altitude in rotation-powered pulsars' force-free magnetospheres: space charge limited flow

Science.gov (United States)

Timokhin, A. N.; Arons, J.

2013-02-01

We report the results of an investigation of particle acceleration and electron-positron plasma generation at low altitude in the polar magnetic flux tubes of rotation-powered pulsars, when the stellar surface is free to emit whatever charges and currents are demanded by the force-free magnetosphere. We apply a new 1D hybrid plasma simulation code to the dynamical problem, using Particle-in-Cell methods for the dynamics of the charged particles, including a determination of the collective electrostatic fluctuations in the plasma, combined with a Monte Carlo treatment of the high-energy gamma-rays that mediate the formation of the electron-positron pairs. We assume the electric current flowing through the pair creation zone is fixed by the much higher inductance magnetosphere, and adopt the results of force-free magnetosphere models to provide the currents which must be carried by the accelerator. The models are spatially one dimensional, and designed to explore the physics, although of practical relevance to young, high-voltage pulsars. We observe novel behaviour (a) When the current density j is less than the Goldreich-Julian value (0 electrically trapped particles with the same sign of charge as the beam. The voltage drops are of the order of mc2/e, and pair creation is absent. (b) When the current density exceeds the Goldreich-Julian value (j/jGJ > 1), the system develops high voltage drops (TV or greater), causing emission of curvature gamma-rays and intense bursts of pair creation. The bursts exhibit limit cycle behaviour, with characteristic time-scales somewhat longer than the relativistic fly-by time over distances comparable to the polar cap diameter (microseconds). (c) In return current regions, where j/jGJ generated pairs allow the system to simultaneously carry the magnetospherically prescribed currents and adjust the charge density and average electric field to force-free conditions. We also elucidate the conditions for pair creating beam flow to be

Flow patterns in vertical two-phase flow

International Nuclear Information System (INIS)

McQuillan, K.W.; Whalley, P.B.

1985-01-01

This paper is concerned with the flow patterns which occur in upwards gas-liquid two-phase flow in vertical tubes. The basic flow patterns are described and the use of flow patter maps is discussed. The transition between plug flow and churn flow is modelled under the assumption that flooding of the falling liquid film limits the stability of plug flow. The resulting equation is combined with other flow pattern transition equations to produce theoretical flow pattern maps, which are then tested against experimental flow pattern data. Encouraging agreement is obtained

Evaluation of changes in central airway dimensions, lung area and mean lung density at paired inspiratory/expiratory high-resolution computed tomography

International Nuclear Information System (INIS)

Ederle, J.R.; Heussel, C.P.; Hast, J.; Ley, S.; Thelen, M.; Kauczor, H.U.; Fischer, B.; Beek, E.J.R. van

2003-01-01

The aim of this study was to improve the understanding of interdependencies of dynamic changes in central airway dimensions, lung area and lung density on HRCT. The HRCT scans of 156 patients obtained at full inspiratory and expiratory position were evaluated retrospectively. Patients were divided into four groups according to lung function tests: normal subjects (n=47); obstructive (n=74); restrictive (n=19); or mixed ventilatory impairment (n=16). Mean lung density (MLD) was correlated with cross-sectional area of the lung (CSA L ), cross-sectional area of the trachea (CSA T ) and diameter of main-stem bronchi (D B ). The CSA L was correlated with CSA T and D B . MLD correlated with CSA L in normal subjects (r=-0.66, p T in the control group (r=-0.50, p B was found (r=-0.52, p L and CSA T correlated in the control group (r=0.67, p L and D B correlated in the control group (r=0.42, p<0.0001) and in patients with obstructive lung disease (r=0.24, p<0.05). Correlations for patients with restrictive and mixed lung disease were constantly lower. Dependencies between central and peripheral airway dimensions and lung parenchyma are demonstrated by HRCT. Best correlations are observed in normal subjects and patients with obstructive lung disease. Based on these findings we postulate that the dependencies are the result of air-flow and pressure patterns. (orig.)

Current application of high flow oxygen nasal cannula in acute hypoxemic respiratory failure in the emergency department

Directory of Open Access Journals (Sweden)

Giulia Bottani

2018-03-01

Full Text Available High flow oxygen with nasal cannula (HFONC is a relatively new mode of oxygen delivery. Advantages of HFONC versus conventional oxygen therapy (COT encompass carbon dioxide washout, generation of a slight positive end-expiratory pressure and maintenance of humidified gas flow through airways. These features are mostly shared with non-invasive mechanical ventilation (NIMV, although with lack of a clearly comparable efficacy. In the last few years, HFONC has gained interest as a third alternative to COT and NIMV in the management of acute hypoxemic respiratory failure in the critically ill patient, both in intensive care units and emergency departments. The aim of this article is to review indications, effects and existing evidence on HFONC, COT and NIMV in the setting of acute hypoxemic respiratory failure.

Experimental Characterisation of the Interfacial Structure during Counter-Current Flow Limitation in a Model of the Hot Leg of a PWR

Directory of Open Access Journals (Sweden)

Christophe Vallée

2012-01-01

Full Text Available In order to investigate the two-phase flow behaviour during counter-current flow limitation in the hot leg of a pressurised water reactor, dedicated experiments were performed in a scaled down model of Kobe University. The experiments were performed with air and water at atmospheric pressure and room temperature. At high flow rates, CCFL occurs and the discharge of water to the reactor pressure vessel simulator is limited by the formation of slugs carrying liquid back to the steam generator. The structure of the interface was observed from the side of the channel test section using a high-speed video camera. An algorithm was developed to recognise the stratified interface in the camera frames after background subtraction. This method allows extracting the water level at any position in the image as well as performing further statistical treatments. The evolution of the interfacial structure along the horizontal part of the hot leg is shown by the visualisation of the probability distribution of the water level and analysed in function of the liquid and gas flow rates. The data achieved are useful for the analysis of the flow conditions as well as for the validation of modelling approaches like computational fluid dynamics.

Pollination of pima pineapple cactus (Coryphantha sheeri var. robustispina): does pollen flow limit abundance of this endangered species?

Science.gov (United States)

Christopher J. McDonald; Guy R. McPherson

2005-01-01

Pima pineapple cactus (PPC) (Coryphantha sheeri var. robustispina), a federally listed endangered species, occurs throughout southeastern Arizona and has relatively low population densities. To determine whether pollination limits reproduction of PPC we used florescent dye to quantify pollen flow between individuals in a PPC...

Practical surrogate marker of pulmonary dysanapsis by simple spirometry: an observational case-control study in primary care.

Science.gov (United States)

Shiota, Satomi; Ichikawa, Masako; Suzuki, Kazuhiro; Fukuchi, Yoshinosuke; Takahashi, Kazuhisa

2015-03-26

We see patients who present with spirometry airflow limitation despite their forced expiratory volume in one second (FEV1) as well as forced vital capacity (FVC) to be supernormal (FEV1/FVC spirometry conditions (results measured with spirometry) could be suitably used as a practical surrogate marker of pulmonary dysanapsis: the condition of disproportionate but physiologically normal growth between airways and lung parenchyma. We compared the conventional surrogate marker of dysanapsis, maximum mid-expiratory flow to FVC (MMF/FVC), in SUBJECTS (FEV1/FVC spirometry results with SUBJECTS) (n = 55), and in CONTROLS (age- and height- matched, normal spirometry results) (n = 25). Next we added imaging analysis to evaluate the relationship between the cross sectional airway luminal area (X-Ai) and the lung volume results among the three groups. The MMF/FVC was significantly lower in SUBJECTS and in EMPHYSEMA compared to CONTROLS. However, percent predicted peak expiratory flow (%PEFR) was significantly lower only in SUBJECTS and not in EMPHYSEMA compared to CONTROLS. The ratio of the X-Ai of the trachea and right apical bronchus to lung volume was significantly lower in SUBJECTS compared to CONTROLS. The simple spirometry conditions in SUBJECTS are highly suggestive of practical surrogate marker of pulmonary dysanapsis. Awareness of this concept would help to attenuate the risk of overdiagnosis of obstructive pulmonary disease.

Alveolar Tidal recruitment/derecruitment and Overdistension During Four Levels of End-Expiratory Pressure with Protective Tidal Volume During Anesthesia in a Murine Lung-Healthy Model.

Science.gov (United States)

Soares, Joao Henrique Neves; Carvalho, Alysson Roncally; Bergamini, Bruno Curty; Gress, Maria Alice Kuster; Jandre, Frederico Caetano; Zin, Walter Araujo; Giannella-Neto, Antonio

2018-06-01

We compared respiratory mechanics between the positive end-expiratory pressure of minimal respiratory system elastance (PEEP minErs ) and three levels of PEEP during low-tidal-volume (6 mL/kg) ventilation in rats. Twenty-four rats were anesthetized, paralyzed, and mechanically ventilated. Airway pressure (P aw ), flow (F), and volume (V) were fitted by a linear single compartment model (LSCM) P aw (t) = E rs  × V(t) + R rs  × F(t) + PEEP or a volume- and flow-dependent SCM (VFDSCM) P aw (t) = (E 1  + E 2  × V(t)) × V(t) + (K 1  + K 2  × |F(t)|) × F(t) + PEEP, where E rs and R rs are respiratory system elastance and resistance, respectively; E 1 and E 2 × V are volume-independent and volume-dependent E rs , respectively; and K 1 and K 2  × F are flow-independent and flow-dependent R rs , respectively. Animals were ventilated for 1 h at PEEP 0 cmH 2 O (ZEEP); PEEP minErs ; 2 cmH 2 O above PEEP minErs (PEEP minErs+2 ); or 4 cmH 2 O above PEEP minErs (PEEP minErs+4 ). Alveolar tidal recruitment/derecruitment and overdistension were assessed by the index %E 2  = 100 × [(E 2  × V T )/(E 1  + |E 2 | × V T )], and alveolar stability by the slope of E rs (t). %E 2 varied between 0 and 30% at PEEP minErs in most respiratory cycles. Alveolar Tidal recruitment/derecruitment (%E 2   30) were predominant in the absence of PEEP and in PEEP levels higher than PEEP minErs , respectively. The slope of E rs (t) was different from zero in all groups besides PEEP minErs+4 . PEEP minErs presented the best compromise between alveolar tidal recruitment/derecruitment and overdistension, during 1 h of low-V T mechanical ventilation.

Respiratory System Mechanics During Low Versus High Positive End-Expiratory Pressure in Open Abdominal Surgery: A Substudy of PROVHILO Randomized Controlled Trial.

Science.gov (United States)

D'Antini, Davide; Huhle, Robert; Herrmann, Jacob; Sulemanji, Demet S; Oto, Jun; Raimondo, Pasquale; Mirabella, Lucia; Hemmes, Sabrine N T; Schultz, Marcus J; Pelosi, Paolo; Kaczka, David W; Vidal Melo, Marcos Francisco; Gama de Abreu, Marcelo; Cinnella, Gilda

2018-01-01

In the 2014 PROtective Ventilation using HIgh versus LOw positive end-expiratory pressure (PROVHILO) trial, intraoperative low tidal volume ventilation with high positive end-expiratory pressure (PEEP = 12 cm H2O) and lung recruitment maneuvers did not decrease postoperative pulmonary complications when compared to low PEEP (0-2 cm H2O) approach without recruitment breaths. However, effects of intraoperative PEEP on lung compliance remain poorly understood. We hypothesized that higher PEEP leads to a dominance of intratidal overdistension, whereas lower PEEP results in intratidal recruitment/derecruitment (R/D). To test our hypothesis, we used the volume-dependent elastance index %E2, a respiratory parameter that allows for noninvasive and radiation-free assessment of dominant overdistension and intratidal R/D. We compared the incidence of intratidal R/D, linear expansion, and overdistension by means of %E2 in a subset of the PROVHILO cohort. In 36 patients from 2 participating centers of the PROVHILO trial, we calculated respiratory system elastance (E), resistance (R), and %E2, a surrogate parameter for intratidal overdistension (%E2 > 30%) and R/D (%E2 mechanical ventilation with protective tidal volumes in patients undergoing open abdominal surgery, lung recruitment followed by PEEP of 12 cm H2O decreased the incidence of intratidal R/D and did not worsen overdistension, when compared to PEEP ≤2 cm H2O.

Experimental characterisation of the interfacial structure during counter-current flow limitation in a model of the hot leg of a PWR

Energy Technology Data Exchange (ETDEWEB)

Vallee, C., E-mail: c.vallee@hzdr.de [Helmholtz-Zentrum Dresden-Rossendorf (HZDR), Inst. of Safety Research, Dresden (Germany); Nariai, T.; Futatsugi, T.; Tomiyama, A., E-mail: nariai@cfrg.scitec.kobe-u.ac.jp, E-mail: futatsugi@cfrg.scitec.kobe-u.ac.jp, E-mail: tomiyama@mech.kobe-u.ac.jp [Kobe Univ., Graduate School of Engineering, Kobe (Japan); Lucas, D., E-mail: d.lucas@hzdr.de [Helmholtz-Zentrum Dresden-Rossendorf (HZDR), Inst. of Safety Research, Dresden (Germany); Murase, M., E-mail: murase@inss.co.jp [Inst. of Nuclear Safety System, Inc. (INSS), Fukui (Japan)

2011-07-01

In order to investigate the two-phase flow behaviour during counter-current flow limitation in the hot leg of a pressurised water reactor, dedicated experiments were performed in a scaled down model of Kobe University. The structure of the interface was observed from the side of the channel test section using a high-speed video camera. An algorithm was developed to recognise the stratified interface in the camera frames after background subtraction. The evolution of the water level along the hot leg is analysed in function of the liquid and gas flow rates. (author)

Differential Effects of Intraoperative Positive End-expiratory Pressure (PEEP) on Respiratory Outcome in Major Abdominal Surgery Versus Craniotomy

DEFF Research Database (Denmark)

de Jong, Myrthe A C; Ladha, Karim S; Melo, Marcos F Vidal

2015-01-01

OBJECTIVES: In this study, we examined whether (1) positive end-expiratory pressure (PEEP) has a protective effect on the risk of major postoperative respiratory complications in a cohort of patients undergoing major abdominal surgeries and craniotomies, and (2) the effect of PEEP is differed......: Within the entire study population (major abdominal surgeries and craniotomies), we found an association between application of PEEP ≥5 cmH2O and a decreased risk of postoperative respiratory complications compared with PEEP 5 cmH2O was associated with a significant lower...... undergoing major abdominal surgery. Our data suggest that default mechanical ventilator settings should include PEEP of 5-10 cmH2O during major abdominal surgery....

Partial analysis of wind power limit in an electric micro system using continuation power flow

International Nuclear Information System (INIS)

Fiallo Guerrero, Jandry; Santos Fuentefria, Ariel; Castro Fernández, Miguel

2013-01-01

The wind power insertion in the power system is an important issue and can create some instability problems in voltage and system frequency due to stochastic origin of wind. Know the Wind Power Limit that can insert in an electric grid without losing stability is a very important matter. Existing in bibliography a few methods for calculation of wind power limit, some of them are based in static constrains, an example is a method based in a continuation power flow analysis. In the present work the method is applied in an electric micro system formed when the system is disconnected of the man grid, the main goal was prove the method in a weak and island network. The software used in the simulations was the Power System Analysis Toolbox (PSAT). (author)

Effect of exercise on the pulmonary system in proliferative phase of menstrual cycle in a group of perimenopausal women

Directory of Open Access Journals (Sweden)

Amrith Pakkala

2014-01-01

Full Text Available Background: Hormonal levels influence dynamic lung function parameters. Significant increase in both progesterone (37% and estradiol (13.5%; where as, no change in plasma follicle stimulating hormone (FSH and luteinizing hormone (LH was observed in exercising women in previous studies. Therefore, this study was intended to see the limitations of the pulmonary system in adaptability to exercise in proliferative phase of menstrual cycle in perimenopausal women. Material and Methods: The present study was conducted as a part of cardiopulmonary efficiency studies on two groups of nonathletes (n = 10 and athletes (n = 10 comparable in age and sex. Menstrual history was ascertained to confirm proliferative phase of menstrual cycle. Dynamic lung functions were measured in both groups before exercise and immediately after exercise. Results: It was observed that exercise per se does not cause a statistically significant change in dynamic lung function parameters maximum mid-expiratory flow (MMEF, peak expiratory flow rate (PEFR, and MEF 25-75% in either of the groups. Conclusion: This finding supports the hypothesis that the respiratory system is not normally the most limiting factor in the delivery of oxygen even under the predominant influence of estrogen in proliferative phase, which is further accentuated by exercise.

Flux Limiter Lattice Boltzmann Scheme Approach to Compressible Flows with Flexible Specific-Heat Ratio and Prandtl Number

International Nuclear Information System (INIS)

Gan Yanbiao; Li Yingjun; Xu Aiguo; Zhang Guangcai

2011-01-01

We further develop the lattice Boltzmann (LB) model [Physica A 382 (2007) 502] for compressible flows from two aspects. Firstly, we modify the Bhatnagar-Gross-Krook (BGK) collision term in the LB equation, which makes the model suitable for simulating flows with different Prandtl numbers. Secondly, the flux limiter finite difference (FLFD) scheme is employed to calculate the convection term of the LB equation, which makes the unphysical oscillations at discontinuities be effectively suppressed and the numerical dissipations be significantly diminished. The proposed model is validated by recovering results of some well-known benchmarks, including (i) The thermal Couette flow; (ii) One- and two-dimensional Riemann problems. Good agreements are obtained between LB results and the exact ones or previously reported solutions. The flexibility, together with the high accuracy of the new model, endows the proposed model considerable potential for tracking some long-standing problems and for investigating nonlinear nonequilibrium complex systems. (electromagnetism, optics, acoustics, heat transfer, classical mechanics, and fluid dynamics)

Pulmonary dysfunctions, oxidative stress and DNA damage in brick kiln workers.

Science.gov (United States)

Kaushik, R; Khaliq, F; Subramaneyaan, M; Ahmed, R S

2012-11-01

Brick kilns in the suburban areas in developing countries pose a big threat to the environment and hence the health of their workers and people residing around them. The present study was planned to assess the lung functions, oxidative stress parameters and DNA damage in brick kiln workers. A total of 31 male subjects working in brick kiln, and 32 age, sex and socioeconomic status matched controls were included in the study. The lung volumes, capacities and flow rates, namely, forced expiratory volume in first second (FEV(1)), forced vital capacity (FVC), FEV(1)/FVC, expiratory reserve volume, inspiratory capacity (IC), maximal expiratory flow when 50% of FVC is remaining to be expired, maximum voluntary ventilation, peak expiratory flow rate and vital capacity were significantly decreased in the brick kiln workers. Increased oxidative stress as evidenced by increased malonedialdehyde levels and reduced glutathione content, glutathione S-transferase activity and ferric reducing ability of plasma were observed in the study group when compared with controls. Our results indicate a significant correlation between oxidative stress parameters and pulmonary dysfunction, which may be due to silica-induced oxidative stress and resulting lung damage.

Level-set reconstruction algorithm for ultrafast limited-angle X-ray computed tomography of two-phase flows.

Science.gov (United States)

Bieberle, M; Hampel, U

2015-06-13

Tomographic image reconstruction is based on recovering an object distribution from its projections, which have been acquired from all angular views around the object. If the angular range is limited to less than 180° of parallel projections, typical reconstruction artefacts arise when using standard algorithms. To compensate for this, specialized algorithms using a priori information about the object need to be applied. The application behind this work is ultrafast limited-angle X-ray computed tomography of two-phase flows. Here, only a binary distribution of the two phases needs to be reconstructed, which reduces the complexity of the inverse problem. To solve it, a new reconstruction algorithm (LSR) based on the level-set method is proposed. It includes one force function term accounting for matching the projection data and one incorporating a curvature-dependent smoothing of the phase boundary. The algorithm has been validated using simulated as well as measured projections of known structures, and its performance has been compared to the algebraic reconstruction technique and a binary derivative of it. The validation as well as the application of the level-set reconstruction on a dynamic two-phase flow demonstrated its applicability and its advantages over other reconstruction algorithms. © 2015 The Author(s) Published by the Royal Society. All rights reserved.

Beyond the Child-Langmuir law: A review of recent results on multidimensional space-charge-limited flow

International Nuclear Information System (INIS)

Luginsland, J.W.; Lau, Y.Y.; Umstattd, R.J.; Watrous, J.J.

2002-01-01

Space-charge-limited (SCL) flows in diodes have been an area of active research since the pioneering work of Child and Langmuir in the early part of the last century. Indeed, the scaling of current density with the voltage to the 3/2's power is one of the best-known limits in the fields of non-neutral plasma physics, accelerator physics, sheath physics, vacuum electronics, and high power microwaves. In the past five years, there has been renewed interest in the physics and characteristics of SCL emission in physically realizable configurations. This research has focused on characterizing the current and current density enhancement possible from two- and three-dimensional geometries, such as field-emitting arrays. In 1996, computational efforts led to the development of a scaling law that described the increased current drawn due to two-dimensional effects. Recently, this scaling has been analytically derived from first principles. In parallel efforts, computational work has characterized the edge enhancement of the current density, leading to a better understanding of the physics of explosive emission cathodes. In this paper, the analytic and computational extensions to the one-dimensional Child-Langmuir law will be reviewed, the accuracy of SCL emission algorithms will be assessed, and the experimental implications of multidimensional SCL flows will be discussed

Analysis of Limit Cycle Oscillation/Transonic High Alpha Flow Visualization

National Research Council Canada - National Science Library

Cunningham, Atlee M

1997-01-01

...) at low alpha condition typical of transonic LCO flows with and without tip stores. Laser light sheet/water vapor techniques were used to illuminate the flows, and video recording was used to obtain the data...

The ecological limits of hydrologic alteration (ELOHA): A new framework for developing regional environmental flow standards

Science.gov (United States)

Poff, N.L.; Richter, B.D.; Arthington, A.H.; Bunn, S.E.; Naiman, R.J.; Kendy, E.; Acreman, M.; Apse, C.; Bledsoe, B.P.; Freeman, Mary C.; Henriksen, J.; Jacobson, R.B.; Kennen, J.G.; Merritt, D.M.; O'Keeffe, J. H.; Olden, J.D.; Rogers, K.; Tharme, R.E.; Warner, A.

2010-01-01

The flow regime is a primary determinant of the structure and function of aquatic and riparian ecosystems for streams and rivers. Hydrologic alteration has impaired riverine ecosystems on a global scale, and the pace and intensity of human development greatly exceeds the ability of scientists to assess the effects on a river-by-river basis. Current scientific understanding of hydrologic controls on riverine ecosystems and experience gained from individual river studies support development of environmental flow standards at the regional scale. 2. This paper presents a consensus view from a group of international scientists on a new framework for assessing environmental flow needs for many streams and rivers simultaneously to foster development and implementation of environmental flow standards at the regional scale. This framework, the ecological limits of hydrologic alteration (ELOHA), is a synthesis of a number of existing hydrologic techniques and environmental flow methods that are currently being used to various degrees and that can support comprehensive regional flow management. The flexible approach allows scientists, water-resource managers and stakeholders to analyse and synthesise available scientific information into ecologically based and socially acceptable goals and standards for management of environmental flows. 3. The ELOHA framework includes the synthesis of existing hydrologic and ecological databases from many rivers within a user-defined region to develop scientifically defensible and empirically testable relationships between flow alteration and ecological responses. These relationships serve as the basis for the societally driven process of developing regional flow standards. This is to be achieved by first using hydrologic modelling to build a 'hydrologic foundation' of baseline and current hydrographs for stream and river segments throughout the region. Second, using a set of ecologically relevant flow variables, river segments within the

Intratidal recruitment/derecruitment persists at low and moderate positive end-expiratory pressure in paediatric patients.

Science.gov (United States)

Wirth, Steffen; Artner, Lisa; Broß, Tobias; Lozano-Zahonero, Sara; Spaeth, Johannes; Schumann, Stefan

2016-12-01

In paediatric patients positive end-expiratory pressure (PEEP) is traditionally set lower than in adults. We investigated whether moderately higher PEEP improves respiratory mechanics and regional ventilation. Therefore, 40 children were mechanically ventilated with PEEP 2 and 5cmH 2 O. Volume-dependent compliance profiles were analysed as a measure of intratidal recruitment/derecruitment. Regional ventilation was assessed using electrical impedance tomography. Mean compliance was 17.9±9.9mLcmH 2 O -1 (PEEP 2cmH 2 O), and 19.0±10.9mLcmH 2 O -1 (PEEP 5 cmH 2 O, pventilation. In conclusion, mechanically ventilated paediatric patients undergo intratidal recruitment/derecruitment which occurs more prominently in younger than in older children. A PEEP of 5cmH 2 O does not fully prevent intratidal recruitment/derecruitment but homogenizes regional ventilation in comparison to 2cmH 2 O. Copyright © 2016 Elsevier B.V. All rights reserved.

Breathing response of the tegu lizard to 1-4% CO2 in the mouth and nose or inspired into the lungs.

Science.gov (United States)

Ballam, G O

1985-12-01

This study investigated the influence on ventilation of elevated CO2 in the nasal and buccal cavities (NaBuCO2) vs the effect of elevated CO2 levels inspired into the lungs (LuCO2). Separate gas sources were used to independently alter NaBuCO2 and LuCO2. As little as 1% NaBuCO2 or LuCO2 significantly increased the pause duration between the active expiratory-inspiratory cycles. Elevated NaBuCO2 caused minor changes in tidal volume, mean inspiratory and expiratory flow, and inspiratory and expiratory durations with a significant reduction in total ventilation. Elevated LuCO2 had little effect on inspiratory or expiratory durations but unlike CO2 in the upper airways, significantly increased tidal volume and mean inspiratory and expiratory flows. This study demonstrates that the increased pause duration seen in the tegu lizard to elevated environmental CO2 is due to a receptor response in the buccal or nasal cavities and also to elevated CO2 concentrations inspired into the lungs. Sensitivity of the ventilatory responses to CO2 in the upper airways is well within a physiologically relevant range.

Chronic air-flow limitation does not increase respiratory epithelial permeability assessed by aerosolized solute, but smoking does

International Nuclear Information System (INIS)

Huchon, G.J.; Russell, J.A.; Barritault, L.G.; Lipavsky, A.; Murray, J.F.

1984-01-01

To determine the separate influences of smoking and severe air-flow limitation on aerosol deposition and respiratory epithelial permeability, we studied 26 normal nonsmokers, 12 smokers without airway obstruction, 12 nonsmokers with chronic obstructive pulmonary disease (COPD), and 11 smokers with COPD. We aerosolized 99mTc-labeled diethylene triamine pentaacetic acid to particles approximately 1 micron activity median aerodynamic diameter. Levels of radioactivity were plotted semilogarithmically against time to calculate clearance as percent per minute. The distribution of radioactivity was homogeneous in control subjects and in smokers, but patchy in both groups with COPD. No difference was found between clearances of the control group (1.18 +/- 0.31% min-1), and nonsmoker COPD group (1.37 +/- 0.82% min-1), whereas values in smokers without COPD (4.00 +/- 1.70% min-1) and smokers with COPD (3.62 +/- 2.88% min-1) were significantly greater than in both nonsmoking groups. We conclude that (1) small particles appear to deposit peripherally, even with severe COPD; (2) respiratory epithelial permeability is normal in nonsmokers with COPD; (3) smoking increases permeability by a mechanism unrelated to air-flow limitation

[Comparative analysis of conventional pulmonary function test results in children with asthma or cough variant asthma].

Science.gov (United States)

Yuan, Jie; An, Shu-Hua; Gao, Wen-Jie; Du, Wen-Jin; Sun, Jun-Feng; Zhang, Man; Yao, Cong-Zhuo

2013-03-01

To compare the conventional pulmonary function test results of children with asthma or cough variant asthma (CVA). A total of 140 children, who were diagnosed with asthma or CVA from May 2010 to May 2011, were divided into acute asthma attack (n=50), asthma remission (n=50) and CVA groups (n=40); 30 healthy children were included as a control group. The forced vital capacity (FVC), forced expiratory volume in one second (FEV1), peak expiratory flow (PEF), forced expiratory flow after 25% of vital capacity has been expelled (FEF25), forced expiratory flow after 50% of vital capacity has been expelled (FEF50), forced expiratory flow after 75% of vital capacity has been expelled (FEF75) and maximal midexpiratory flow (MMEF75/25) were measured. The mean percent predicted values of all the above indices were lower than 80% in the acute asthma attack group, with FEF50, FEF75 and MMEF75/25 declining markedly; the mean percent predicted values of FEF75 and MMEF75/25 were lower than 80% in the CVA group. All the pulmonary function indices in the acute asthma attack group were lower than those in the control group. The mean percent predicted values of FVC, FEV1, FEF25 and MMEF75/25 in the asthma remission and CVA groups were lower than in the control group. All the pulmonary function indices in the acute asthma attack group were lower than in the asthma remission and CVA groups, but there were no significant differences between the asthma remission and CVA groups. There is small and large airway dysfunction, particularly small airway dysfunction, in children with acute asthma attack. Children with CVA present mainly with mild small airway dysfunction, as do those with asthma in remission.

Numerical simulation study on the air/water countercurrent flow limitation in nuclear reactors

Energy Technology Data Exchange (ETDEWEB)

Morghi, Youssef; Mesquita, Amir Z., E-mail: ssfmorghi@gmail.com, E-mail: amir@cdtn.br [Centro de Desenvolvimento da Tecnologia Nuclear (CDTN/CNEN-MG), Belo Horizonte, MG (Brazil); Puente, Jesus, E-mail: jpuente720@gmail.com [Centro Federal de Educaçao Tecnologica Celso Suckowda Fonseca (CEFET), Angra dos Reis, RJ (Brazil); Baliza, Ana R., E-mail: baliza@eletronuclear.gov.br [Eletrobras Eletronuclear Angra dos Reis, RJ (Brazil)

2017-07-01

After a loss-of-coolant accident (LOCA) in a Pressurized Water Reactor (PWR), the temperature of the fuel elements cladding increases dramatically due to the heat produced by the fission products decay, which is not adequately removed by the vapor contained in the core. In order to avoid this sharp rise in temperature and consequent melting of the core, the Emergency Core Cooling System is activated. This system initially injects borated water from accumulator tanks of the reactor through the inlet pipe (cold leg) and the outlet pipe (hot leg), or through the cold leg only, depending on the plant manufacturer. Some manufacturers add to this, direct injection into the upper plenum of the reactor. The penetration of water into the reactor core is a complex thermo fluid dynamic process because it involves the mixing of water with the vapor contained in the reactor, added to that generated in the contact of the water with the still hot surfaces in various geometries. In some critical locations, the vapor flowing in the opposite direction of the water can control the penetration of this into the core. This phenomenon is known as Countercurrent Flow Limitation (CCFL) or Flooding, and it is characterized by the control that a gas exerts in the liquid flow in the opposite direction. This work presents a proposal to use a CFD to simulate the CCFL phenomenon. Numerical computing can provide important information and data that is difficult or expensive to measure or test experimentally. Given the importance of computational science today, it can be considered a third and independent branch of science on an equal footing with the theoretical and experimental sciences. (author)

Multidimensional flux-limited advection schemes

International Nuclear Information System (INIS)

Thuburn, J.

1996-01-01

A general method for building multidimensional shape preserving advection schemes using flux limiters is presented. The method works for advected passive scalars in either compressible or incompressible flow and on arbitrary grids. With a minor modification it can be applied to the equation for fluid density. Schemes using the simplest form of the flux limiter can cause distortion of the advected profile, particularly sideways spreading, depending on the orientation of the flow relative to the grid. This is partly because the simple limiter is too restrictive. However, some straightforward refinements lead to a shape-preserving scheme that gives satisfactory results, with negligible grid-flow angle-dependent distortion

Flow-Through Stream Modeling with MODFLOW and MT3D: Certainties and Limitations.

Science.gov (United States)

Ben Simon, Rose; Bernard, Stéphane; Meurville, Charles; Rebour, Vincent

2015-01-01

This paper aims to assess MODFLOW and MT3D capabilities for simulating the spread of contaminants from a river exhibiting an unusual relationship with an alluvial aquifer, with the groundwater head higher than the river head on one side and lower on the other (flow-through stream). A series of simulation tests is conducted using a simple hypothetical model so as to characterize and quantify these limitations. Simulation results show that the expected contaminant spread could be achieved with a specific configuration composed of two sets of parameters: (1) modeled object parameters (hydraulic groundwater gradient, hydraulic conductivity values of aquifer and streambed), and (2) modeling parameters (vertical discretization of aquifer, horizontal refinement of stream modeled with River [RIV] package). The influence of these various parameters on simulation results is investigated, and potential complications and errors are identified. Contaminant spread from stream to aquifer is not always reproduced by MT3D due to the RIV package's inability to simulate lateral exchange fluxes between stream and aquifer. This paper identifies the need for a MODFLOW streamflow package allowing lateral stream-aquifer interactions and streamflow routine calculations. Such developments could be of particular interest for modeling contaminated flow-through streams. © 2015, National Ground Water Association.

Pulmonary function testing of animals chronically exposed to diluted diesel exhaust

Energy Technology Data Exchange (ETDEWEB)

Gross, K B

1981-04-01

The purpose of this work was to assess the potential effect that chronic inhalation of diesel exhaust may have on lung mechanics and lung volume. Noninvasive pulmonary function tests that produced data on lung air flows and volumes have been conducted repeatedly on 25 male Fischer-344 rats exposed to diesel exhaust at a particulate concentration of 1500 micrograms m-3, 20 h per day, 5 1/2 days per week, for 612 days. The same tests were conducted on 25 clean air control animals. When the data were normalized, the majority of tests did not reveal any significant deviation from the norm for the first year of exposure. In the second year, the functional residual capacity and its component volumes - expiratory reserve and residual volume, maximum expiratory flow at 40% of vital capacity, maximum expiratory flow at 20% of vital capacity and the forced expiratory volume in 0.1 s - were significantly greater in the diesel exposed animals. The data are inconsistent with known clinically significant adverse health effects. Although the lung volume changes in the diesel exposed animals could be indicative of emphysema or other forms of chronic obstructive lung disease, this interpretation is contradicted by the air flow data which suggest simultaneous lowering of the resistance of the smaller airways. The observations are not consistent with documented clinical lung disease in man.

Quantitative assessment of global and regional air trappings using non-rigid registration and regional specific volume change of inspiratory/expiratory CT scans: Studies on healthy volunteers and asthmatics

International Nuclear Information System (INIS)

Lee, Eun Sol; Seo, Joon Beom; Lee, Hyun Joo; Chae, Eun Jin; Lee, Sang Min; Oh, Sang Young; Kim, Nam Kug

2015-01-01

The purpose of this study was to compare air trapping in healthy volunteers with asthmatics using pulmonary function test and quantitative data, such as specific volume change from paired inspiratory CT and registered expiratory CT. Sixteen healthy volunteers and 9 asthmatics underwent paired inspiratory/expiratory CT. DeltaSV, which represents the ratio of air fraction released after exhalation, was measured with paired inspiratory and anatomically registered expiratory CT scans. Air trapping indexes, DeltaSV0.4 and DeltaSV0.5, were defined as volume fraction of lung below 0.4 and 0.5 DeltaSV, respectively. To assess the gravity effect of air-trapping, DeltaSV values of anterior and posterior lung at three different levels were measured and DeltaSV ratio of anterior lung to posterior lung was calculated. Color-coded DeltaSV map of the whole lung was generated and visually assessed. Mean DeltaSV, DeltaSV0.4, and DeltaSV0.5 were compared between healthy volunteers and asthmatics. In asthmatics, correlation between air trapping indexes and clinical parameters were assessed. Mean DeltaSV, DeltaSV0.4, and DeltaSV0.5 in asthmatics were significantly higher than those in healthy volunteer group (all p < 0.05). DeltaSV values in posterior lung in asthmatics were significantly higher than those in healthy volunteer group (p = 0.049). In asthmatics, air trapping indexes, such as DeltaSV0.5 and DeltaSV0.4, showed negative strong correlation with FEF25-75, FEV1, and FEV1/FVC. DeltaSV map of asthmatics showed abnormal geographic pattern in 5 patients (55.6%) and disappearance of anterior-posterior gradient in 3 patients (33.3%). Quantitative assessment of DeltaSV (the ratio of air fraction released after exhalation) shows the difference in extent of air trapping between health volunteers and asthmatics.

Quantitative assessment of global and regional air trappings using non-rigid registration and regional specific volume change of inspiratory/expiratory CT scans: Studies on healthy volunteers and asthmatics

Energy Technology Data Exchange (ETDEWEB)

Lee, Eun Sol; Seo, Joon Beom; Lee, Hyun Joo; Chae, Eun Jin; Lee, Sang Min; Oh, Sang Young; Kim, Nam Kug [Dept. of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of)

2015-06-15

The purpose of this study was to compare air trapping in healthy volunteers with asthmatics using pulmonary function test and quantitative data, such as specific volume change from paired inspiratory CT and registered expiratory CT. Sixteen healthy volunteers and 9 asthmatics underwent paired inspiratory/expiratory CT. DeltaSV, which represents the ratio of air fraction released after exhalation, was measured with paired inspiratory and anatomically registered expiratory CT scans. Air trapping indexes, DeltaSV0.4 and DeltaSV0.5, were defined as volume fraction of lung below 0.4 and 0.5 DeltaSV, respectively. To assess the gravity effect of air-trapping, DeltaSV values of anterior and posterior lung at three different levels were measured and DeltaSV ratio of anterior lung to posterior lung was calculated. Color-coded DeltaSV map of the whole lung was generated and visually assessed. Mean DeltaSV, DeltaSV0.4, and DeltaSV0.5 were compared between healthy volunteers and asthmatics. In asthmatics, correlation between air trapping indexes and clinical parameters were assessed. Mean DeltaSV, DeltaSV0.4, and DeltaSV0.5 in asthmatics were significantly higher than those in healthy volunteer group (all p < 0.05). DeltaSV values in posterior lung in asthmatics were significantly higher than those in healthy volunteer group (p = 0.049). In asthmatics, air trapping indexes, such as DeltaSV0.5 and DeltaSV0.4, showed negative strong correlation with FEF25-75, FEV1, and FEV1/FVC. DeltaSV map of asthmatics showed abnormal geographic pattern in 5 patients (55.6%) and disappearance of anterior-posterior gradient in 3 patients (33.3%). Quantitative assessment of DeltaSV (the ratio of air fraction released after exhalation) shows the difference in extent of air trapping between health volunteers and asthmatics.

16 reference population equations using peak expiratory flow meters

African Journals Online (AJOL)

DR. AMINU

equations in current use are based on linear statistical models which are subject to change and they did not ... assess risks of surgery and to assist in evaluations performed ... identify and quantify pulmonary involvement incases of asthma.

Corruption and illicit financial flows: The limits and possibilities of current approaches

OpenAIRE

Reed, Quentin; Fontana, Alessandra

2011-01-01

This paper attempts to clarify the links between illicit financial flows and corruption, and how corruption may be tackled by stemming such flows. For this purpose, it clarifies the terminology surrounding illicit flows, describes the impact of such flows, outlines the techniques used to launder them (with a particular focus on laundering of the proceeds of corruption), and critically analyses existing policies designed to tackle illicit flows. This paper contributes to the regulatory de...

The correlation between the paired inspiratory and expiratory three-dimensional quantitative CT and pulmonary function test in chronic obstructive pulmonary disease

International Nuclear Information System (INIS)

Sui Xi; Song Wei; Xue Huadan; Song Lan; Yang Liang; Jin Zhengyu

2013-01-01

Objective: To investigate the correlation between the paired inspiratory and expiratory quantitative CT and pulmonary function tests (PFTs) in patients with chronic obstructive pulmonary disease (COPD). Methods: A total of 84 patients with COPD were enrolled. For each patient, CT scan was performed in deep inspiration and expiration. Using automatic post-processing software, a three-dimension quantitative measurement was employed to assess the CT parameters of emphysema and air trapping. The correlation between CT and PFT was evaluated by the Spearman rank correlation test and multivariate linear regression analysis. Results: The percent 1 [Perc_1, (-984.28 ± 17.93) HU] and percent 15 [Perc_1_5, (-948.35 ± 22.26) HU] from the CT parameters of emphysema were positively correlated with the forced expiratory volume in 1 second predicted (FEV_1%, 48.69 ± 23, 47), the ratio of forced expiratory volume in 1 second over forced vital capacity [FEV_1/FVC, (45.89 ± 15.36)%, r = 0.45-0.67, P < 0.01], was negatively correlated with the ratio of residual volume to total lung capacity [RV/TLC, (61.32 ± 14.48)%]. The other CT parameters of emphysema index (EI) and the parameters of air trapping, the change in relative lung volume with attenuation values from -860 to -950 HU [RVC_-_8_6_0_-_-_9_5_0, (17.66 ± 22.36)%], the expiration to inspiration ratio of mean lung density (MLD_e_x_/_i_n, 0.93 ± 0.06), the expiration to inspiration ratio of lung volume (LV_e_x_/_i_n, 0.71 ± 0.14) had negative correlations with logFEV_1%, FEV_1/FVC (r = -0.48--0.69, P < 0.01) and positive correlations with RV/TLC (r = 0.41-0.66, P < 0.01). The further univariate linear regressions showed that EI, Perc_1, Pere_1_5, RVC_-_8_6_0_-_-_9_5_0, MLD_e_x_/_i_n, LV_e_x_/_i_n were correlated with the parameters of PFTs (R square values of the regression equation, ranged from 0.27 to 0.66, P < 0.01). After the pairwise combinations of the parameters of emphysema and air trapping, multivariate stepwise

Nonlocal rheological properties of granular flows near a jamming limit.

Science.gov (United States)

Aranson, Igor S; Tsimring, Lev S; Malloggi, Florent; Clément, Eric

2008-09-01

We study the rheology of sheared granular flows close to a jamming transition. We use the approach of partially fluidized theory (PFT) with a full set of equations extending the thin layer approximation derived previously for the description of the granular avalanches phenomenology. This theory provides a picture compatible with a local rheology at large shear rates [G. D. R. Midi, Eur. Phys. J. E 14, 341 (2004)] and it works in the vicinity of the jamming transition, where a description in terms of a simple local rheology comes short. We investigate two situations displaying important deviations from local rheology. The first one is based on a set of numerical simulations of sheared soft two-dimensional circular grains. The next case describes previous experimental results obtained on avalanches of sandy material flowing down an incline. Both cases display, close to jamming, significant deviations from the now standard Pouliquen's flow rule [O. Pouliquen, Phys. Fluids 11, 542 (1999); 11, 1956 (1999)]. This discrepancy is the hallmark of a strongly nonlocal rheology and in both cases, we relate the empirical results and the outcomes of PFT. The numerical simulations show a characteristic constitutive structure for the fluid part of the stress involving the confining pressure and the material stiffness that appear in the form of an additional dimensionless parameter. This constitutive relation is then used to describe the case of sandy flows. We show a quantitative agreement as far as the effective flow rules are concerned. A fundamental feature is identified in PFT as the existence of a jammed layer developing in the vicinity of the flow arrest that corroborates the experimental findings. Finally, we study the case of solitary erosive granular avalanches and relate the outcome with the PFT analysis.

Måling af lungefunktion hos patienter indlagt med akut forvaerring af kronisk obstruktiv lungesygdom eller astma

DEFF Research Database (Denmark)

Lange, Peter; Rasmussen, Lisbeth Kappelgaard; Said, Nihaya Mahmoud

2005-01-01

Acute exacerbation of COPD or asthma leads to many acute hospital admissions every year. Even though the pathogenesis of these diseases differs, in both cases the cardinal manifestation is increased airway obstruction, which can be measured using peak expiratory flow measurement (PEF......) or measurement of forced expiratory volume in one second (FEV1)....

Effects of Hemibridge with Ball and Balloon Exercise on Forced Expiratory Volume and Pain in Patients with Chronic Low Back Pain: An Experimental Study

Directory of Open Access Journals (Sweden)

Jorida Fernandes

2017-08-01

Full Text Available Background and objectives: Suboptimal breathing patterns and impairments of posture and trunk stability are often associated with musculoskeletal complaints such as low back pain. Respiration is also affected by poor neuromuscular control of core muscles. Immediate effects of hemibridge with ball and balloon exercise has been studied on chronic pain in athlete population. Objective: To evaluate the effects of hemibridge with ball and balloon exercise on pain, forced expiratory volume and functional abilities in patients with chronic low back pain using Visual Analogue Scale (VAS, Forced Expiratory Volume (FEV and Modified Oswestry Disability Questionnaire (MODQ. Methods: The present experimental study was conducted among 30 participants between the age of 21 to 55 years with chronic non-specific LBP. The participants were given a hemibridge with ball and balloon exercise. Pre-interventional and 3rd day Post-interventional outcome measurements were taken using VAS, FEV1 and FEV6 and MODQ. Results: The difference between pre-and post of VAS was statistically highly significant (p=0.0001. The p value of FEV6 and MODQ by paired t test was statistically significant with p value of 0.02 and 0.0007 respectively. Conclusion: The study concludes that there is an immediate effect of hemibridge with ball and balloon exercise on pain, FEV6 and functional ability in patients with chronic LBP.

Risk factors of bronchial hyperresponsiveness in children with wheezing-associated respiratory infection.

Science.gov (United States)

Futrakul, Sitthivuddhi; Deerojanawong, Jitladda; Prapphal, Nuanchan

2005-07-01

The objectives of this study were to identify possible risk factors of bronchial hyperesponsiveness (BHR) in children up to 5 years of age with wheezing-associated respiratory infection (WARI), and to study the prevalence of BHR. Children up to 5 years of age with WARI were enrolled in the study. The parents or caregivers of children were asked about their demographic data and clinical histories. Physical examination and clinical score assessment were performed. Pulmonary function tests, i.e., tidal breathing flow volume (TBFV), were performed to measure tidal breathing parameters before and after salbutamol nebulization. If volume at peak tidal expiratory flow/expiratory tidal volume and time to peak expiratory flow/total expiratory time increased > or = 20%, or tidal expiratory flow at 25% of tidal volume/peak tidal expiratory flow increased > or = 20% after nebulization therapy, BHR was diagnosed. The number in the positive BHR group was used to calculate the prevalence of BHR, and clinical features were compared with those of the negative BHR group. Categorical data were analyzed for statistical significance (P < 0.05) by chi-square test or Fisher's exact test, or Student's t-test, as appropriate. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated for those with statistical significance. One hundred and six wheezing children underwent pulmonary function tests before and after salbutamol nebulization. With the aforementioned criteria, 41 cases (38.7%) were diagnosed with BHR. History of reactive airway disease, (OR, 6.31; 95% CI, 1.68-25), maternal history of asthma (OR, 3.45; 95% CI, 1.34-9), breastfeeding less than 3 months (OR, 3.18; 95% CI, 1.26-8.12), and passive smoking (OR, 3; 95% CI, 1.15-7.62) were significant risk factors of BHR. The eosinophil count was significantly higher in the BHR (+) group particularly, in children 1-5 years of age (P < or = 0.01). Patchy infiltrates were more commonly found in patients with negative BHR but not

Reversibility of trapped air on chest computed tomography in cystic fibrosis patients

DEFF Research Database (Denmark)

Loeve, Martine; Rosenow, Tim; Gorbunova, Vladlena

2015-01-01

measured by plethysmography and helium dilution, residual volume to total lung capacity ratio, forced expiratory flow at 75% of vital capacity, and maximum mid-expiratory flow as pulmonary function test markers of trapped air. Statistical analysis included Wilcoxon's signed rank test and Spearman......PURPOSE: To investigate changes in trapped air volume and distribution over time and compare computed tomography (CT) with pulmonary function tests for determining trapped air. METHODS: Thirty children contributed two CTs and pulmonary function tests over 2 years. Localized changes in trapped air...

Prediction of Counter-Current Flow Limitation at Hot Leg Pipe During a Small-Break Loca

Energy Technology Data Exchange (ETDEWEB)

Jeong, H.Y. [Korea Electric Power Research Institute, Taejeon (Korea)

2001-07-01

The possibility of hot leg flooding during reflux condensation cooling after a small-break loss-of-coolant accident in a nuclear power plant is evaluated. The vapor and liquid velocities in hot leg and steam generator tubes are calculated during reflux condensation cooling with the accident scenarios of three typical break sizes, 0.13 %, 1.02 % and 10.19 % cold leg break. The effect of initial water level to counter-current flow limitation is taken into account. It is predicted that the hot leg flooding is precluded when all steam generators are available for heat removal. It is also shown the both hot leg flooding and SG flooding are possible under the operation of one steam generators. Therefore, it can be said that the occurrence of hot leg flooding under reflux condensation cooling is possible when the number of steam generators available for heat removal is limited. (author). 15 refs., 15 figs., 3 tabs.

Respiratory impairment and the aging lung: a novel paradigm for assessing pulmonary function.

Science.gov (United States)

Vaz Fragoso, Carlos A; Gill, Thomas M

2012-03-01

Older persons have an increased risk of developing respiratory impairment because the aging lung is likely to have experienced exposures to environmental toxins as well as reductions in physiological capacity. Systematic review of risk factors and measures of pulmonary function that are most often considered when defining respiratory impairment in aging populations. Across the adult life span, there are frequent exposures to environmental toxins, including tobacco smoke, respiratory infections, air pollution, and occupational dusts. Concurrently, there are reductions in physiological capacity that may adversely affect ventilatory control, respiratory muscle strength, respiratory mechanics, and gas exchange. Recent work has provided a strong rationale for defining respiratory impairment as an age-adjusted reduction in spirometric measures of pulmonary function that are independently associated with adverse health outcomes. Specifically, establishing respiratory impairment based on spirometric Z-scores has been shown to be strongly associated with respiratory symptoms, frailty, and mortality. Alternatively, respiratory impairment may be defined by the peak expiratory flow, as measured by a peak flow meter. The peak expiratory flow, when expressed as a Z-score, has been shown to be strongly associated with disability and mortality. However, because it has a reduced diagnostic accuracy, peak expiratory flow should only define respiratory impairment when spirometry is not readily available or an older person cannot adequately perform spirometry. Aging is associated with an increased risk of developing respiratory impairment, which is best defined by spirometric Z-scores. Alternatively, in selected cases, respiratory impairment may be defined by peak expiratory flow, also expressed as a Z-score.

High altitude pulmonary edema and exercise at 4,400 meters on Mount McKinley. Effect of expiratory positive airway pressure.

Science.gov (United States)

Schoene, R B; Roach, R C; Hackett, P H; Harrison, G; Mills, W J

1985-03-01

Breathing against positive expiratory pressure has been used to improve gas exchange in many forms of pulmonary edema, and forced expiration against resistance during exercise has been advocated for climbing at high altitude as a method to optimize performance. To evaluate the effect of expiratory positive airway pressure (EPAP) on climbers with high altitude pulmonary edema (HAPE) and on exercise at high altitude, we studied four climbers with HAPE at rest and 13 healthy climbers during exercise on a bicycle ergometer at 4400 m. We measured minute ventilation (VI, L/min), arterial oxygen saturation (SaO2 percent), end-tidal carbon dioxide (PACO2, mm Hg), respiratory rate (RR), and heart rate (HR) during the last minute of a five minute interval at rest in the climbers with HAPE, and at rest, 300, and 600 kpm/minute workloads on a bicycle ergometer in the healthy subjects. The HAPE subjects demonstrated an increased SaO2 percent, no change in HR or VI, and a decrease in RR on EPAP as compared to control. In normal subjects, SaO2 percent, VI, and heart rate were significantly higher on EPAP 10 cm H2O than 0 cm H2O control (p less than 0.01, 0.01, and 0.05, respectively). The RR and PaCO2 were not significantly different. In summary, EPAP improves gas exchange in HAPE subjects at rest. The EPAP in normal subjects at high altitude resulted in a higher SaO2 percent at the expense of a higher VI and higher HR. These results suggest that the work of breathing is higher and the stroke volume lower on EPAP. The positive pressure mask may be an effective temporizing measure for victims of HAPE who cannot immediately go to a lower altitude.

Prediction of post-operative pulmonary function after lobectomy for primary lung cancer: A comparison among counting method, effective lobar volume, and lobar collapsibility using inspiratory/expiratory CT

Energy Technology Data Exchange (ETDEWEB)

Yabuuchi, Hidetake, E-mail: h-yabu@med.kyushu-u.ac.jp [Department of Health Sciences, Kyushu University Graduate School of Medical Sciences, Fukuoka (Japan); Kawanami, Satoshi, E-mail: kawanami_01@mac.com [Department of Clinical Radiology, Kyushu University Graduate School of Medical Sciences, Fukuoka (Japan); Kamitani, Takeshi, E-mail: kamitani@radiol.med.kyushu-u.ac.jp [Department of Clinical Radiology, Kyushu University Graduate School of Medical Sciences, Fukuoka (Japan); Yonezawa, Masato, E-mail: ymasato@radiol.med.kyushu-u.ac.jp [Department of Clinical Radiology, Kyushu University Graduate School of Medical Sciences, Fukuoka (Japan); Yamasaki, Yuzo, E-mail: yyama@radiol.med.kyushu-u.ac.jp [Department of Clinical Radiology, Kyushu University Graduate School of Medical Sciences, Fukuoka (Japan); Yamanouchi, Torahiko, E-mail: tora0228jp@yahoo.co.jp [Department of Clinical Radiology, Kyushu University Graduate School of Medical Sciences, Fukuoka (Japan); Nagao, Michinobu, E-mail: minagao@radiol.med.kyushu-u.ac.jp [Department of Clinical Radiology, Kyushu University Graduate School of Medical Sciences, Fukuoka (Japan); Okamoto, Tatsuro, E-mail: tatsuro@surg2.med.kyushu-u.ac.jp [Department of Surgery and Science, Kyushu University Graduate School of Medical Sciences, Fukuoka (Japan); Honda, Hiroshi, E-mail: honda@radiol.med.kyushu-u.ac.jp [Department of Clinical Radiology, Kyushu University Graduate School of Medical Sciences, Fukuoka (Japan)

2016-11-15

Highlights: • ΔFEV{sub 1.0} and ppoΔFEV{sub 1.0} using lobar collapsibility were strongly correlated. • ΔVC and ppoΔVC using effective lobar volume were strongly correlated. • Counting method was inferior to lobar collapsibility for prediction of ppoFEV{sub 1.0}. • Inspiratory/expiratory CT is useful to predict post-operative pulmonary function. - Abstract: Purpose: To compare the predictabilities of postoperative pulmonary function after lobectomy for primary lung cancer among counting method, effective lobar volume, and lobar collapsibility. Methods: Forty-nine patients who underwent lobectomy for primary lung cancer were enrolled. All patients underwent inspiratory/expiratory CT and pulmonary function tests 2 weeks before surgery and postoperative pulmonary function tests 6–7 months after surgery. Pulmonary function losses (ΔFEV{sub 1.0} and ΔVC) were calculated from the pulmonary function tests. Predictive postoperative pulmonary function losses (ppoΔFEV{sub 1.0} and ppoΔVC) were calculated using counting method, effective volume, and lobar collapsibility. Correlations and agreements between ΔFEV{sub 1.0} and ppoFEV{sub 1.0} and those between ΔVC and ppoΔVC were tested among three methods using Spearman’s correlation coefficient and Bland-Altman plots. Results: ΔFEV{sub 1.0} and ppoΔFEV{sub 1.0insp-exp} were strongly correlated (r = 0.72), whereas ΔFEV{sub 1.0} and ppoΔFEV{sub 1.0count} and ΔFEV{sub 1.0} and Pred. ΔFEV{sub 1.0eff.vol.} were moderately correlated (r = 0.50, 0.56). ΔVC and ppoΔVC{sub eff.vol.} (r = 0.71) were strongly correlated, whereas ΔVC and ppoΔVC{sub count}, and ΔVC and ppoΔVC {sub insp-exp} were moderately correlated (r = 0.55, 0.42). Conclusions: Volumetry from inspiratory/expiratory CT data could be useful to predict postoperative pulmonary function after lobectomy for primary lung cancer.

A Study on adverse effect of smoke/flue on lung functions of glass factory workers of Firozabad district

Directory of Open Access Journals (Sweden)

Santosh Kumar Sant

2014-03-01

Full Text Available The pulmonary function impairment is the most common respiratory problem in industrial plants and their vicinity. Therefore, the purpose was to study the effects of furnace smoke and flue and its duration of exposure on lung function. This was a matched cross-sectional study of Spirometry in 100 bangle workers with age range 20 – 60 years, who worked without the benefit of smoke control ventilation or respiratory protective devices. Pulmonary function test was performed by using Digital Spirometer (Spiro-excel. Significant reduction was observed in the mean values of Forced Vital Capacity (FVC, Forced Expiratory Volume in one second (FEV1, Forced Expiratory Ratio (FEV1/FVC, Forced Expiratory Flow (25%-75% and Peak Expiratory Flow Rate (PEFR in bangle workers relative to their matched controls. This impairment was increased with the duration of exposure to fumes in bangle industries. It is concluded that lung function in bangle workers is impaired and stratification of results shows a dose-response effect of years of smoke and flue exposure on lung function. 

Nanoscale Capillary Flows in Alumina: Testing the Limits of Classical Theory.

Science.gov (United States)

Lei, Wenwen; McKenzie, David R

2016-07-21

Anodic aluminum oxide (AAO) membranes have well-formed cylindrical channels, as small as 10 nm in diameter, in a close packed hexagonal array. The channels in AAO membranes simulate very small leaks that may be present for example in an aluminum oxide device encapsulation. The 10 nm alumina channel is the smallest that has been studied to date for its moisture flow properties and provides a stringent test of classical capillary theory. We measure the rate at which moisture penetrates channels with diameters in the range of 10 to 120 nm with moist air present at 1 atm on one side and dry air at the same total pressure on the other. We extend classical theory for water leak rates at high humidities by allowing for variable meniscus curvature at the entrance and show that the extended theory explains why the flow increases greatly when capillary filling occurs and enables the contact angle to be determined. At low humidities our measurements for air-filled channels agree well with theory for the interdiffusive flow of water vapor in air. The flow rate of water-filled channels is one order of magnitude less than expected from classical capillary filling theory and is coincidentally equal to the helium flow rate, validating the use of helium leak testing for evaluating moisture flows in aluminum oxide leaks.

Comparison of five portable peak flow meters.

Science.gov (United States)

Takara, Glaucia Nency; Ruas, Gualberto; Pessoa, Bruna Varanda; Jamami, Luciana Kawakami; Di Lorenzo, Valéria Amorim Pires; Jamami, Mauricio

2010-05-01

To compare the measurements of spirometric peak expiratory flow (PEF) from five different PEF meters and to determine if their values are in agreement. Inaccurate equipment may result in incorrect diagnoses of asthma and inappropriate treatments. Sixty-eight healthy, sedentary and insufficiently active subjects, aged from 19 to 40 years, performed PEF measurements using Air Zone, Assess, Galemed, Personal Best and Vitalograph peak flow meters. The highest value recorded for each subject for each device was compared to the corresponding spirometric values using Friedman's test with Dunn's post-hoc (pmeters were 428 (263-688 L/min), 450 (350-800 L/min), 420 (310-720 L/min), 380 (300-735 L/min), 400 (310-685 L/min) and 415 (335-610 L/min), respectively. Significant differences were found when the spirometric values were compared to those recorded by the Air Zone(R) (pmeters. There was no agreement between the spirometric values and the five PEF meters. The results suggest that the values recorded from Galemed meters may underestimate the actual value, which could lead to unnecessary interventions, and that Air Zone meters overestimate spirometric values, which could obfuscate the need for intervention. These findings must be taken into account when interpreting both devices' results in younger people. These differences should also be considered when directly comparing values from different types of PEF meters.

Buoyancy-driven flow excursions in fuel assemblies

International Nuclear Information System (INIS)

Laurinat, J.E.; Paul, P.K.; Menna, J.D.

1995-01-01

A power limit criterion was developed for a postulated Loss of Pumping Accident (LOPA) in one of the recently shut down heavy water production reactors at the Savannah River Site. These reactors were cooled by recirculating heavy water moderator downward through channels in cylindrical fuel tubes. Powers were limited to safeguard against a flow excursion in one of more of these parallel channels. During-full-power operation, limits safeguarded against a boiling flow excursion. At low flow rates, during the addition of emergency cooling water, buoyant forces reverse the flow in one of the coolant channels before boiling occurs. As power increased beyond the point of flow reversal, the maximum wall temperature approaches the fluid saturation temperature, and a thermal excursion occurs. The power limit criterion for low flow rates was the onset of flow reversal. To determine conditions for flow reversal, tests were performed in a mock-up of a fuel assembly that contained two electrically heated concentric tubes surrounded by three flow channels. These tests were modeled using a finite difference thermal-hydraulic code. According to code calculations, flow reversed in the outer flow channel before the maximum wall temperature reached the local fluid saturation temperature. Thermal excursions occurred when the maximum wall temperature approximately equaled the saturation temperature. For a postulated LOPA, the flow reversal criterion for emergency cooling water addition was more limiting than the boiling excursion criterion for full power operation. This criterion limited powers to 37% of the limiting power for previous long-term reactor operations

Buoyancy-driven flow excursions in fuel assemblies

Energy Technology Data Exchange (ETDEWEB)

Laurinat, J.E.; Paul, P.K.; Menna, J.D. [Westinghouse Savannah River Company, Aiken, SC (United States)

1995-09-01

A power limit criterion was developed for a postulated Loss of Pumping Accident (LOPA) in one of the recently shut down heavy water production reactors at the Savannah River Site. These reactors were cooled by recirculating heavy water moderator downward through channels in cylindrical fuel tubes. Powers were limited to safeguard against a flow excursion in one of more of these parallel channels. During-full-power operation, limits safeguarded against a boiling flow excursion. At low flow rates, during the addition of emergency cooling water, buoyant forces reverse the flow in one of the coolant channels before boiling occurs. As power increased beyond the point of flow reversal, the maximum wall temperature approaches the fluid saturation temperature, and a thermal excursion occurs. The power limit criterion for low flow rates was the onset of flow reversal. To determine conditions for flow reversal, tests were performed in a mock-up of a fuel assembly that contained two electrically heated concentric tubes surrounded by three flow channels. These tests were modeled using a finite difference thermal-hydraulic code. According to code calculations, flow reversed in the outer flow channel before the maximum wall temperature reached the local fluid saturation temperature. Thermal excursions occurred when the maximum wall temperature approximately equaled the saturation temperature. For a postulated LOPA, the flow reversal criterion for emergency cooling water addition was more limiting than the boiling excursion criterion for full power operation. This criterion limited powers to 37% of the limiting power for previous long-term reactor operations.

Limited contemporary gene flow and high self-replenishment drives peripheral isolation in an endemic coral reef fish.

Science.gov (United States)

van der Meer, Martin H; Horne, John B; Gardner, Michael G; Hobbs, Jean-Paul A; Pratchett, Morgan; van Herwerden, Lynne

2013-06-01

Extensive ongoing degradation of coral reef habitats worldwide has lead to declines in abundance of coral reef fishes and local extinction of some species. Those most vulnerable are ecological specialists and endemic species. Determining connectivity between locations is vital to understanding recovery and long-term persistence of these species following local extinction. This study explored population connectivity in the ecologically-specialized endemic three-striped butterflyfish (Chaetodon tricinctus) using mt and msatDNA (nuclear microsatellites) to distinguish evolutionary versus contemporary gene flow, estimate self-replenishment and measure genetic diversity among locations at the remote Australian offshore coral reefs of Middleton Reef (MR), Elizabeth Reef (ER), Lord Howe Island (LHI), and Norfolk Island (NI). Mt and msatDNA suggested genetic differentiation of the most peripheral location (NI) from the remaining three locations (MR, ER, LHI). Despite high levels of mtDNA gene flow, there is limited msatDNA gene flow with evidence of high levels of self-replenishment (≥76%) at all four locations. Taken together, this suggests prolonged population recovery times following population declines. The peripheral population (NI) is most vulnerable to local extinction due to its relative isolation, extreme levels of self-replenishment (95%), and low contemporary abundance.

Immediate effect of suryanadi pranayama on pulmonary function (ventilatory volumes and capacities in healthy volunteers

Directory of Open Access Journals (Sweden)

Shravya Keerthi G, Hari Krishna Bandi, Suresh M, Mallikarjuna Reddy N

2013-10-01

Full Text Available Objectives: we found only effects of at least a short term practice extended over a period of a few days to weeks of pranayama (alternate nostril breathing rather than acute effects of unilateral right nostril breathing (suryanadi pranayama. Keeping this in mind the present study was designed to test the hypothesis that 10 min. of right nostril breathing have any immediate effect on ventilatory volumes and capacities in healthy volunteers. Methodology: Forced vital capacity (FVC, Forced expiratory volume in the first second (FEV1, Forced expiratory volume percent (FEV1/FVC%, Peak expiratory flow rate (PEFR, Forced expiratory flow25-75% (FEF25-75%, Maximum voluntary ventilation (MVV, Slow vital capacity (SVC, Expiratory reserve volume (ERV, Inspiratory reserve volume (IRV and Tidal volume (TV were recorded before and after Surya Nadi Pranayama. Results & Conclusion: There was a significant increase in FVC (p<0.0001, FEV1 (p<0.0007, PEFR (p<0.0001, FEF25-75% (p<0.0001, MVV (p<0.0001, SVC (p<0.0001, ERV (0.0006, IRV (p<0.0001 and TV (0.0055 after suryanadi pranayama. The immediate effect of suryanadi pranayama practice showed alleviation of ventilatory capacities and volumes. Any practice that increases PEFR and FEF25–75% is expected to retard the development of COPD’s. The increase in PEFR, vital capacities and flow rates by suryanadi pranayama practice obviously offers an increment in respiratory efficiency and it can be advocated to the patients of early bronchitis and as a preventive measure for COPD.

A randomised controlled trial of flow driver and bubble continuous positive airway pressure in preterm infants in a resource-limited setting.

Science.gov (United States)

Mazmanyan, P; Mellor, K; Doré, C J; Modi, N

2016-01-01

The variable-flow flow driver (FD; EME) and continuous-flow bubble (Fisher-Paykel) continuous positive airway pressure (CPAP) systems are widely used. As these differ in cost and technical requirements, determining comparative efficacy is important particularly where resources are limited. We performed a randomised, controlled, equivalence trial of CPAP systems. We specified the margin of equivalence as 2 days. We analysed binary variables by logistical regression adjusted for gestation, and log transformed continuous variables by multiple linear regression adjusted for gestation, sex and antenatal steroids. A neonatal unit with no blood gas analyser or surfactant availability and limited X-ray and laboratory facilities Neonates CPAP at delivery followed by randomisation to FD or bubble (B). Primary outcome included total days receiving CPAP; secondary outcomes included days receiving CPAP, supplemental oxygen, ventilation, death, pneumothorax and nasal excoriation. We randomised 125 infants (B 66, FD 59). Differences in infant outcomes on B and FD were not statistically significant. The median (range) for CPAP days for survivors was B 0.8 (0.04 to 17.5), FD 0.5 (0.04 to 5.3). B:FD (95% CI) ratios were CPAP days 1.3 (0.9 to 2.1), CPAP plus supplementary oxygen days 1.2 (0.7 to 1.9). B:FD (95% CI) ORs were death 2.3 (0.2 to 28), ventilation 2.1 (0.5 to 9), nasal excoriation 1.2 (0.2 to 8) and pneumothorax 2.4 (0.2 to 26). In a resource-limited setting we found B CPAP equivalent to FD CPAP in the total number of days receiving CPAP within a margin of 2 days. ISRCTN22578364. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Mechanics of occurrence of critical flow in compressible two-phase flow

International Nuclear Information System (INIS)

Katto, Yoshiro; Sudo, Yukio

1976-01-01

Fundamental framework of mechanics for the occurrence of critical flow is investigated, following the principle that the critical flow appears as a limit in a continuous change of state of flow along a nozzle (or a pipe) and should be derived only from simultaneous mechanical equations concerned with the flow. Mathematical procedures with which the critical flow: (i) the single phase flow of an arbitrary fluid, unrestricted by the equation of state of ideal gas, where the number of simultaneous equations is equal to the number of independent variables, and (ii) the one-component, separated two-phase flow under saturated condition, where the number of equations exceeds that of variables. In each case, interesting mechanism of leading to the occurrence of a limiting state of flow at a definite cross-section in a nozzle (incl. a pipe) is clarified, and a definite state of flow at the critical cross-section is also determined. Then, the analysis is extended to the critical flow which should appear in the completely isolated and the homogeneously dispersed, two-component, two-phase flow (composed of a compressible and an incompressible substance). It is found that the analyses of these special flow patterns provide several supplementary information to the mechanics of critical flow. (auth.)

Buoyancy-driven flow excursions in fuel assemblies

International Nuclear Information System (INIS)

Laurinat, J.E.; Paul, P.K.; Menna, J.D.

1995-01-01

A power limit criterion was developed for a postulated Loss of Pumping Accident (LOPA) in one of the recently shut down heavy water production reactors at the Savannah River Site. These reactors were cooled by recirculating moderator downward through channels in cylindrical fuel tubes. Powers were limited to prevent a flow excursion from occurring in one or more of these parallel channels. During full-power operation, limits prevented a boiling flow excursion from taking place. At low flow rates, during the addition of emergency cooling water, buoyant forces reverse the flow in one of the coolant channels before boiling occurs. As power increases beyond the point of flow reversal, the maximum wall temperature approaches the fluid saturation temperature, and a thermal excursion occurs. The power limit criterion for low flow rates was the onset of flow reversal. To determine conditions for flow reversal, tests were performed in a mock-up of a fuel assembly that contained two electrically heated concentric tubes surrounded by three flow channels. These tests were modeled using a finite difference thermal-hydraulic code. According to code calculations, flow reversed in the outer flow channel before the maximum wall temperature reached the local fluid saturation temperature. Thermal excursions occurred when the maximum wall temperature approximately equaled the saturation temperature. For a postulated LOPA, the flow reversal criterion for emergency cooling water addition was more limiting than the boiling excursion criterion for full power operation. This criterion limited powers to 37% of historical levels

Redox flow batteries with serpentine flow fields: Distributions of electrolyte flow reactant penetration into the porous carbon electrodes and effects on performance

Science.gov (United States)

Ke, Xinyou; Prahl, Joseph M.; Alexander, J. Iwan D.; Savinell, Robert F.

2018-04-01

Redox flow batteries with flow field designs have been demonstrated to boost their capacities to deliver high current density and power density in medium and large-scale energy storage applications. Nevertheless, the fundamental mechanisms involved with improved current density in flow batteries with serpentine flow field designs have been not fully understood. Here we report a three-dimensional model of a serpentine flow field over a porous carbon electrode to examine the distributions of pressure driven electrolyte flow penetrations into the porous carbon electrodes. We also estimate the maximum current densities associated with stoichiometric availability of electrolyte reactant flow penetrations through the porous carbon electrodes. The results predict reasonably well observed experimental data without using any adjustable parameters. This fundamental work on electrolyte flow distributions of limiting reactant availability will contribute to a better understanding of limits on electrochemical performance in flow batteries with serpentine flow field designs and should be helpful to optimizing flow batteries.

Genetic Influences on Pulmonary Function: A Large Sample Twin Study

DEFF Research Database (Denmark)

Ingebrigtsen, Truls S; Thomsen, Simon F; van der Sluis, Sophie

2011-01-01

Heritability of forced expiratory volume in one second (FEV(1)), forced vital capacity (FVC), and peak expiratory flow (PEF) has not been previously addressed in large twin studies. We evaluated the genetic contribution to individual differences observed in FEV(1), FVC, and PEF using data from...... the largest population-based twin study on spirometry. Specially trained lay interviewers with previous experience in spirometric measurements tested 4,314 Danish twins (individuals), 46-68 years of age, in their homes using a hand-held spirometer, and their flow-volume curves were evaluated. Modern variance...

Axial annular flow of power-law fluids - applicability of the limiting cases

Czech Academy of Sciences Publication Activity Database

Filip, Petr; David, Jiří

2007-01-01

Roč. 52, č. 4 (2007), s. 365-371 ISSN 0001-7043 R&D Projects: GA ČR GA103/06/1033 Institutional research plan: CEZ:AV0Z20600510 Keywords : Concentric annuli * Poiseuile flow * annular flow * power- law fluids * flow rate * pressure drop Subject RIV: BK - Fluid Dynamics

Seasonal shift in climatic limiting factors on tree transpiration: evidence from sap flow observations at alpine treelines in southeast Tibet

Directory of Open Access Journals (Sweden)

Liu Xinsheng

2016-07-01

Full Text Available Alpine and northern treelines are primarily controlled by low temperatures. However, little is known about the impact of low soil temperature on tree transpiration at treelines. We aim to test the hypothesis that in cold-limited forests, the main limiting factors for tree transpiration switch from low soil temperature before summer solstice to atmospheric evaporative demand after summer solstice, which generally results in low transpiration in the early growing season. Sap flow, meteorological factors and predawn needle water potential were continuously monitored throughout one growing season across Smith fir (Abies georgei var. smithii and juniper (Juniperus saltuaria treelines in southeast Tibet. Sap flow started in early May and corresponded to a threshold mean air-temperature of 0 oC. Across tree species, transpiration was mainly limited by low soil temperature prior to the summer solstice but by vapor pressure deficit and solar radiation post-summer solstice, which was further confirmed on a daily scale. As a result, tree transpiration for both tree species was significantly reduced in the pre-summer solstice period as compared to post-summer solstice, resulting in a lower predawn needle water potential for Smith fir trees in the early growing season. Our data supported the hypothesis, suggesting that tree transpiration mainly responds to soil temperature variations in the early growing season. The results are important for understanding the hydrological response of cold-limited forest ecosystems to climate change.

Ground Testing for Hypervelocity Flow, Capabilities and Limitations

Science.gov (United States)

2010-03-29

Brisbane (T4) in Australia, see http://www.uq.edu.au/~e4dmee/t4.html, and larger ones at Göttingen in Germany (HEG), see e. g., Hannemann (2002), and...Fluids, 11:4026–4039. Hannemann , K. (2002). High-enthalpy flows in the HEG shock tunnel: Experiment and numerical rebuilding. 22nd AIAA Aerodynamic

Analysis of cantilever pipes in transverse fluid flow with motion limiting stopper at the free end

International Nuclear Information System (INIS)

Jiyavan, R.

1983-01-01

Flow-induced vibration in heat exchanger tubes can result in impact with the baffle plates and subsequent tube failure through fatigue, fracture and fretting wear. As a step towards the correlation between the random flow excitations and the rate of wear, this paper presents a general theory for predicting the tube motion and the tube baffle impact forces through a case of cantilever pipe with motion limiting stopper at the free end and simultaneously subjected to transverse fluid flow. The mathematical model has been developed using the theory of fluid-structure interactions with model superposition technique. The pipe displacement induced by lift forces is evaluated by numerical integration. When displacement increases to greater than the pipe-stopper clearance, the pipe impacts on stopper. Assuming semielastic impact, the equation of pipe motion during impact is developed using extended Hertz's theory to include the vibration of one of the colliding bodies. The stopper is assumed to be at rest before and after the impact. The constraint imposed on pipe motion, at the free end due to impact of the pipe on stopper, is considered as one of the boundary conditions and is used to evaluate the pipe natural frequencies. The nonlinear equations are solved numerically. The response of the pipe due to wake induced lift forces superposed by the impact response is evaluated. (orig./GL)

Flow regimes

International Nuclear Information System (INIS)

Kh'yuitt, G.

1980-01-01

An introduction into the problem of two-phase flows is presented. Flow regimes arizing in two-phase flows are described, and classification of these regimes is given. Structures of vertical and horizontal two-phase flows and a method of their identification using regime maps are considered. The limits of this method application are discussed. The flooding phenomena and phenomena of direction change (flow reversal) of the flow and interrelation of these phenomena as well as transitions from slug regime to churn one and from churn one to annular one in vertical flows are described. Problems of phase transitions and equilibrium are discussed. Flow regimes in tubes where evaporating liquid is running, are described [ru

Assessment of Respiratory Function in Students, Residing in Different Industrial Areas

Directory of Open Access Journals (Sweden)

Aiman E. Konkabaeva

2013-01-01

Full Text Available The article considers the results of the examination of three groups of apparently healthy volunteer students of one social group, both men and women, without bad habits, aged 19-22. Students live in three different industrial areas of Central Khazakhstan, containing ironworks (Temirtau and non-ferrous smelters (Balkhash, Zhezkazgan. It determined the necessity of respiratory function examination, using automated lung tester. The examination of respiratory function determined the decrease of the following parameters: lung vital capacity, maximal expiratory flow volume, forced expiratory volume 1, peak expiratory flow rate, cardiac minute output 25-50 if compared to proper parameters. The examination enabled us to make the conclusion that respiratory function is restricted due to high respiratory load, caused by air pollution. Changes intensity is different and can indicate the pollution in the examined areas.

Numerical simulations for effects of pressure and temperature on counter-current flow limitation at lower end of a vertical pipe

International Nuclear Information System (INIS)

Kusunoki, Takayoshi; Tomiyama, Akio; Murase, Michio; Takata, Takashi

2015-01-01

The purpose of this study is to derive a CCFL (counter-current flow limitation) correlation and its uncertainty for steam generator (SG) U-tubes in a pressurized water reactor. Pressure and temperature are very high in actual U-tubes. Hence, in this paper, we evaluated effects of pressure and temperature on CCFL characteristics using numerical simulations. Results computed with the k-ω SST turbulence model gave a trend opposite to the ROSA-IV/LSTF data in the pressure range of 1.0-7.0 MPa, and the computed falling water flow rates decreased as pressure increased. Because computations with the k-ω SST were unstable at lower pressures than 1.0 MPa, the laminar flow model was used even though it significantly overestimated falling water flow rates. The results showed that: (1) the flooding under steam-water conditions was mitigated more than that under air-water conditions; (2) the falling water flow rate had a maximum value at about 1.0 MPa; and (3) the laminar flow model resulted in an opposite trend to the ROSA-IV/LSTF data in the pressure range of 1.0-7.0 MPa, as the k-ω SST turbulence model did. Thus, we concluded that accurate measurements should be made in a wide range of pressures using a single vertical pipe in order to confirm effects of fluid properties on CCFL. (author)

Estimation of Flow Channel Parameters for Flowing Gas Mixed with Air in Atmospheric-pressure Plasma Jets

Science.gov (United States)

Yambe, Kiyoyuki; Saito, Hidetoshi

2017-12-01

When the working gas of an atmospheric-pressure non-equilibrium (cold) plasma flows into free space, the diameter of the resulting flow channel changes continuously. The shape of the channel is observed through the light emitted by the working gas of the atmospheric-pressure plasma. When the plasma jet forms a conical shape, the diameter of the cylindrical shape, which approximates the conical shape, defines the diameter of the flow channel. When the working gas flows into the atmosphere from the inside of a quartz tube, the gas mixes with air. The molar ratio of the working gas and air is estimated from the corresponding volume ratio through the relationship between the diameter of the cylindrical plasma channel and the inner diameter of the quartz tube. The Reynolds number is calculated from the kinematic viscosity of the mixed gas and the molar ratio. The gas flow rates for the upper limit of laminar flow and the lower limit of turbulent flow are determined by the corresponding Reynolds numbers estimated from the molar ratio. It is confirmed that the plasma jet length and the internal plasma length associated with strong light emission increase with the increasing gas flow rate until the rate for the upper limit of laminar flow and the lower limit of turbulent flow, respectively. Thus, we are able to explain the increasing trend in the plasma lengths with the diameter of the flow channel and the molar ratio by using the cylindrical approximation.

Guiding Inspiratory Flow: Development of the In-Check DIAL G16, a Tool for Improving Inhaler Technique

Directory of Open Access Journals (Sweden)

Mark Jeremy Sanders

2017-01-01

Full Text Available Portable inhalers are divisible into those that deliver medication by patient triggering (pMDIs: a gentle slow inhalation and those that use the patient’s inspiratory effort as the force for deaggregation and delivery (DPIs: a stronger deeper inspiratory effort. Patient confusion and poor technique are commonplace. The use of training tools has become standard practice, and unique amongst these is an inspiratory flow meter (In-Check which is able to simulate the resistance characteristics of different inhalers and, thereby, guide the patient to the correct effort. In-Check’s origins lie in the 1960s peak expiratory flow meters, the development of the Mini-Wright peak flow meter, and inspiratory flow assessment via the nose during the 1970s–1980s. The current device (In-Check DIAL G16 is the third iteration of the original 1998 training tool, with detailed and ongoing assessments of all common inhaler resistances (including combination and breath-actuated inhaler types summarised into resistance ranges that are preset within the device. The device works by interpolating one of six ranges with the inspiratory effort. Use of the tool has been shown to be contributory to significant improvements in asthma care and control, and it is being advocated for assessment and training in irreversible lung disease.

Neonatal Caffeine Treatment and Respiratory Function at 11 Years in Children under 1,251 g at Birth.

Science.gov (United States)

Doyle, Lex W; Ranganathan, Sarath; Cheong, Jeanie L Y

2017-11-15

Caffeine in the newborn period shortens the duration of assisted ventilation and reduces the incidence of bronchopulmonary dysplasia, but its effects on respiratory function in later childhood are unknown. To determine if children born with birth weight less than 1,251 g who were treated with neonatal caffeine had improved respiratory function at 11 years of age compared with children treated with placebo. Children enrolled in the CAP (Caffeine for Apnea of Prematurity) randomized controlled trial and assessed at the Royal Women's Hospital in Melbourne at 11 years of age had expiratory flow rates measured according to the standards of the American Thoracic Society. Values were converted to z-scores predicted for age, height, ethnicity, and sex. Parents completed questionnaires related to their child's respiratory health. A total of 142 children had expiratory flows measured. Expiratory flows were better in the caffeine group, by approximately 0.5 SD for most variables (e.g., FEV 1 ; mean z-score, -1.00 vs. -1.53; mean difference, 0.54; 95% confidence interval, 0.14-0.94; P = 0.008). Fewer children in the caffeine group had values for FVC below the fifth centile (11% vs. 28%; odds ratio, 0.31; 95% confidence interval, 0.12-0.77; P = 0.012). When adjusted for bronchopulmonary dysplasia, the difference in flow rates between groups diminished. Caffeine treatment in the newborn period improves expiratory flow rates in midchildhood, which seems to be achieved by improving respiratory health in the newborn period. Follow-up lung function testing in adulthood is vital for these individuals. Future placebo-controlled randomized trials of neonatal caffeine are unlikely. Clinical trial registered with www.clinicaltrials.gov (NCT00182312).

Numerical methods for limit problems in two-phase flow models

International Nuclear Information System (INIS)

Cordier, F.

2011-01-01

Numerical difficulties are encountered during the simulation of two-phase flows. Two issues are studied in this thesis: the simulation of phase transitions on one hand, and the simulation of both compressible and incompressible flows in the other hand. Un asymptotic study has shown that the loss of hyperbolicity of the bi fluid model was responsible for the difficulties encountered by the Roe scheme during the simulation of phase transitions. Robust and accurate polynomial schemes have thus been developed. To tackle the occasional lack of positivity of the solution, a numerical treatment based on adaptive diffusion was proposed and allowed to simulate with accuracy the test-cases of a boiling channel with creation of vapor and a tee-junction with separation of the phases. In a second part, an all-speed scheme for compressible and incompressible flows have been proposed. This pressure-based semi-implicit asymptotic preserving scheme is conservative, solves an elliptic equation on the pressure, and has been designed for general equations of state. The scheme was first developed for the full Euler equations and then extended to the Navier-Stokes equations. The good behaviour of the scheme in both compressible and incompressible regimes have been investigated. An extension of the scheme to the two-phase mixture model was implemented and demonstrated the ability of the scheme to simulate two-phase flows with phase change and a water-steam equation of state. (author) [fr

Spirometry and volumetric capnography in lung function assessment of obese and normal-weight individuals without asthma.

Science.gov (United States)

Ferreira, Mariana S; Mendes, Roberto T; Marson, Fernando A L; Zambon, Mariana P; Antonio, Maria A R G M; Paschoal, Ilma A; Toro, Adyléia A D C; Severino, Silvana D; Ribeiro, Maria A G O; Ribeiro, José D

To analyze and compare lung function of obese and healthy, normal-weight children and adolescents, without asthma, through spirometry and volumetric capnography. Cross-sectional study including 77 subjects (38 obese) aged 5-17 years. All subjects underwent spirometry and volumetric capnography. The evaluations were repeated in obese subjects after the use of a bronchodilator. At the spirometry assessment, obese individuals, when compared with the control group, showed lower values of forced expiratory volume in the first second by forced vital capacity (FEV 1 /FVC) and expiratory flows at 75% and between 25 and 75% of the FVC (p11 years (p<0.05). Even without the diagnosis of asthma by clinical criteria and without response to bronchodilator use, obese individuals showed lower FEV 1 /FVC values and forced expiratory flow, indicating the presence of an obstructive process. Volumetric capnography showed that obese individuals had higher alveolar tidal volume, with no alterations in ventilation homogeneity, suggesting flow alterations, without affecting lung volumes. Copyright © 2017 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

Peak flow as predictor of overall mortality in asthma and chronic obstructive pulmonary disease

DEFF Research Database (Denmark)

Hansen, Ejvind Frausing; Vestbo, Jørgen; Phanareth, K

2001-01-01

Lung function is a strong predictor of overall mortality in asthma and chronic obstructive pulmonary disease (COPD). FEV1 is considered to be the "gold standard," whereas peak expiratory flow (PEF) is mostly used in absence of FEV1 measurements. We compared the predictive power of PEF and FEV1......, measured after maximal bronchodilation, which included a short course of oral corticosteroids. The study population comprised 491 asthmatics and 1,095 subjects with COPD. Pulmonary function tests were performed between 1983 and 1988, and survival data were obtained by September 1997, when 127 asthmatics...... reflecting different components of COPD, i.e., chronic bronchitis, small airways disease, and emphysema. Furthermore, extrapulmonary components such as muscle mass and general "vigour" probably affect PEF to a greater extent than they affect FEV1....

Characteristics of turbulent particle transport in human airways under steady and cyclic flows

International Nuclear Information System (INIS)

Jedelsky, Jan; Lizal, Frantisek; Jicha, Miroslav

2012-01-01

Highlights: ► PDA data allow to estimate PSD of particle velocity fluctuations in realistic model. ► PSD of micron-sized particles is independent of their size up to 700 Hz. ► Such particles follow air flow and turb. diffusion contributes to their deposition. ► Cyclic flow PSDs contain more TKE at high freq. than equivalent steady-flow PSDs. ► Exp. breathing phase differs from insp. phase at high frequency part of the spectra. - Abstract: Motion of monodispersed aerosol particles suspended in air flow has been studied on realistic transparent model of human airways using Phase Doppler Particle Analyser (P/DPA). Time-resolved velocity data for particles in size range 1–8 μm were processed using Fuzzy Slotting Technique to estimate the power spectral density (PSD) of velocity fluctuations. The optimum processing setup for our data was found and recommendations for future experiments to improve PSD quality were suggested. Typical PSD plots at mainstream positions of the trachea and the upper bronchi are documented and differences among (1) steady-flow regimes and equivalent cyclic breathing regimes, (2) inspiration and expiration breathing phase and (3) behaviour of particles of different sizes are described in several positions of the airway model. Systematically higher level of velocity fluctuations in the upper part of the frequency range (30–500 Hz) was found for cyclic flows in comparison with corresponding steady flows. Expiratory flows in both the steady and cyclic cases produce more high-frequency fluctuations compared to inspiratory flows. Negligible differences were found for flow of particles in the inspected size range 1–8 μm at frequencies below 500 Hz. This finding was explained by Stokes number analysis. Implied match of the air and particle flows thereby indicates turbulent diffusion as important deposition mechanism and confirms the capability to use the P/DPA data as the air flow velocity estimate.

Clinical evidence on high flow oxygen therapy and active humidification in adults

Directory of Open Access Journals (Sweden)

C. Gotera

2013-09-01

Full Text Available Recently there has been growing interest in an alternative to conventional oxygen therapy: the heated, humidified high flow nasal cannula oxygen therapy (HFNC. A number of physiological effects have been described with HFNC: pharyngeal dead space washout, reduction of nasopharyngeal resistance, a positive expiratory pressure effect, an alveolar recruitment, greater humidification, more comfort and better tolerance by the patient, better control of FiO2 and mucociliary clearance. There is limited experience of HFNC in adults. There are no established guidelines or decision-making pathways to guide use of the HFNC therapy for adults. In this article we review the existing evidence of HFNC oxygen therapy in adult patients, its advantages, limitations and the current literature on clinical applications. Further research is required to determine the long-term effect of this therapy and identify the adult patient population to whom it is most beneficial. Resumo: Recentemente, uma alternativa à oxigenoterapia convencional tem recebido atenção crescente: trata-se da oxigenoterapia humidificada de alto débito com cânulas nasais (HFNC. Um número de efeitos fisiológicos têm sido descritos: «lavagem» do espaço morto faríngeo, redução da resistência da nasofarige, efeito tipo «CPAP», recrutamento alveolar, maior humidificação, maior conforto e melhor tolerância do doente, melhor controle do FiO2 e do «clearance» mucociliar. A experiência com HFNC em adultos ainda é limitada e de momento não há «guidelines» para o seu uso. Neste artigo revemos a evidência existente do uso da HFNC em adultos, as suas vantagens, limitações e a literatura mais recente sobre as suas aplicações clínicas. Mais investigação será necessária para determinar os efeitos a longo prazo desta terapêutica e identificar quais as populações em que é mais benéfica. Keywords: High flow nasal cannula, Non-invasive ventilation, Gas exchange, Respiratory

Simulation of gas compressible flow by free surface water flow

International Nuclear Information System (INIS)

Altafini, C.R.; Silva Ferreira, R.T. da

1981-01-01

The analogy between the water flow with a free surface and the compressible fluid flow, commonly called hydraulic analogy, is analyzed and its limitations are identified. The water table is the equipment used for this simulation, which allows the quatitative analysis of subsonic and supersonic flow with a low cost apparatus. The hydraulic analogy is applied to subsonic flow around circular cylinders and supersonic flow around cones. The results are compared with available theoretical and experimental data and a good agreement is achieved. (Author) [pt

[Micro-invasive embedding combined with montelukast sodium for children cough variant asthma:a randomized controlled trial].

Science.gov (United States)

Wang, Xiaoyan; Liu, Baoqin; Lu, Bin; Zhang, Yanmei; Wang, Liran; Li, Haijin; Han, Xue; Ding, Dan

2017-03-12

To observe the effects of micro-invasive embedding combined with montelukast sodium and simple montelukast sodium for children cough variant asthma (CVA). A total of 240 patients were randomly assigned into an observation group and a control group, 120 cases in each one. Considering of cases dropping, 101 patients in the observation group and 105 cases in the control group were included. Montelukast sodium chewable tablets were applied before sleep for 3 months in the control group, 5 mg a time, once a day. Based on the treatment as the control group, micro-invasive embedding was used for 3 months in the observation group, twice in the first month and once in the other two months. The acupoints were Feishu (BL 13), Danzhong (CV 17), Dingchuan (EX-B 1), and Zusanli (ST 36). Follow-up was conducted 9 months after treatment in the two groups. The cough score, serum immunoglobulin (IgE, IgG, IgA), platelet activating factor (PAF) were observed before and after treatment. The indices were compared before and after treatment and at follow-up, including pulmonary function indices[peak expiratory flow rate (PEF), forced expiratory volume at the 1st second (FEV1)], and small airway function indices[forced expiratory flow rate with remaining 25% vital capacity (MEF25%), forced expiratory flow rate with remaining 50% vital capacity (MEF50%), forced expiratory flow rate with remaining 75% vital capacity (MEF75%) and mid expiratory flow rate (MEF25%-75%)]. Also, the total effects were evaluated. ①The total effective rate in the observation group was 93.1% (94/101), which was better than 87.6% (92/105) in the control group ( P disappearance time of the cured children in the observation group was (10.38±2.64) d, and it was shorter than (10.72 ±2.60) d of those in the control group ( P 0.05). ④ There was no statistically significance before and after treatment on small airway function indices in the two groups (all P >0.05). The indices at follow-up increased compared with

Solubility limits on radionuclide dissolution

Energy Technology Data Exchange (ETDEWEB)

Kerrisk, J.F.

1984-12-31

This paper examines the effects of solubility in limiting dissolution rates of a number of important radionuclides from spent fuel and high-level waste. Two simple dissolution models were used for calculations that would be characteristics of a Yucca Mountain repository. A saturation-limited dissolution model, in which the water flowing through the repository is assumed to be saturated with each waste element, is very conservative in that it overestimates dissolution rates. A diffusion-limited dissolution model, in which element-dissolution rates are limited by diffusion of waste elements into water flowing past the waste, is more realistic, but it is subject to some uncertainty at this time. Dissolution rates of some elements (Pu, Am, Sn, Th, Zr, Sm) are always limited by solubility. Dissolution rates of other elements (Cs, Tc, Np, Sr, C, I) are never solubility limited; their release would be limited by dissolution of the bulk waste form. Still other elements (U, Cm, Ni, Ra) show solubility-limited dissolution under some conditions. 9 references, 3 tables.

External stent for repair of secondary tracheomalacia.

Science.gov (United States)

Johnston, M R; Loeber, N; Hillyer, P; Stephenson, L W; Edmunds, L H

1980-09-01

Tracheomalacia was created in anesthetized piglets by submucosal resection of 3 to 5 tracheal cartilages. Measurements of airway pressure and flow showed that expiratory airway resistance is maximal at low lung volumes and is significantly increased by creation of the malacic segment. Cervical flexion increases expiratory airway resistance, whereas hyperextension of the neck reduces resistance toward normal. External stenting of the malacic segment reduces expiratory airway resistance, and the combination of external stenting and hyperextension restores airway resistance to normal except at low lung volume. Two patients with secondary tracheomalacia required tracheostomy and could not be decannulated after the indication for the tracheostomy was corrected. Both were successfully decannulated after external stenting of the malacic segment with rib grafts. Postoperative measurements of expiratory pulmonary resistance show a marked decrease from preoperative measurements. External stenting of symptomatic tracheomalacia reduces expiratory airway resistance by supporting and stretching the malacic segment and is preferable to prolonged internal stenting or tracheal resection.

Impact of spinal anaesthesia on peri-operative lung volumes in obese and morbidly obese female patients.

Science.gov (United States)

Regli, A; von Ungern-Sternberg, B S; Reber, A; Schneider, M C

2006-03-01

Although obesity predisposes to postoperative pulmonary complications, data on the relationship between body mass index (BMI) and peri-operative respiratory performance are limited. We prospectively studied the impact of spinal anaesthesia, obesity and vaginal surgery on lung volumes measured by spirometry in 28 patients with BMI 30-40 kg.m(-2) and in 13 patients with BMI > or = 40 kg.m(-2). Vital capacity, forced vital capacity, forced expiratory volume in 1 s, mid-expiratory and peak expiratory flows were measured during the pre-operative visit (baseline), after effective spinal anaesthesia with premedication, and after the operation at 20 min, 1 h, 2 h, and 3 h (after mobilisation). Spinal anaesthesia and premedication were associated with a significant decrease in spirometric parameters. Spinal anaesthesia and premedication were associated with a significant decrease in spirometric parameters; mean (SD) vital capacities were - 19% (6.4) in patients with BMI 30-40 kg.m(-2) and - 33% (9.0) in patients with BMI > 40 kg.m(-2). The decrease of lung volumes remained constant for 2 h, whereas 3 h after the operation and after mobilisation, spirometric parameters significantly improved in all patients. This study showed that both spinal anaesthesia and obesity significantly impaired peri-operative respiratory function.

Externally Phase-Locked Flux Flow Oscillator for Submm Integrated Receivers; Achievements and Limitations

DEFF Research Database (Denmark)

Koshelets, V. P.; Shitov, S. V.; Dmitriev, P. N.

2003-01-01

A Josephson Flux Flow Oscillator (FFO) is the most developed superconducting local oscillator for integration with an SIS mixer in a single-chip submm-wave receiver. Recently, using a new FFO design, a free-running linewidth less than or equal to10 MHz has been measured in the frequency range up...... to 712 GHz, limited only by the gap frequency of Nb. This enabled us to phase lock the FFO in the frequency range 500-712 GHz where continuous frequency tuning is possible; resulting in an absolute FFO phase noise as low as -80 dBc at 707 GHz. Comprehensive measurements of the FFO radiation linewidth...... have been performed using an integrated SIS harmonic mixer. The influence of FFO parameters on radiation linewidth, particularly the effect of the differential resistances associated both with the bias current and the applied magnetic field has been studied in order to further optimize the FFO design...

[Study of personal best value of peak expiratory flow in patients with asthma--comparison of the highest value of daily PEF under good control and the highest value of daily PEF obtained after using repeated inhaled beta2-agonist during high-dose inhaled steroid treatment].

Science.gov (United States)

Watanabe, Naoto; Makino, Sohei; Kihara, Norio; Fukuda, Takeshi

2008-12-01

In the guideline for asthma management, it is important to find the personal best value of peak expiratory flow (best PEF). Recently, we have substituted the highest value of PEF in daily life under good control (daily highest PEF) for the best PEF. In the present study, we considered whether the daily highest PEF could be used as the best PEF or not. Subjects were 30 asthmatics who were well controlled but whose baseline PEF values were less than 80 percent of predicted values. We compared the daily highest PEF and the highest of PEF obtained after repeated inhaled beta2-agonist (salbutamol MDI every 20 minutes three times). All subjects then received 1600 microg/day of beclomethasone dipropionate (BDP) for 4 to 8 weeks. We studied the effect of high-dose inhaled steroid treatment on each PEF value and compared the daily highest PEF and the highest PEF obtained after using repeated salbutamol MDI during high dose inhaled steroid therapy on the examination day again. The baseline PEF, daily highest PEF and the highest PEF obtained after salbutamol MDI were significantly less than the each values obtained after high-dose BDP. The best PEF value of them was the value obtained after repeated salbutamol MDI during high dose BDP. We suggest that the daily highest PEF under good control is not a substitute for best PEF because it changes according to the degree of improvement of airway inflammation. We recommend that a course of high dose inhaled steroid is effective in finding the best value of PEF for each individual with moderate asthma.

Detection of T and B cells specific complement-fixing alloantibodies using flow cytometry: A diagnostic approach for a resource limited laboratory

Directory of Open Access Journals (Sweden)

Dharmendra Jain

2017-01-01

Conclusions: We postulate that this method incorporates most of the features of all the available modalities (i.e., National Institute of Health-complement dependent lymphocytotoxicity, FCXM, cytotoxic FCXM and C4d-flowPRA yet cost-effective and best suited for resource-limited laboratory/ies which is a common scenario in developing countries.

Confidence limits for regional cerebral blood flow values obtained with circular positron system, using krypton-77

International Nuclear Information System (INIS)

Meyer, E.; Yamamoto, Y.L.; Thompson, C.J.

1978-01-01

The 90% confidence limits have been determined for regional cerebral blood flow (rCBF) values obtained in each cm 2 of a cross section of the human head after inhalation of radioactive krypton-77, using the MNI circular positron emission tomography system (Positome). CBF values for small brain tissue elements are calculated by linear regression analysis on the semi-logarithmically transformed clearance curve. A computer program displays CBF values and their estimated error in numeric and gray scale forms. The following typical results have been obtained on a control subject: mean CBF in the entire cross section of the head: 54.6 + - 5 ml/min/100 g tissue, rCBF for small area of frontal gray matter: 75.8 + - 9 ml/min/100 g tissue. Confidence intervals for individual rCBF values varied between + - 13 and + - 55% except for areas pertaining to the ventricular system where particularly poor statistics have been obtained. Knowledge of confidence limits for rCBF values improves their diagnostic significance, particularly with respect to the assessment of reduced rCBF in stroke patients. A nomogram for convenient determination of 90% confidence limits for slope values obtained in linear regression analysis has been designed with the number of fitted points (n) and the correlation coefficient (r) as parameters. (author)

Limitations of radionuclide flow studies in bilateral carotid thrombosis

International Nuclear Information System (INIS)

Messert, B.; Tyson, I.B.; Barron, S.A.

1975-01-01

Radionuclide angiography as a noninvasive procedure has become an important tool in the evaluation of cerebrovascular diseases. Determinations of arm-to-brain circulation times complemented by the transit times of the radionuclide bolus through the brain afford insight into the functional status of the vascular system of the brain. Delays in perfusion, asymmetries in appearance, and washout of the radionuclide material can be correlated with disease entities. However, as with many procedures elevated to the status of a screening test, the possibility of false-positive and false-negative results exists. Two cases of bilateral carotid occlusion are presented, showing normal or only delayed, fairly symmetrical brain perfusion. The appearance of the radionuclide flow in the neck in AP and lateral views gave no suggestion of the involved deficits. Even multiple-projection imaging might fail to demonstrate major vascular obstructions. However, attentive study of these projections might yield interesting evidence of unexpected collateral flow systems. (U.S.)

Review of Constructed Subsurface Flow vs. Surface Flow Wetlands

International Nuclear Information System (INIS)

HALVERSON, NANCY

2004-01-01

The purpose of this document is to use existing documentation to review the effectiveness of subsurface flow and surface flow constructed wetlands in treating wastewater and to demonstrate the viability of treating effluent from Savannah River Site outfalls H-02 and H-04 with a subsurface flow constructed wetland to lower copper, lead and zinc concentrations to within National Pollutant Discharge Elimination System (NPDES) Permit limits. Constructed treatment wetlands are engineered systems that have been designed and constructed to use the natural functions of wetlands for wastewater treatment. Constructed wetlands have significantly lower total lifetime costs and often lower capital costs than conventional treatment systems. The two main types of constructed wetlands are surface flow and subsurface flow. In surface flow constructed wetlands, water flows above ground. Subsurface flow constructed wetlands are designed to keep the water level below the top of the rock or gravel media, thus minimizing human and ecological exposure. Subsurface flow wetlands demonstrate higher rates of contaminant removal per unit of land than surface flow (free water surface) wetlands, therefore subsurface flow wetlands can be smaller while achieving the same level of contaminant removal. Wetlands remove metals using a variety of processes including filtration of solids, sorption onto organic matter, oxidation and hydrolysis, formation of carbonates, formation of insoluble sulfides, binding to iron and manganese oxides, reduction to immobile forms by bacterial activity, and uptake by plants and bacteria. Metal removal rates in both subsurface flow and surface flow wetlands can be high, but can vary greatly depending upon the influent concentrations and the mass loading rate. Removal rates of greater than 90 per cent for copper, lead and zinc have been demonstrated in operating surface flow and subsurface flow wetlands. The constituents that exceed NPDES limits at outfalls H-02 a nd H

Defining a Ventilation Strategy for Flexible Bronchoscopy on Mechanically Ventilated Patients in the Medical Intensive Care Unit.

Science.gov (United States)

Greenstein, Yonatan Y; Shakespeare, Eric; Doelken, Peter; Mayo, Paul H

2017-07-01

Flexible bronchoscopy (FB) in intubated patients on mechanical ventilation increases airway resistance. During FB, two ventilatory strategies are possible: maintaining tidal volume (VT) while maintaining baseline CO2 or allowing reduction of VT. The former strategy carries risk of hyperinflation due to expiratory flow limitation with FB. The aim of the authors was too study end expiratory lung volume (EELV) during FB of intubated subjects while limiting VT. We studied 16 subjects who were intubated on mechanical ventilation and required FB. Changes in EELV were measured by respiratory inductance plethysmography. Ventilator mechanics, EELV, and arterial blood gases, were measured. FB insertions decreased EELV in 64% of cases (-325±371 mL) and increased it in 32% of cases (65±59 mL). Suctioning decreased EELV in 76% of cases (-120±104 mL) and increased it in 16% of cases (29±33 mL). Respiratory mechanics were unchanged. Pre-FB and post-FB, PaO2 decreased by 61±96 mm Hg and PaCO2 increased by 15±7 mm Hg. There was no clinically significant increase in EELV in any subject during FB. Decreases in EELV coincided with FB-suctioning maneuvers. Peak pressure limiting ventilation protected the subject against hyperinflation with a consequent, well-tolerated reduction in VT, and hypercapnea. Suctioning should be limited, especially in patients vulnerable to derecruitment effect.

Current limiter circuit system

Science.gov (United States)

Witcher, Joseph Brandon; Bredemann, Michael V.

2017-09-05

An apparatus comprising a steady state sensing circuit, a switching circuit, and a detection circuit. The steady state sensing circuit is connected to a first, a second and a third node. The first node is connected to a first device, the second node is connected to a second device, and the steady state sensing circuit causes a scaled current to flow at the third node. The scaled current is proportional to a voltage difference between the first and second node. The switching circuit limits an amount of current that flows between the first and second device. The detection circuit is connected to the third node and the switching circuit. The detection circuit monitors the scaled current at the third node and controls the switching circuit to limit the amount of the current that flows between the first and second device when the scaled current is greater than a desired level.

Flow visualization

International Nuclear Information System (INIS)

Weinstein, L.M.

1991-01-01

Flow visualization techniques are reviewed, with particular attention given to those applicable to liquid helium flows. Three techniques capable of obtaining qualitative and quantitative measurements of complex 3D flow fields are discussed including focusing schlieren, particle image volocimetry, and holocinematography (HCV). It is concluded that the HCV appears to be uniquely capable of obtaining full time-varying, 3D velocity field data, but is limited to the low speeds typical of liquid helium facilities. 8 refs

Study of counter current flow limitation model of MARS-KS and SPACE codes under Dukler's air/water flooding test conditions

International Nuclear Information System (INIS)

Lee, Won Woong; Kim, Min Gil; Lee, Jeong Ik; Bang, Young Seok

2015-01-01

In particular, CCFL(the counter current flow limitation) occurs in components such as hot leg, downcomer annulus and steam generator inlet plenum during LOCA which is possible to have flows in two opposite directions. Therefore, CCFL is one of the thermal-hydraulic models which has significant effect on the reactor safety analysis code performance. In this study, the CCFL model will be evaluated with MARS-KS based on two-phase two-field governing equations and SPACE code based on two-phase three-field governing equations. This study will be conducted by comparing MARS-KS code which is being used for evaluating the safety of a Korean Nuclear Power Plant and SPACE code which is currently under assessment for evaluating the safety of the designed nuclear power plant. In this study, comparison of the results of liquid upflow and liquid downflow rate for different gas flow rate from two code to the famous Dukler's CCFL experimental data are presented. This study will be helpful to understand the difference between system analysis codes with different governing equations, models and correlations, and further improving the accuracy of system analysis codes. In the nuclear reactor system, CCFL is an important phenomenon for evaluating the safety of nuclear reactors. This is because CCFL phenomenon can limit injection of ECCS water when CCFL occurs in components such as hot leg, downcomer annulus or steam generator inlet plenum during LOCA which is possible to flow in two opposite directions. Therefore, CCFL is one of the thermal-hydraulic models which has significant effect on the reactor safety analysis code performance. In this study, the CCFL model was evaluated with MARS-KS and SPACE codes for studying the difference between system analysis codes with different governing equations, models and correlations. This study was conducted by comparing MARS-KS and SPACE code results of liquid upflow and liquid downflow rate for different gas flow rate to the famous Dukler

The flow field structure of highly stabilized partially premixed flames in a concentric flow conical nozzle burner with coflow

KAUST Repository

Elbaz, Ayman M.

2015-08-29

The stability limits, the stabilization mechanism, and the flow field structure of highly stabilized partially premixed methane flames in a concentric flow conical nozzle burner with air co-flow have been investigated and presented in this work. The stability map of partial premixed flames illustrates that the flames are stable between two extinction limits. A low extinction limit when partial premixed flames approach non-premixed flame conditions, and a high extinction limit, with the partial premixed flames approach fully premixed flame conditions. These two limits showed that the most stable flame conditions are achieved at a certain degree of partial premixed. The stability is improved by adding air co-flow. As the air co-flow velocity increases the most stable flames are those that approach fully premixed. The turbulent flow field of three flames at 0, 5, 10 m/s co-flow velocity are investigated using Stereo Particle Image Velocimetry (SPIV) in order to explore the improvement of the flame stability due to the use of air co-flow. The three flames are all at a jet equivalence ratio (Φj) of 2, fixed level of partial premixing and jet Reynolds number (Rej) of 10,000. The use of co-flow results in the formation of two vortices at the cone exit. These vortices act like stabilization anchors for the flames to the nozzle tip. With these vortices in the flow field, the reaction zone shifts toward the reduced turbulence intensity at the nozzle rim of the cone. Interesting information about the structure of the flow field with and without co-flow are identified and reported in this work.

Scaling laws, renormalization group flow and the continuum limit in non-compact lattice QED

International Nuclear Information System (INIS)

Goeckeler, M.; Horsley, R.; Rakow, P.; Schierholz, G.; Sommer, R.

1992-01-01

We investigate the ultra-violet behavior of non-compact lattice QED with light staggered fermions. The main question is whether QED is a non-trivial theory in the continuum limit, and if not, what is its range of validity as a low-energy theory. Perhaps the limited range of validity could offer an explanation of why the fine-structure constant is so small. Non-compact QED undergoes a second-order chiral phase transition at strong coupling, at which the continuum limit can be taken. We examine the phase diagram and the critical behavior of the theory in detail. Moreover, we address the question as to whether QED confines in the chirally broken phase. This is done by investigating the potential between static external charges. We then compute the renormalized charge and derive the Callan-Symanzik β-function in the critical region. No ultra-violet stable zero is found. Instead, we find that the evolution of charge is well described by renormalized perturbation theory, and that the renormalized charge vanishes at the critical point. The consequence is that QED can only be regarded as a cut-off theory. We evaluate the maximum value of the cut-off as a function of the renormalized charge. Next, we compute the masses of fermion-antifermion composite states. The scaling behavior of these masses is well described by an effective action with mean-field critical exponents plus logarithmic corrections. This indicates that also the matter sector of the theory is non-interacting. Finally, we investigate and compare the renormalization group flow of different quantities. Altogether, we find that QED is a valid theory only for samll renormalized charges. (orig.)

One-dimensional two-fluid model for wavy flow beyond the Kelvin–Helmholtz instability: Limit cycles and chaos

Energy Technology Data Exchange (ETDEWEB)

Lopez de Bertodano, Martín, E-mail: bertodan@purdue.edu [School of Nuclear Engineering, Purdue University, West Lafayette, IN 47907 (United States); Fullmer, William D. [Department of Chemical and Biological Engineering, U. of Colorado, Boulder, CO 80309 (United States); Clausse, Alejandro [CNEA-CONICET and Universidad Nacional del Centro, 7000 Tandil (Argentina)

2016-12-15

A 1D TFM numerical simulation of near horizontal stratified two-phase flow is performed where the TFM, including surface tension and viscous stresses, is simplified to a two-equation model using the fixed-flux approximation. As the angle of inclination of the channel increases so does the driving body force, so the flow becomes KH unstable, and waves grow and develop nonlinearities. It is shown that these waves grow until they reach a limit cycle due to viscous dissipation at wave fronts. Upon further inclination of the channel, chaos is observed. The appearance of chaos in a 1D TFM implies a nonlinear process that transfers energy intermittently from long wavelengths where energy is produced to short wavelengths where energy is dissipated by viscosity, so that an averaged energy equilibrium in frequency space is attained. This is comparable to the well-known turbulent stability mechanism of the multi-dimensional Navier–Stokes equations, i.e., chaos implies Lyapunov stability, but in this case it is strictly a two-phase phenomenon.

Positive Rates and Factors Associated with Abnormal Lung Function of Greenhouse Workers in China: A Cross-Sectional Study.

Science.gov (United States)

Zhu, Xiaojun; Gao, Panjun; Gu, Yishuo; Xiao, Pei; Liu, Mengxuan; Chen, Juan; Cen, Yacai; Ma, Wenjun; Li, Tao

2017-08-24

Since the number of greenhouse workers are increasing in China, this observational cross-sectional study was designed to evaluate lung function and discuss the potential risk factors, to provide evidence in the surveillance of greenhouse workers' health. 678 greenhouse workers in Gansu Province, China were enrolled. A questionnaire which included demographic and occupational information was used. Vital capacity (VC), forced vital capacity (FVC), forced expiratory volume in 1 s (FEV₁), and FEV₁:FVC ratios (FEV₁/FVC), maximal expiratory flow after 50% of the FVC has not been exhaled (MEF 50 ), maximal expiratory flow after 25% of the FVC has not been exhaled (MEF 25 ) and maximal mid-expiratory flow curve (MMEF) were measured as lung function indicators. The mean values and standard deviations (SDs) of VC% predicted, FVC% predicted, FEV₁% predicted and FEV₁/FVC ratio were 106.07 ± 13.36, 107.60 ± 13.95, 97.19 ± 14.80 and 89.76 ± 10.78 respectively. The positive rates of above four and abnormal lung ventilation function were 2.9%, 2.8%, 11.2%, 4.6% and 6.5% respectively. Gender, age, BMI and number of greenhouses owned were influence factors of lung ventilation function ( p greenhouses owned were influence factors for small airway function ( p greenhouse might influence lung function of the workers. Small airway function indicators could be used as priority indicators for the surveillance of greenhouse workers' health.

Effects of inspiratory muscle training on pulmonary function, respiratory muscle strength and functional capacity in patients with atrial fibrillation: a randomized controlled trial.

Science.gov (United States)

Zeren, Melih; Demir, Rengin; Yigit, Zerrin; Gurses, Hulya N

2016-12-01

To investigate the effects of inspiratory muscle training on pulmonary function, respiratory muscle strength and functional capacity in patients with atrial fibrillation. Prospective randomized controlled single-blind study. Cardiology department of a university hospital. A total of 38 patients with permanent atrial fibrillation were randomly allocated to either a treatment group (n = 19; age 66.2 years (8.8)) or a control group (n = 19; age 67.1 years (6.4)). The training group received inspiratory muscle training at 30% of maximal inspiratory pressure for 15 minutes twice a day, 7 days a week, for 12 weeks alongside the standard medical treatment. The control group received standard medical treatment only. Spirometry, maximal inspiratory and expiratory pressures and 6-minute walking distance was measured at the beginning and end of the study. There was a significant increase in maximal inspiratory pressure (27.94 cmH 2 O (8.90)), maximal expiratory pressure (24.53 cmH 2 O (10.34)), forced vital capacity (10.29% (8.18) predicted), forced expiratory volume in one second (13.88% (13.42) predicted), forced expiratory flow 25%-75% (14.82% (12.44) predicted), peak expiratory flow (19.82% (15.62) predicted) and 6-minute walking distance (55.53 m (14.13)) in the training group (p  0.05). Inspiratory muscle training can improve pulmonary function, respiratory muscle strength and functional capacity in patients with atrial fibrillation. © The Author(s) 2016.

Influência da técnica de pressão expiratória positiva oscilante utilizando pressões expiratórias pré-determinadas na viscosidade e na transportabilidade do escarro em pacientes com bronquiectasia Influence that oscillating positive expiratory pressure using predetermined expiratory pressures has on the viscosity and transportability of sputum in patients with bronchiectasis

Directory of Open Access Journals (Sweden)

Ercy Mara Cipulo Ramos

2009-12-01

Full Text Available OBJETIVO: Verificar a efetividade da técnica de pressão expiratória positiva oscilante (PEPO utilizando pressões expiratórias pré-determinadas sobre a viscosidade e a transportabilidade do escarro em pacientes com bronquiectasia. MÉTODOS: Foram incluídos no estudo 15 pacientes estáveis com bronquiectasia (7 homens; média de idade = 53 ± 16 anos, submetidos a duas intervenções PEPO consecutivas, com 24 h de intervalo entre si, utilizando pressões expiratórias de 15 cmH2O (P15 e 25 cmH2O (P25. O protocolo consistiu de tosse voluntária; nova expectoração voluntária após 20 min, denominado tempo zero (T0; repouso de 10 min; e utilização da técnica em duas séries de 10 min (S1 e S2 de PEPO em P15 e P25, com intervalo de 10 min entre si. A viscosidade e transportabilidade do escarro foram avaliadas pela viscosimetria, velocidade relativa de transporte no palato de rã, deslocamento em máquina simuladora de tosse e ângulo de adesão. As amostras de escarro foram coletadas em T0, após S1 e após S2. Testes estatísticos específicos foram aplicados de acordo com a distribuição dos dados. RESULTADOS: Houve diminuição significante da viscosidade do escarro após S1 em P15 e após S2 em P25. Não houve diferenças significantes entre todas as amostras para a transportabilidade. CONCLUSÕES: Houve diminuição da viscosidade do escarro quando a PEPO foi realizada em P15 e P25, o que sugere que não seja necessário gerar alta pressão expiratória para obter o resultado desejado.OBJECTIVE: To determine the effectiveness of oscillating positive expiratory pressure (OPEP using predetermined expiratory pressures on the viscosity and transportability of sputum in patients with bronchiectasis. METHODS: The study involved 15 stable patients with bronchiectasis (7 males; mean age = 53 ± 16 years, submitted to two consecutive OPEP interventions, with a 24-h interval between the two, using positive expiratory pressures set at 15 cmH2O

Chest physiotherapy with positive expiratory pressure breathing after abdominal and thoracic surgery: a systematic review.

Science.gov (United States)

Orman, J; Westerdahl, E

2010-03-01

A variety of chest physiotherapy techniques are used following abdominal and thoracic surgery to prevent or reduce post-operative complications. Breathing techniques with a positive expiratory pressure (PEP) are used to increase airway pressure and improve pulmonary function. No systematic review of the effects of PEP in surgery patients has been performed previously. The purpose of this systematic review was to determine the effect of PEP breathing after an open upper abdominal or thoracic surgery. A literature search of randomised-controlled trials (RCT) was performed in five databases. The trials included were systematically reviewed by two independent observers and critically assessed for methodological quality. We selected six RCT evaluating the PEP technique performed with a mechanical device in spontaneously breathing adult patients after abdominal or thoracic surgery via thoracotomy. The methodological quality score varied between 4 and 6 on the Physiotherapy Evidence Database score. The studies were published between 1979 and 1993. Only one of the included trials showed any positive effects of PEP compared to other breathing techniques. Today, there is scarce scientific evidence that PEP treatment is better than other physiotherapy breathing techniques in patients undergoing abdominal or thoracic surgery. There is a lack of studies investigating the effect of PEP over placebo or no physiotherapy treatment.

Simulation of late inspiratory rise in airway pressure during pressure support ventilation.

Science.gov (United States)

Yu, Chun-Hsiang; Su, Po-Lan; Lin, Wei-Chieh; Lin, Sheng-Hsiang; Chen, Chang-Wen

2015-02-01

Late inspiratory rise in airway pressure (LIRAP, Paw/ΔT) caused by inspiratory muscle relaxation or expiratory muscle contraction is frequently seen during pressure support ventilation (PSV), although the modulating factors are unknown. We investigated the effects of respiratory mechanics (normal, obstructive, restrictive, or mixed), inspiratory effort (-2, -8, or -15 cm H2O), flow cycle criteria (5-40% peak inspiratory flow), and duration of inspiratory muscle relaxation (0.18-0.3 s) on LIRAP during PSV using a lung simulator and 4 types of ventilators. LIRAP occurred with all lung models when inspiratory effort was medium to high and duration of inspiratory muscle relaxation was short. The normal lung model was associated with the fastest LIRAP, whereas the obstructive lung model was associated with the slowest. Unless lung mechanics were normal or mixed, LIRAP was unlikely to occur when inspiratory effort was low. Different ventilators were also associated with differences in LIRAP speed. Except for within the restrictive lung model, changes in flow cycle level did not abolish LIRAP if inspiratory effort was medium to high. Increased duration of inspiratory relaxation also led to the elimination of LIRAP. Simulation of expiratory muscle contraction revealed that LIRAP occurred only when expiratory muscle contraction occurred sometime after the beginning of inspiration. Our simulation study reveals that both respiratory resistance and compliance may affect LIRAP. Except for under restrictive lung conditions, LIRAP is unlikely to be abolished by simply lowering flow cycle criteria when inspiratory effort is strong and relaxation time is rapid. LIRAP may be caused by expiratory muscle contraction when it occurs during inspiration. Copyright © 2015 by Daedalus Enterprises.

Pilot study for home monitoring of cough capacity in amyotrophic lateral sclerosis: A case series.

Science.gov (United States)

Paneroni, M; Trainini, D; Winck, J C; Vitacca, M

2014-01-01

Cough capacity derangement is associated with a high risk of pulmonary complications in amyotrophic lateral sclerosis patients when cough assistance is not routinely performed at home. The primary aim of this study was to evaluate the feasibility of a long-term home based daily self-monitoring cough capacity. Eighteen subjects were enrolled in a 9-month study at home. Changes in peak cough expiratory flow, oxygen saturation, respiratory discomfort and incidence of respiratory deterioration events were evaluated. In subjects presenting respiratory deterioration events, decline in the abovementioned respiratory variables was evaluated (#NCT00613899). During an average follow-up of 125±102 days, a total of 1175 measures were performed on 12 subjects. Mean compliance to proposed evaluations was 37±32% which worsened over time. Peak cough expiratory flow decreased by 15.08±32.43L/min monthly. Five subjects reported 6 episodes of respiratory deterioration events, after a mean period of 136±108 days. They had poor respiratory function and more years of disease. There was no difference in peak cough expiratory flow and its decline whether subjects presented respiratory deterioration events or not. In 4 subjects the respiratory discomfort score significantly worsened after respiratory deterioration events from 3.0±1.41 to 4.25±1.71. Daily self-monitoring of peak cough expiratory flow, oxygen saturation and respiratory discomfort seems difficult to obtain because of poor adherence to measures; this protocol does not seem to add anything to current practice of advising on clinical derangements. Confirmatory larger studies are necessary. Copyright © 2013 Sociedade Portuguesa de Pneumologia. Published by Elsevier España. All rights reserved.

Knowledge, attitude and practice of physicians toward peak ...

African Journals Online (AJOL)

Background: Peak expiratory flow meter (PEFM) may reduce diagnostic delay and improve decision-making in asthma by providing an objective assessment of their flow and hence identify air flow variability that is essential for management of air way diseases. Objectives: This study was designed to reveal extent of ...

Prevalence of asthma with airflow limitation, COPD, and COPD with variable airflow limitation in older subjects in a general Japanese population: the Hisayama Study.

Science.gov (United States)

Matsumoto, Koichiro; Seki, Nanae; Fukuyama, Satoru; Moriwaki, Atsushi; Kan-o, Keiko; Matsunaga, Yuko; Noda, Naotaka; Yoshida, Makoto; Koto, Hiroshi; Takata, Shohei; Nakanishi, Yoichi; Kiyohara, Yutaka; Inoue, Hiromasa

2015-01-01

Elucidating the prevalence of asthma and chronic obstructive pulmonary disease (COPD) is important for designing a public health strategy. Recent studies have discriminated a phenotype of COPD with variable airflow limitation (COPD-VAL) associated with asthma-COPD overlap syndrome. Its prevalence remains uncertain. The age and occupational distributions in the town of Hisayama and in Japan are nearly identical. Each disease's prevalence was estimated for the town's residents. In 2008, town residents (≥ 40 years) were solicited to participate in a health checkup. Individuals with abnormal spirometry (forced expiratory volume in 1s/forced vital capacity [FEV1/FVC]fashion reviewed their medical records, including bronchodilator reversibility. Individuals with airflow limitation were classified as having asthma, COPD, COPD-VAL, or other diseases. The prevalence of each disease was then estimated. A total of 2100 residents (43.4% of residents in the age group) completed spirometry. In 455 residents with abnormal spirometry, 190 residents had further evaluations, and the medical records of 174 residents were reviewed. The prevalence of asthma with airflow limitation, COPD, and COPD-VAL, were 2.0%, 8.4%, and 0.9%, respectively. The prevalence of COPD and COPD-VAL were higher in men and smokers than in women and never-smokers. The prevalence of COPD, but not COPD-VAL or asthma, increased with age. The prevalence of asthma with airflow limitation, COPD, and COPD-VAL were estimated in a population of residents (≥ 40 years) in Hisayama. Copyright © 2014 The Japanese Respiratory Society. Published by Elsevier B.V. All rights reserved.

Pedestrian Flow in the Mean Field Limit

KAUST Repository

Haji Ali, Abdul Lateef

2012-11-01

We study the mean-field limit of a particle-based system modeling the behavior of many indistinguishable pedestrians as their number increases. The base model is a modified version of Helbing\\'s social force model. In the mean-field limit, the time-dependent density of two-dimensional pedestrians satisfies a four-dimensional integro-differential Fokker-Planck equation. To approximate the solution of the Fokker-Planck equation we use a time-splitting approach and solve the diffusion part using a Crank-Nicholson method. The advection part is solved using a Lax-Wendroff-Leveque method or an upwind Backward Euler method depending on the advection speed. Moreover, we use multilevel Monte Carlo to estimate observables from the particle-based system. We discuss these numerical methods, and present numerical results showing the convergence of observables that were calculated using the particle-based model as the number of pedestrians increases to those calculated using the probability density function satisfying the Fokker-Planck equation.

Mask Ventilation during Induction of General Anesthesia: Influences of Obstructive Sleep Apnea.

Science.gov (United States)

Sato, Shin; Hasegawa, Makoto; Okuyama, Megumi; Okazaki, Junko; Kitamura, Yuji; Sato, Yumi; Ishikawa, Teruhiko; Sato, Yasunori; Isono, Shiroh

2017-01-01

Depending on upper airway patency during anesthesia induction, tidal volume achieved by mask ventilation may vary. In 80 adult patients undergoing general anesthesia, the authors tested a hypothesis that tidal volume during mask ventilation is smaller in patients with sleep-disordered breathing priorly defined as apnea hypopnea index greater than 5 per hour. One-hand mask ventilation with a constant ventilator setting (pressure-controlled ventilation) was started 20 s after injection of rocuronium and maintained for 1 min during anesthesia induction. Mask ventilation efficiency was assessed by the breath number needed to initially exceed 5 ml/kg ideal body weight of expiratory tidal volume (primary outcome) and tidal volumes (secondary outcomes) during initial 15 breaths (UMIN000012494). Tidal volume progressively increased by more than 70% in 1 min and did not differ between sleep-disordered breathing (n = 42) and non-sleep-disordered breathing (n = 38) patients. In post hoc subgroup analyses, the primary outcome breath number (mean [95% CI], 5.7 [4.1 to 7.3] vs. 1.7 [0.2 to 3.2] breath; P = 0.001) and mean tidal volume (6.5 [4.6 to 8.3] vs. 9.6 [7.7 to 11.4] ml/kg ideal body weight; P = 0.032) were significantly smaller in 20 sleep-disordered breathing patients with higher apnea hypopnea index (median [25th to 75th percentile]: 21.7 [17.6 to 31] per hour) than in 20 non-sleep disordered breathing subjects with lower apnea hypopnea index (1.0 [0.3 to 1.5] per hour). Obesity and occurrence of expiratory flow limitation during one-hand mask ventilation independently explained the reduction of efficiency of mask ventilation, while the use of two hands effectively normalized inefficient mask ventilation during one-hand mask ventilation. One-hand mask ventilation is difficult in patients with obesity and severe sleep-disordered breathing particularly when expiratory flow limitation occurs during mask ventilation.

Doppler ultrasonographic measurement of short-term effects of valsalva maneuver on retrobulbar blood flow.

Science.gov (United States)

Kimyon, Sabit; Mete, Ahmet; Mete, Alper; Mete, Duçem

2017-11-12

To investigate the effects of Valsalva maneuver (VM) on retrobulbar blood flow parameters in healthy subjects. Participants without any ophthalmologic or systemic pathology were examined in supine position with color and pulsed Doppler imaging for blood flow measurement, via a paraocular approach, in the ophthalmic artery (OA), central retinal artery (CRA), central retinal vein (CRV), nasal posterior ciliary artery (NPCA), and temporal posterior ciliary artery (TPCA), 10 seconds after a 35- to 40-mm Hg expiratory pressure was reached. Peak systolic velocity (PSV), end-diastolic velocity (EDV), pulsatility index (PI), and resistivity index (RI) values were recorded for each artery. PSV and EDV values were recorded for CRV. There were significant differences between resting and VM values of PSV and EDV of CRA, RI of NPCA, and PI, RI, and EDV of TPCA. Resting CRA-EDV, CRV-PSV, and CRV-EDV were positively correlated whereas resting OA-PSV and CRA-PI, and OA-PSV, CRA-PSV, and CRA-EDV during VM, were negatively correlated with age. VM induces a short-term increase in CRA blood flow and a decrease in NPCA and TPCA RI. Additional studies with a longer Doppler recording during VM, in a larger population sample, are required to allow definitive interpretation. © 2017 Wiley Periodicals, Inc. J Clin Ultrasound 45:551-555, 2017. © 2017 Wiley Periodicals, Inc.

End-tidal control vs. manually controlled minimal-flow anesthesia: a prospective comparative trial.

Science.gov (United States)

Wetz, A J; Mueller, M M; Walliser, K; Foest, C; Wand, S; Brandes, I F; Waeschle, R M; Bauer, M

2017-11-01

To ensure safe general anesthesia, manually controlled anesthesia requires constant monitoring and numerous manual adjustments of the gas dosage, especially for low- and minimal-flow anesthesia. Oxygen flow-rate and administration of volatile anesthetics can also be controlled automatically by anesthesia machines using the end-tidal control technique, which ensures constant end-tidal concentrations of oxygen and anesthetic gas via feedback and continuous adjustment mechanisms. We investigated the hypothesis that end-tidal control is superior to manually controlled minimal-flow anesthesia (0.5 l/min). In this prospective trial, we included 64 patients undergoing elective surgery under general anesthesia. We analyzed the precision of maintenance of the sevoflurane concentration (1.2-1.4%) and expiratory oxygen (35-40%) and the number of necessary adjustments. Target-concentrations of sevoflurane and oxygen were maintained at more stable levels with the use of end-tidal control (during the first 15 min 28% vs. 51% and from 15 to 60 min 1% vs. 19% deviation from sevoflurane target, P tidal oxygen (5, IQR 3-6). The target-concentrations were reached earlier with the use of end-tidal compared with manual controlled minimal-flow anesthesia but required slightly greater use of anesthetic agents (6.9 vs. 6.0 ml/h). End-tidal control is a superior technique for setting and maintaining oxygen and anesthetic gas concentrations in a stable and rapid manner compared with manual control. Consequently, end-tidal control can effectively support the anesthetist. © 2017 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

Suppression of the sonic heat transfer limit in high-temperature heat pipes

Science.gov (United States)

Dobran, Flavio

1989-08-01

The design of high-performance heat pipes requires optimization of heat transfer surfaces and liquid and vapor flow channels to suppress the heat transfer operating limits. In the paper an analytical model of the vapor flow in high-temperature heat pipes is presented, showing that the axial heat transport capacity limited by the sonic heat transfer limit depends on the working fluid, vapor flow area, manner of liquid evaporation into the vapor core of the evaporator, and lengths of the evaporator and adiabatic regions. Limited comparisons of the model predictions with data of the sonic heat transfer limits are shown to be very reasonable, giving credibility to the proposed analytical approach to determine the effect of various parameters on the axial heat transport capacity. Large axial heat transfer rates can be achieved with large vapor flow cross-sectional areas, small lengths of evaporator and adiabatic regions or a vapor flow area increase in these regions, and liquid evaporation in the evaporator normal to the main flow.

A single photon emission computed tomograph based on a limited dumber of detectors for fluid flow visualization; Tomographie d'emission gamma a partir d'un nombre limite de detecteurs appliquee a la visualisation d'ecoulements

Energy Technology Data Exchange (ETDEWEB)

Legoupil, S

1999-07-01

We present in this work a method for fluid flow visualization in a system using radioactive tracers. The method is based on single photon emission computed tomography techniques, applied to a limited number of discrete detectors. We propose in this work a method for the estimation of the transport matrix of photons, associated to the acquisition system.This method is based on the modelization of profiles acquired for a set of point sources located in the imaged volume. Monte Carlo simulations allow to separate scattered photons from those directly collected by the system. The influence of the energy tracer is exposed. The reconstruction method is based on the maximum likelihood - expectation maximization algorithm. An experimental device, based on 36 detectors was realised for the visualization of water circulation in a vessel. A video monitoring allows to visualize the dye water tracer. Dye and radioactive tracers are injected simultaneously in a water flow circulating in the vessel. Reconstructed and video images are compared. Quantitative and qualitative analysis show that fluid flow visualization is feasible with a limited number of detectors. This method can be applied for system involving circulations of fluids. (author)

Blood flow and vascular reactivity during attacks of classic migraine--limitations of the Xe-133 intraarterial technique

DEFF Research Database (Denmark)

Skyhøj Olsen, T; Lassen, N A

1989-01-01

. The Xenon-133 intraarterial injection technique was used to measure CBF. In this study, based in part on previously published data, methodological limitations, in particular caused by scattered radiation (Compton scatter), are critically analysed. Based on this analysis and the results of the CBF studies...... it is concluded: During CM attacks CBF appears to decrease focally in the posterior part of the brain to a level around 20 ml/100 g/min which is consistent with a mild degree of ischemia. Changes of CBF in focal low flow areas are difficult to evaluate accurately with the Xe-133 technique. In most cases true CBF...

Performance of intact and partially degraded concrete barriers in limiting fluid flow

International Nuclear Information System (INIS)

Walton, J.C.; Seitz, R.R.

1991-07-01

Concrete barriers will play a critical role in the long-term isolation of low-level radioactive wastes. Over time the barriers will degrade, and in many cases, the fundamental processes controlling performance of the barriers will be different for intact and degraded conditions. This document examines factors controlling fluid flow through intact and degraded concrete disposal facilities. Simplified models are presented fro predicting build up of fluid above a vault; fluid flow through and around intact vaults, through flaws in coatings/liners applied to a vault, and through cracks in a concrete vault; and the influence of different backfill materials around the outside of the vault. Example calculations are presented to illustrate the parameters and processes that influence fluid flow. 46 refs., 49 figs., 2 tabs

Eficácia da eletroestimulação muscular expiratória na tosse de pacientes após acidente vascular encefálico Effectiveness of electrical stimulation in expiratory muscle on cough of patients after stroke

Directory of Open Access Journals (Sweden)

André Luís Ferreira de Meireles

2012-12-01

recruitment in many muscle groups and pathologies. The present study aimed to evaluate the efficiency of electrical stimulation with median frequencies (ETMF in expiratory muscles strength and cough in patients with sequels of stroke. It is a quasi-experimental study (before and after where 11 individuals were selected after stroke between 40 and 65 years, both sexes and hemodynamically stable. Patients were evaluated about clinic and respiratory scores (ventilometer, peak of expiratory flow (PEF and manometer (MIP and MEP and submitted to the protocol, which consisted of ETMF in expiratory muscle (abdominals rectus with the unit of Russian current with 2,500 Hz carrier frequency modulated at 40 Hz for 15 minutes by 15 sessions. In the initial assessment evidenced decreasing in inspiratory and expiratory muscular strength (MIP, MEP and PEF when compared to predicted values in literature. In the end of ETMF it happened an increase in MIP, MEP without statistical significance (p=0.18 and p=0.29 but the PEF has had an increase of 283.73 L/minute to 347.27 L/minute (p=0.03. It can be seen that the ETMF was effective in the improvement of the parameters evaluated, with PEF being the greatest impact and statistical significance, however further studies with larger populations are necessary to analyze this new therapeutic approach.

MR flow measurements for assessment of the pulmonary, systemic and bronchosystemic circulation: Impact of different ECG gating methods and breathing schema

International Nuclear Information System (INIS)

Ley, Sebastian; Ley-Zaporozhan, Julia; Kreitner, Karl-Friedrich; Iliyushenko, Svitlana; Puderbach, Michael; Hosch, Waldemar; Wenz, Heiner; Schenk, Jens-Peter; Kauczor, Hans-Ulrich

2007-01-01

Purpose: Different ECG gating techniques are available for MR phase-contrast (PC) flow measurements. Until now no study has reported the impact of different ECG gating techniques on quantitative flow parameters. The goal was to evaluate the impact of the gating method and the breathing schema on the pulmonary, systemic and bronchosystemic circulation. Material and methods: Twenty volunteers were examined (1.5 T) with free breathing phase-contrast flow (PC-flow) measurements with prospective (free-prospective) and retrospective (free-retrospective) ECG gating. Additionally, expiratory breath-hold retrospective ECG gated measurements (bh-retrospective) were performed. Blood flow per minute; peak velocity and time to peak velocity were compared. The clinically important difference between the systemic and pulmonary circulation (bronchosystemic shunt) was calculated. Results: Blood flow per minute was lowest for free-prospective (6 l/min, pulmonary trunc) and highest for bh-retrospective measurements (6.9 l/min, pulmonary trunc). No clinically significant difference in peak velocity was assessed (82-83 cm/s pulmonary trunc, 109-113 cm/s aorta). Time to peak velocity was shorter for retro-gated free-retrospective and bh-retrospective than for pro-gated free-prospective. The difference between systemic and pulmonary measurements was least for the free-retrospective technique. Conclusion: The type of gating has a significant impact on flow measurements. Therefore, it is important to use the same ECG gating method, especially for follow-up examinations. Retrospective ECG gated free breathing measurements allow for the most precise assessment of the bronchosystemic blood flow and should be used in clinical routine

Analysis of Limit Cycle Oscillation/Transonic High Alpha Flow Visualization. Part 1: Discussion

National Research Council Canada - National Science Library

Cunningham, Atlee M

1998-01-01

...) at low alpha conditions typical of transonic LCO flows with and without tip stores. Laser light sheet/water vapor techniques were used to illuminate the flows, and video recording was used to obtain the data...

Fluid flow nozzle energy harvesters

Science.gov (United States)

Sherrit, Stewart; Lee, Hyeong Jae; Walkemeyer, Phillip; Winn, Tyler; Tosi, Luis Phillipe; Colonius, Tim

2015-04-01

Power generation schemes that could be used downhole in an oil well to produce about 1 Watt average power with long-life (decades) are actively being developed. A variety of proposed energy harvesting schemes could be used to extract energy from this environment but each of these has their own limitations that limit their practical use. Since vibrating piezoelectric structures are solid state and can be driven below their fatigue limit, harvesters based on these structures are capable of operating for very long lifetimes (decades); thereby, possibly overcoming a principle limitation of existing technology based on rotating turbo-machinery. An initial survey [1] identified that spline nozzle configurations can be used to excite a vibrating piezoelectric structure in such a way as to convert the abundant flow energy into useful amounts of electrical power. This paper presents current flow energy harvesting designs and experimental results of specific spline nozzle/ bimorph design configurations which have generated suitable power per nozzle at or above well production analogous flow rates. Theoretical models for non-dimensional analysis and constitutive electromechanical model are also presented in this paper to optimize the flow harvesting system.

Klystron - Space-charge limited flow, guns, Perveance

International Nuclear Information System (INIS)

Isagawa, S.

1999-01-01

This paper treats Thermionic emission, Cathode as an e - emitter, Space-charge limited effect and 3/2 power law, Perveance, Beam spread due to space charge, Pierce guns, Magnetically immersed guns, Method of gun design including simulations, and Examples, mainly treating E3786, which attendees will operate above 1 MW-CW in a practical exercise course at KEK. (author). 74 refs

A high-flow nasal cannula system with relatively low flow effectively washes out CO2 from the anatomical dead space in a sophisticated respiratory model made by a 3D printer.

Science.gov (United States)

Onodera, Yu; Akimoto, Ryo; Suzuki, Hiroto; Okada, Masayuki; Nakane, Masaki; Kawamae, Kaneyuki

2018-03-15

Although clinical studies of the high-flow nasal cannula (HFNC) and its effect on positive end-expiratory pressure (PEEP) have been done, the washout effect has not been well evaluated. Therefore, we made an experimental respiratory model to evaluate the respiratory physiological effect of HFNC. An airway model was made by a 3D printer using the craniocervical 3D-CT data of a healthy 32-year-old male. CO 2 was infused into four respiratory lung models (normal-lung, open- and closed-mouth models; restrictive- and obstructive-lung, open-mouth models) to maintain the partial pressure of end-tidal CO 2 (P ET CO 2 ) at 40 mmHg. HFNC flow was changed from 10 to 60 L/min. Capnograms were recorded at the upper pharynx, oral cavity, subglottic, and inlet sites of each lung model. With the normal-lung, open-mouth model, 10 L/min of HFNC flow decreased the subglottic P ET CO 2 to 30 mmHg. Increasing the HFNC flow did not further decrease the subglottic P ET CO 2 . With the normal-lung, closed-mouth model, HFNC flow of 40 L/min was required to decrease the P ET CO 2 at all sites. Subglottic P ET CO 2 reached 30 mmHg with an HFNC flow of 60 L/min. In the obstructive-lung, open-mouth model, P ET CO 2 at all sites had the same trend as in the normal-lung, open-mouth model. In the restrictive-lung, open-mouth model, 20 L/min of HFNC flow decreased the subglottic P ET CO 2 to 25 mmHg, and it did not decrease further. As HFNC flow was increased, PEEP up to 7 cmH 2 O was gradually generated in the open-mouth models and up to 17 cmH 2 O in the normal-lung, closed-mouth model. The washout effect of the HFNC was effective with relatively low flow in the open-mouth models. The closed-mouth model needed more flow to generate a washout effect. Therefore, HFNC flow should be considered based on the need for the washout effect or PEEP.

Respiratory impedance is correlated with airway narrowing in asthma using three-dimensional computed tomography.

Science.gov (United States)

Karayama, M; Inui, N; Mori, K; Kono, M; Hozumi, H; Suzuki, Y; Furuhashi, K; Hashimoto, D; Enomoto, N; Fujisawa, T; Nakamura, Y; Watanabe, H; Suda, T

2018-03-01

Respiratory impedance comprises the resistance and reactance of the respiratory system and can provide detailed information on respiratory function. However, details of the relationship between impedance and morphological airway changes in asthma are unknown. We aimed to evaluate the correlation between imaging-based airway changes and respiratory impedance in patients with asthma. Respiratory impedance and spirometric data were evaluated in 72 patients with asthma and 29 reference subjects. We measured the intraluminal area (Ai) and wall thickness (WT) of third- to sixth-generation bronchi using three-dimensional computed tomographic analyses, and values were adjusted by body surface area (BSA, Ai/BSA, and WT/the square root (√) of BSA). Asthma patients had significantly increased respiratory impedance, decreased Ai/BSA, and increased WT/√BSA, as was the case in those without airflow limitation as assessed by spirometry. Ai/BSA was inversely correlated with respiratory resistance at 5 Hz (R5) and 20 Hz (R20). R20 had a stronger correlation with Ai/BSA than did R5. Ai/BSA was positively correlated with forced expiratory volume in 1 second/forced vital capacity ratio, percentage predicted forced expiratory volume in 1 second, and percentage predicted mid-expiratory flow. WT/√BSA had no significant correlation with spirometry or respiratory impedance. Respiratory resistance is associated with airway narrowing. © 2018 John Wiley & Sons Ltd.

[Effect of obesity on pulmonary function in asthmatic children of different age groups].

Science.gov (United States)

Xu, Xiao-Wen; Huang, Ying; Wang, Jian; Zhang, Xue-Li; Liang, Fan-Mei; Luo, Rong

2017-05-01

To study the effect of obesity on pulmonary function in newly diagnosed asthmatic children of different age groups. Two hundred and ninety-four children with newly diagnosed asthma were classified into preschool-age (age (6 to 12.5 years) groups. They were then classified into obese, overweight, and normal-weight subgroups based on their body mass index (BMI). All the children underwent pulmonary function tests, including large airway function tests [forced vital capacity (FVC%) and forced expiratory volume in one second (FEV1%)] and small airway function tests [maximal expiratory flow at 25% of vital capacity (MEF25%), maximal expiratory flow at 50% of vital capacity (MEF50%), and maximal expiratory flow at 75% of vital capacity (MEF75%)]. The school-age group showed lower FEV1%, MEF25%, and MEF50% than the preschool-age group (Page group had lower FEV1%, MEF25%, and MEF50% compared with their counterparts in the preschool-age group (Page group showed lower FVC% and MEF50% than those in the preschool-age group. However, all the pulmonary function parameters showed no significant differences between the obese children in the preschool-age and school-age groups. In the preschool-age group, FVC%, FEV1%, and MEF75% of the obese children were lower than those of the normal-weight children. In the school-age group, only FVC% and FEV1% showed differences between the obese and normal-weight children (Page in children with asthma, and the effect is more obvious in those of preschool age.

Spirometry reference values in the Brazilian population.

Science.gov (United States)

Rufino, R; Costa, C H; Lopes, A J; Maiworm, A I; Maynard, K; Silva, L M R A; Dias, R M

2017-03-02

The aim of the present study was to provide new spirometry reference equations in a sample of the Brazilian population for the following parameters: forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), FEV1/FVC ratio, peak of expiratory flow (PEF), forced expiratory flow at 50% (FEF50%), 75% average vital capacity (FEF25-75%), and average forced expiratory flow time (FEFT). This was a prospective study using results from chest radiographs, electrocardiograms, and questionnaires to investigate the participants' respiratory symptoms, sedentarism, and comorbidities (Charlson comorbidity index). From December 2010 to July 2014, individuals were randomly selected from various locations in the state of Rio de Janeiro. All individuals were examined by a single technician in the morning at the laboratory, and performed the spirometry with the same spirometer. Spirometry values were tabulated for the creation of three equation models: linear regression, logarithmic regression, and logarithms through a method that incorporates the lambda, median, and coefficient of variation (LMS method). Initially, 7003 individuals from both genders were contacted, and 454 were recruited. The data from the new equations were compared with one Brazilian and eight international equations, resulting in a high correlation (r>0.9). The values derived from the LMS method and linear regression were very similar (P>0.5), and both could be used to acquire the reference values for Brazilian spirometry. Data derived from the equations of this study were different from the current Brazilian equation, which could be justified by the different method used.

Spirometry reference values in the Brazilian population

Directory of Open Access Journals (Sweden)

R. Rufino

Full Text Available The aim of the present study was to provide new spirometry reference equations in a sample of the Brazilian population for the following parameters: forced vital capacity (FVC, forced expiratory volume in 1 second (FEV1, FEV1/FVC ratio, peak of expiratory flow (PEF, forced expiratory flow at 50% (FEF50%, 75% average vital capacity (FEF25-75%, and average forced expiratory flow time (FEFT. This was a prospective study using results from chest radiographs, electrocardiograms, and questionnaires to investigate the participants' respiratory symptoms, sedentarism, and comorbidities (Charlson comorbidity index. From December 2010 to July 2014, individuals were randomly selected from various locations in the state of Rio de Janeiro. All individuals were examined by a single technician in the morning at the laboratory, and performed the spirometry with the same spirometer. Spirometry values were tabulated for the creation of three equation models: linear regression, logarithmic regression, and logarithms through a method that incorporates the lambda, median, and coefficient of variation (LMS method. Initially, 7003 individuals from both genders were contacted, and 454 were recruited. The data from the new equations were compared with one Brazilian and eight international equations, resulting in a high correlation (r>0.9. The values derived from the LMS method and linear regression were very similar (P>0.5, and both could be used to acquire the reference values for Brazilian spirometry. Data derived from the equations of this study were different from the current Brazilian equation, which could be justified by the different method used.

Teaching Phagocytosis Using Flow Cytometry

Directory of Open Access Journals (Sweden)

John Boothby

2009-12-01

Full Text Available Investigative microbiology on protists in a basic teaching laboratory environment is limited by student skill level, ease of microbial culture and manipulation, instrumentation, and time. The flow cytometer is gaining use as a mainstream instrument in research and clinical laboratories, but has had minimal application in teaching laboratories. Although the cost of a flow cytometer is currently prohibitive for many microbiology teaching environments and the number of trained instructors and teaching materials is limited, in many ways the flow cytometer is an ideal instrument for teaching basic microbiology. We report here on a laboratory module to study phagocytosis in Tetrahymena sp. using flow cytometry in a basic microbiology teaching laboratory. Students and instructors found the flow cytometry data analysis program, Paint-A-GatePRO-TM, to be very intuitive and easy to learn within a short period of time. Assessment of student learning about Tetrahymena sp., phagocytosis, flow cytometry, and investigative microbiology using an inquiry-based format demonstrated an overall positive response from students.

Deep breathing exercises with positive expiratory pressure at a higher rate improve oxygenation in the early period after cardiac surgery--a randomised controlled trial.

Science.gov (United States)

Urell, Charlotte; Emtner, Margareta; Hedenström, Hans; Tenling, Arne; Breidenskog, Marie; Westerdahl, Elisabeth

2011-07-01

In addition to early mobilisation, a variety of breathing exercises are used to prevent postoperative pulmonary complications after cardiac surgery. The optimal duration of the treatment is not well evaluated. The aim of this study was to determine the effect of 30 versus 10 deep breaths hourly, while awake, with positive expiratory pressure on oxygenation and pulmonary function the first days after cardiac surgery. A total of 181 patients, undergoing cardiac surgery, were randomised into a treatment group, performing 30 deep breaths hourly the first postoperative days, or into a control group performing 10 deep breaths hourly. The main outcome measurement arterial blood gases and the secondary outcome pulmonary function, evaluated with spirometry, were determined on the second postoperative day. Preoperatively, both study groups were similar in terms of age, SpO(2), forced expiratory volume in 1s and New York Heart Association classification. On the second postoperative day, arterial oxygen tension (PaO(2)) was 8.9 ± 1.7 kPa in the treatment group and 8.1 ± 1.4 kPa in the control group (p = 0.004). Arterial oxygen saturation (SaO(2)) was 92.7 ± 3.7% in the treatment group and 91.1 ± 3.8% in the control group (p = 0.016). There were no differences in measured lung function between the groups or in compliance to the breathing exercises. Compliance was 65% of possible breathing sessions. A significantly increased oxygenation was found in patients performing 30 deep breaths the first two postoperative days compared with control patients performing 10 deep breaths hourly. These results support the implementation of a higher rate of deep breathing exercises in the initial phase after cardiac surgery. Copyright © 2010 European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved.

Lung sound intensity in patients with emphysema and in normal subjects at standardised airflows.

Science.gov (United States)

Schreur, H J; Sterk, P J; Vanderschoot, J; van Klink, H C; van Vollenhoven, E; Dijkman, J H

1992-01-01

BACKGROUND: A common auscultatory finding in pulmonary emphysema is a reduction of lung sounds. This might be due to a reduction in the generation of sounds due to the accompanying airflow limitation or to poor transmission of sounds due to destruction of parenchyma. Lung sound intensity was investigated in normal and emphysematous subjects in relation to airflow. METHODS: Eight normal men (45-63 years, FEV1 79-126% predicted) and nine men with severe emphysema (50-70 years, FEV1 14-63% predicted) participated in the study. Emphysema was diagnosed according to pulmonary history, results of lung function tests, and radiographic criteria. All subjects underwent phonopneumography during standardised breathing manoeuvres between 0.5 and 2 1 below total lung capacity with inspiratory and expiratory target airflows of 2 and 1 l/s respectively during 50 seconds. The synchronous measurements included airflow at the mouth and lung volume changes, and lung sounds at four locations on the right chest wall. For each microphone airflow dependent power spectra were computed by using fast Fourier transformation. Lung sound intensity was expressed as log power (in dB) at 200 Hz at inspiratory flow rates of 1 and 2 l/s and at an expiratory flow rate of 1 l/s. RESULTS: Lung sound intensity was well repeatable on two separate days, the intraclass correlation coefficient ranging from 0.77 to 0.94 between the four microphones. The intensity was strongly influenced by microphone location and airflow. There was, however, no significant difference in lung sound intensity at any flow rate between the normal and the emphysema group. CONCLUSION: Airflow standardised lung sound intensity does not differ between normal and emphysematous subjects. This suggests that the auscultatory finding of diminished breath sounds during the regular physical examination in patients with emphysema is due predominantly to airflow limitation. Images PMID:1440459

Studies on provoked asthma

International Nuclear Information System (INIS)

Munkner, L.; Bundgaard, A.

1982-01-01

A group of adult patients with perennial bronchial asthma has been studied as to lung perfusion and alveolar ventilation (81m-Kr) at rest and after provocation of an acute attack. Asthma was provoked by exercise and by histamine inhalation. After provocation the peak expiratory flow values were reduced to less than 80% of the base line values. Perfusion was often deranged. Regional ventilation changed rapidly after provocation and not always in the same fashion after exercise and histamine. During attacks lung volume increased. The expansion decreased (in parallel with increased peak expiratory flow) after inhalator of a #betta#-2 agonist (terbutaline). 81m-Kr offers unique opportunities for studying acute regional changes in alveolar ventilation. (Author)

Effect of laryngeal anesthesia on pulmonary function testing in normal subjects.

Science.gov (United States)

Kuna, S T; Woodson, G E; Sant'Ambrogio, G

1988-03-01

Pulmonary function tests (PFT) were performed on 11 normal subjects before and after topical anesthesia of the larynx. The PFT consisted of flow volume loops and body box determinations of functional residual capacity and airway resistance, each performed in triplicate. After the first set of tests, cotton pledgets soaked in 4% lidocaine were held in the pyriform sinuses for 2 min to block the superior laryngeal nerves. In addition, 1.5 ml of 10% cocaine was dropped on the vocal cords via indirect laryngoscopy. PFT were repeated 5 min after anesthesia. Besides routine analysis of the flow volume loops, areas under the inspiratory (Area I) and expiratory (Area E) portions of the loops were calculated by planimetry. Area I, peak inspiratory flow (PIF), as well as forced inspiratory flow at 25, 50, and 75% forced vital capacity (FVC), decreased after anesthesia. Peak expiratory flow decreased after anesthesia, but Area E and forced expiratory flow at 25, 50, and 75% FVC were unchanged. This protocol also was performed in 12 normal subjects with isotonic saline being substituted for the lidocaine and cocaine. In this group, no significant differences were observed when flow volume loop parameters were compared before and after topical application of saline. In 5 spontaneously breathing anesthetized dogs, posterior cricoarytenoid muscle and afferent superior laryngeal nerve activity were recorded before and after laryngeal anesthesia performed with the same procedure used in the human subjects. Laryngeal anesthesia resulted in a substantial decrease or a complete disappearance of afferent SLN activity recorded during unobstructed and obstructed respiration. The data suggest that laryngeal receptors help modulate upper airway patency in man.

Integrated Cantilever-Based Flow Sensors with Tunable Sensitivity for In-Line Monitoring of Flow Fluctuations in Microfluidic Systems

Directory of Open Access Journals (Sweden)

Nadine Noeth

2013-12-01

Full Text Available For devices such as bio-/chemical sensors in microfluidic systems, flow fluctuations result in noise in the sensor output. Here, we demonstrate in-line monitoring of flow fluctuations with a cantilever-like sensor integrated in a microfluidic channel. The cantilevers are fabricated in different materials (SU-8 and SiN and with different thicknesses. The integration of arrays of holes with different hole size and number of holes allows the modification of device sensitivity, theoretical detection limit and measurement range. For an average flow in the microliter range, the cantilever deflection is directly proportional to the flow rate fluctuations in the microfluidic channel. The SiN cantilevers show a detection limit below 1 nL/min and the thinnest SU-8 cantilevers a detection limit below 5 nL/min. Finally, the sensor is applied for in-line monitoring of flow fluctuations generated by external pumps connected to the microfluidic system.

The Control of Junction Flows

National Research Council Canada - National Science Library

Smith, Charles

1997-01-01

An experimental study of the effects of spatially-limited (i.e. localized) surface suction on unsteady laminar and turbulent junction flows was performed using hydrogen bubble flow visualization and Particle Image Velocimetry (PIV...

Effects of Glossopharyngeal Insufflation in Ankylosing Spondylitis: A Pilot Study

Directory of Open Access Journals (Sweden)

Nina Brodin

2014-01-01

Full Text Available In Ankylosing Spondylitis (AS, thoracic range of motion is often greatly limited. The objective of the study was to describe the effects of 12 weeks of Glossopharyngeal Insufflation (GI training in patients with AS. Dynamic spirometry included vital capacity, forced expiratory volume, and peak expiratory flow. Thoracic and lumbar range of motion was assessed by tragus-to-wall distance, modified Schober test, and tape measure. Disease activity, activity limitation, and health perception were assessed using the BAS-Indices, and tension in the thoracic region during GI was assessed using the Borg CR-10 scale. Adherence to training was recorded in an activity log, along with any remarks on the training. Ten patients were recruited and six male patients fulfilled the study protocol. Three patients were able to learn GI by exceeding their maximal vital capacity with 5% using GI. A significant increase in thoracic range of motion both on costae IV (P=0.04 and at the level of the xiphoid process (P=0.04 was seen. Thus, patients with AS can practice GI, it is safe if maximal exertion is avoided, and patients with some mobility in the chest can increase their lung function substantially by performing GI during 12 weeks.

Vanishing viscosity limits of mixed hyperbolic–elliptic systems arising in multilayer channel flows

International Nuclear Information System (INIS)

Papaefthymiou, E S; Papageorgiou, D T

2015-01-01

This study considers the spatially periodic initial value problem of 2 × 2 quasi-linear parabolic systems in one space dimension having quadratic polynomial flux functions. These systems arise physically in the interfacial dynamics of viscous immiscible multilayer channel flows. The equations describe the spatiotemporal evolution of phase-separating interfaces with dissipation arising from surface tension (fourth-order) and/or stable stratification effects (second-order). A crucial mathematical aspect of these systems is the presence of mixed hyperbolic–elliptic flux functions that provide the only source of instability. The study concentrates on scaled spatially 2π-periodic solutions as the dissipation vanishes, and in particular the behaviour of such limits when generalized dissipation operators (spanning second to fourth-order) are considered. Extensive numerical computations and asymptotic analysis suggest that the existence (or not) of bounded vanishing viscosity solutions depends crucially on the structure of the flux function. In the absence of linear terms (i.e. homogeneous flux functions) the vanishing viscosity limit does not exist in the L ∞ -norm. On the other hand, if linear terms in the flux function are present the computations strongly suggest that the solutions exist and are bounded in the L ∞ -norm as the dissipation vanishes. It is found that the key mechanism that provides such boundedness centres on persistent spatiotemporal hyperbolic–elliptic transitions. Strikingly, as the dissipation decreases, the flux function becomes almost everywhere hyperbolic except on a fractal set of elliptic regions, whose dimension depends on the order of the regularized operator. Furthermore, the spatial structures of the emerging weak solutions are found to support an increasing number of discontinuities (measure-valued solutions) located in the vicinity of the fractally distributed elliptic regions. For the unscaled problem, such spatially

Integrated cantilever-based flow sensors with tunable sensitivity for in-line monitoring of flow fluctuations in microfluidic systems

DEFF Research Database (Denmark)

Noeth, Nadine-Nicole; Keller, Stephan Sylvest; Boisen, Anja

2014-01-01

For devices such as bio-/chemical sensors in microfluidic systems, flow fluctuations result in noise in the sensor output. Here, we demonstrate in-line monitoring of flow fluctuations with a cantilever-like sensor integrated in a microfluidic channel. The cantilevers are fabricated in different...... is directly proportional to the flow rate fluctuations in the microfluidic channel. The SiN cantilevers show a detection limit below 1 nL/min and the thinnest SU-8 cantilevers a detection limit below 5 nL/min. Finally, the sensor is applied for in-line monitoring of flow fluctuations generated by external...

Intraoperative protective mechanical ventilation for prevention of postoperative pulmonary complications: a comprehensive review of the role of tidal volume, positive end-expiratory pressure, and lung recruitment maneuvers.

Science.gov (United States)

Güldner, Andreas; Kiss, Thomas; Serpa Neto, Ary; Hemmes, Sabrine N T; Canet, Jaume; Spieth, Peter M; Rocco, Patricia R M; Schultz, Marcus J; Pelosi, Paolo; Gama de Abreu, Marcelo

2015-09-01

Postoperative pulmonary complications are associated with increased morbidity, length of hospital stay, and mortality after major surgery. Intraoperative lung-protective mechanical ventilation has the potential to reduce the incidence of postoperative pulmonary complications. This review discusses the relevant literature on definition and methods to predict the occurrence of postoperative pulmonary complication, the pathophysiology of ventilator-induced lung injury with emphasis on the noninjured lung, and protective ventilation strategies, including the respective roles of tidal volumes, positive end-expiratory pressure, and recruitment maneuvers. The authors propose an algorithm for protective intraoperative mechanical ventilation based on evidence from recent randomized controlled trials.

OPTIMUM LEVEL OF POSITIVE END-EXPIRATORY PRESSURE IN ACUTE RESPIRATORY DISTRESS SYNDROME CAUSED BY INFLUENZA A(H1NI)PDM09: BALANCE BETWEEN MAXIMAL END-EXPIRATORY VOLUME AND MINIMAL ALVEOLAR OVERDISTENSION.

Science.gov (United States)

Yaroshetskiym A I; Protsenko, D N; Boytsov, P V; Chentsov, V B; Nistratov, S L; Kudlyakov, O N; Solov'ev, V V; Banova, Zh I; Shkuratova, N V; Rezenov, N A; Gel'fand, B R

2016-11-01

to determine optimum level ofpositive end-expiratory pressure (PEEP) according to balance between maxi- mal end-expiratory lung volume (EEL V)(more than predicted) and minimal decrease in exhaled carbon dioxide volume (VCO) and then to develop the algorithm of gas exchange correction based on prognostic values of EEL K; alveolar recruitability, PA/FiO2, static compliance (C,,,) and VCO2. 27 mechanically ventilatedpatients with acute respiratory distress syndrome (ARDS) caused by influenza A (HINJ)pdm09 in Moscow Municipal Clinics ICU's from January to March 2016 were included in the trial. At the beginning of the study patients had the following characteristic: duration offlu symptoms 5 (3-10) days, p.0/FiO2 120 (70-50) mmHg. SOFA 7 (5-9), body mass index 30.1 (26.4-33.8) kg/m², static compliance of respiratory system 35 (30-40) ml/mbar: Under sedation and paralysis we measured EELV, C VCO and end-tidal carbon dioxide concentration (EtCO) (for CO₂ measurements we fixed short-term values after 2 min after PEEP level change) at PEEP 8, 11,13,15,18, 20 mbar consequently, and incase of good recruitability, at 22 and 24 mbar. After analyses of obtained data we determined PEEP value in which increase in EELV was maximal (more than predicted) and depression of VCO₂ was less than 20%, change in mean blood pressure and heart rate were both less than 20% (measured at PEEP 8 mbar). After that we set thus determined level of PEEP and didn't change it for 5 days. Comparision of predicted and measured EELV revealed two typical points of alveloar recruiment: the first at PEEP 11-15 mbar, the second at PEEP 20-22 mbar. EELV measured at PEEP 18 mbar appeared to be higher than predicted at PEEP 8 mbar by 400 ml (approx.), which was the sign of alveolar recruitment-1536 (1020-1845) ml vs 1955 (1360-2320) ml, p=0,001, Friedman test). we didn't found significant changes of VCO₂ when increased PEEP in the range from 8 to 15 mbar (p>0.05, Friedman test). PEEP increase from 15 to

Pressure Drop Versus Flow Rate Analysis of the Limited Streamer Tube Gas System of the BaBar Muon Detector Upgrade

International Nuclear Information System (INIS)

Yi, M.

2004-01-01

It has been proposed that Limited Streamer Tubes (LST) be used in the current upgrade of the muon detector in the BaBar detector. An LST consists of a thin silver plated wire centered in a graphite-coated cell. One standard LST tube consists of eight such cells, and two or three such tubes form an LST module. Under operation, the cells are filled with a gas mixture of CO 2 , argon and isobutane. During normal operation of the detector, the gas will be flushed out of the system at a constant low rate of one volume change per day. During times such as installation, however, it is often desired to flush and change the LST gas volumes very rapidly, leading to higher than normal pressure which may damage the modules. This project studied this pressure as a function of flow rate and the number of modules that are put in series in search of the maximal safe flow rate at which to flush the modules. Measurements of pressure drop versus flow rate were taken using a flow meter and a pressure transducer on configurations of one to five modules put in series. Minimal Poly-Flo tubing was used for all connections between test equipment and modules. They contributed less than 25% to all measurements. A ratio of 0.00022 ± 0.00001 mmHg per Standard Cubic Centimeter per Minute (SCCM) per module was found, which was a slight overestimate since it included the contributions from the tubing connections. However, for the purpose of finding a flow rate at which the modules can be safely flushed, this overestimate acts as a safety cushion. For a standard module with a volume of 16 liters and a known safe overpressure of 2 inches of water, the ratio translates into a flow rate of 17000 ± 1000SCCM and a time requirement of 56 ± 5 seconds to flush an entire module

Countercurrent two-phase flow

International Nuclear Information System (INIS)

Hewitt, G.F.; Imperial Coll. of Science and Technology, London

1989-01-01

A survey is presented of counter-current flow with particular reference to the limits of the regime, namely the 'flooding' phenomena. Emphasis is also given to the transiently counter-current type of flow ('churn flow') which is formed on the break-down of falling film counter-current flow. The mechanisms of flooding are reviewed and flooding in systems with heat transfer and in non-vertical channels is discussed. New data on the flooding phenomena and the region of simultaneous downflow and upflow beyond flooding are presented. The onset of churn flow is discussed and new measurements on churn flow are presented. The characteristics of the churn flow regime are shown to be independent of the coexistence of a falling film region below the liquid injection point. (orig.)

Peak Expiratory Flow as a Surrogate for Health Related Quality of ...

African Journals Online (AJOL)

Spirometry was done using American Thoracic Society's standards and reference equations from African American norms of the US population. Quality of life was measured with the St George's Respiratory Questionnaire (SGRQ) Results: Out of 50 patients recruited for the study, 48 provided complete data with acceptable ...

Evaluation of Peak Expiratory Flow rates (PEFR) of Workers in a ...

African Journals Online (AJOL)

Background: Occupational lung diseases (OLD) remain one of the most common workplace health challenges since the industrial revolution. One of the risks for OLD is the exposure to cement dust which is associated with varying degrees of respiratory symptoms and reduction in lung function. This study aimed to measure ...

Heat-flow and temperature control in Tian–Calvet microcalorimeters: toward higher detection limits

International Nuclear Information System (INIS)

Vilchiz-Bravo, L E; Pacheco-Vega, A; Handy, B E

2010-01-01

Strategies based on the principle of heat flow and temperature control were implemented, and experimentally tested, to increase the sensitivity of a Tian–Calvet microcalorimeter for measuring heats of adsorption. Here, both heat-flow and temperature control schemes were explored to diminish heater-induced thermal variations within the heat sink element, hence obtaining less noise in the baseline signal. PID controllers were implemented within a closed-loop system to perform the control actions in a calorimetric setup. The experimental results demonstrate that the heat flow control strategy provided a better baseline stability when compared to the temperature control. The effects on the results stemming from the type of power supply used were also investigated

Ventilatory Function in Relation to Mining Experience and Smoking in a Random Sample of Miners and Non-miners in a Witwatersrand Town1

Science.gov (United States)

Sluis-Cremer, G. K.; Walters, L. G.; Sichel, H. S.

1967-01-01

The ventilatory capacity of a random sample of men over the age of 35 years in the town of Carletonville was estimated by the forced expiratory volume and the peak expiratory flow rate. Five hundred and sixty-two persons were working or had worked in gold-mines and 265 had never worked in gold-mines. No difference in ventilatory function was found between the miners and non-miners other than that due to the excess of chronic bronchitis in miners. PMID:6017134

Limiting oxygen concentration for extinction of upward spreading flames over inclined thin polyethylene-insulated NiCr electrical wires with opposed-flow under normal- and micro-gravity

KAUST Repository

Hu, Longhua; Lu, Yong; Yoshioka, Kosuke; Zhang, Yangshu; Fernandez-Pello, Carlos; Chung, Suk-Ho; Fujita, Osamu

2016-01-01

. The experiments reported here used polyethylene (PE)-insulated (thickness of 0.15 mm) Nichrome (NiCr)-core (diameter of 0.5 mm) electrical wires. Limiting oxygen concentrations (LOC) at extinction were measured for upward spreading flame at various forced opposed-flow

Low flow anesthesia: Efficacy and outcome of laryngeal mask airway versus pressure-optimized cuffed-endotracheal tube

Directory of Open Access Journals (Sweden)

El-Seify Zeinab

2010-01-01

Full Text Available Background: Low flow anesthesia can lead to reduction of anesthetic gas and vapor consumption. Laryngeal mask airway (LMA has proved to be an effective and safe airway device. The aim of this study is to assess the feasibility of laryngeal mask airway during controlled ventilation using low fresh gas flow (1.0 L/min as compared to endotracheal tube (ETT. Patients and Methods : Fifty nine non-smoking adult patients; ASA I or II, being scheduled for elective surgical procedures, with an expected duration of anesthesia 60 minutes or more, were randomly allocated into two groups - Group I (29 patients had been ventilated using LMA size 4 for females and 5 for males respectively; and Group II (30 patients were intubated using ETT. After 10 minutes of high fresh gas flow, the flow was reduced to 1 L/min. Patients were monitored for airway leakage, end-tidal CO 2 (ETCO 2 , inspiratory and expiratory isoflurane and nitrous oxide fraction concentrations, and postoperative airway-related complications Results : Two patients in the LMA-group developed initial airway leakage (6.9% versus no patient in ETT-group. Cough and sore throat were significantly higher in ETT patients. There were no evidences of differences between both groups regarding ETCO 2 , uptake of gases, nor difficulty in swallowing. Conclusion : The laryngeal mask airway proved to be effective and safe in establishing an airtight seal during controlled ventilation under low fresh gas flow of 1 L/min, inducing less coughing and sore throat during the immediate postoperative period than did the ETT, with continuous measurement and readjustment of the tube cuff pressure.

Current limiters

Energy Technology Data Exchange (ETDEWEB)

Loescher, D.H. [Sandia National Labs., Albuquerque, NM (United States). Systems Surety Assessment Dept.; Noren, K. [Univ. of Idaho, Moscow, ID (United States). Dept. of Electrical Engineering

1996-09-01

The current that flows between the electrical test equipment and the nuclear explosive must be limited to safe levels during electrical tests conducted on nuclear explosives at the DOE Pantex facility. The safest way to limit the current is to use batteries that can provide only acceptably low current into a short circuit; unfortunately this is not always possible. When it is not possible, current limiters, along with other design features, are used to limit the current. Three types of current limiters, the fuse blower, the resistor limiter, and the MOSFET-pass-transistor limiters, are used extensively in Pantex test equipment. Detailed failure mode and effects analyses were conducted on these limiters. Two other types of limiters were also analyzed. It was found that there is no best type of limiter that should be used in all applications. The fuse blower has advantages when many circuits must be monitored, a low insertion voltage drop is important, and size and weight must be kept low. However, this limiter has many failure modes that can lead to the loss of over current protection. The resistor limiter is simple and inexpensive, but is normally usable only on circuits for which the nominal current is less than a few tens of milliamperes. The MOSFET limiter can be used on high current circuits, but it has a number of single point failure modes that can lead to a loss of protective action. Because bad component placement or poor wire routing can defeat any limiter, placement and routing must be designed carefully and documented thoroughly.

TFTR movable limiter instrumentation and controls

International Nuclear Information System (INIS)

Frankenberg, J.; Collins, D.; Kaufmann, D.; Mamoun, A.

1983-01-01

The TFTR movable limiter is a single poloidal limiter located within one 18 /SUP o/ segment of the vacuum vessel. It consists of three (3) interconnected inconel backing plates covered with titanium carbide coated graphite tiles. The backing plates are positioned by three independent screw drive actuators. Cooling water is fed through the horizontal port cover to tubes brazed onto the backs of the backing plates. Thermocouples monitor the limiter temperature. (1) and more fully described in refs. (1) and (2). The positioning actuators are driven by independently controlled DC servo motors, controlled either locally or from CICADA. Drive motor shaft position is monitored by chain driven encoders and potentiometers. Limiter blade position can be varied to suit any plasma within the operating range. CICADA is programmed to keep the limiter stroke within safe operating limits. A microprocessor duplicates the CICADA protective function allowing limiter operation without CICADA. The potentiometer signal is sent to an analog computer, which safeguards the limiter against failure of the encoders or the micro-processor. Cooling water flows through the limiter in 3 separate paths, one for each blade. The flow rate and temperature rise through each loop are measured accurately to allow CICADA to calculate the heat into each blade. The water system is also interlocked and alarmed to prevent dumping of water into the vacuum vessel

Lung volumes identify an at-risk group in persons with prolonged secondhand tobacco smoke exposure but without overt airflow obstruction.

Science.gov (United States)

Arjomandi, Mehrdad; Zeng, Siyang; Geerts, Jeroen; Stiner, Rachel K; Bos, Bruce; van Koeverden, Ian; Keene, Jason; Elicker, Brett; Blanc, Paul D; Gold, Warren M

2018-01-01

Exposure to secondhand smoke (SHS) is associated with occult obstructive lung disease as evident by abnormal airflow indices representing small airway disease despite having preserved spirometry (normal forced expiratory volume in 1 s-to-forced vital capacity ratio, FEV 1 /FVC). The significance of lung volumes that reflect air trapping in the presence of preserved spirometry is unclear. To investigate whether lung volumes representing air trapping could determine susceptibility to respiratory morbidity in people with SHS exposure but without spirometric chronic obstructive pulmonary disease, we examined a cohort of 256 subjects with prolonged occupational SHS exposure and preserved spirometry. We elicited symptom prevalence by structured questionnaires, examined functional capacity (maximum oxygen uptake, VO 2max ) by exercise testing, and estimated associations of those outcomes with air trapping (plethysmography-measured residual volume-to-total lung capacity ratio, RV/TLC), and progressive air trapping with exertion (increase in fraction of tidal breathing that is flow limited on expiration during exercise (per cent of expiratory flow limitation, %EFL)). RV/TLC was within the predicted normal limits, but was highly variable spanning 22%±13% and 16%±8% across the increments of FEV 1 /FVC and FEV 1 , respectively. Respiratory complaints were prevalent (50.4%) with the most common symptom being ≥2 episodes of cough per year (44.5%). Higher RV/TLC was associated with higher OR of reporting respiratory symptoms (n=256; r 2 =0.03; p=0.011) and lower VO 2max (n=179; r 2 =0.47; p=0.013), and %EFL was negatively associated with VO 2max (n=32; r 2 =0.40; p=0.017). In those at risk for obstruction due to SHS exposure but with preserved spirometry, higher RV/TLC identifies a subgroup with increased respiratory symptoms and lower exercise capacity.

Pathogenesis of hyperinflation in chronic obstructive pulmonary disease

Directory of Open Access Journals (Sweden)

Gagnon P

2014-02-01

Full Text Available Philippe Gagnon,1,2 Jordan A Guenette,3,4 Daniel Langer,5 Louis Laviolette,2 Vincent Mainguy,1 François Maltais,1,2 Fernanda Ribeiro,1,2 Didier Saey1,2 1Faculté de Médecine, Université Laval, 2Centre de Recherche, Institut Universitaire de Cardiologie et de Pneumologie de Québec, Université Laval, Québec, QC, 3Centre for Heart Lung Innovation, University of British Columbia, St Paul's Hospital, 4Department of Physical Therapy, University of British Columbia, Vancouver, BC, Canada; 5Department of Kinesiology and Rehabilitation Sciences, KU Leuven, Leuven, Belgium Abstract: Chronic obstructive pulmonary disease (COPD is a preventable and treatable lung disease characterized by airflow limitation that is not fully reversible. In a significant proportion of patients with COPD, reduced lung elastic recoil combined with expiratory flow limitation leads to lung hyperinflation during the course of the disease. Development of hyperinflation during the course of COPD is insidious. Dynamic hyperinflation is highly prevalent in the advanced stages of COPD, and new evidence suggests that it also occurs in many patients with mild disease, independently of the presence of resting hyperinflation. Hyperinflation is clinically relevant for patients with COPD mainly because it contributes to dyspnea, exercise intolerance, skeletal muscle limitations, morbidity, and reduced physical activity levels associated with the disease. Various pharmacological and nonpharmacological interventions have been shown to reduce hyperinflation and delay the onset of ventilatory limitation in patients with COPD. The aim of this review is to address the more recent literature regarding the pathogenesis, assessment, and management of both static and dynamic lung hyperinflation in patients with COPD. We also address the influence of biological sex and obesity and new developments in our understanding of hyperinflation in patients with mild COPD and its evolution during

Hemodynamic responses to external counterbalancing of auto-positive end-expiratory pressure in mechanically ventilated patients with chronic obstructive pulmonary disease.

Science.gov (United States)

Baigorri, F; de Monte, A; Blanch, L; Fernández, R; Vallés, J; Mestre, J; Saura, P; Artigas, A

1994-11-01

To study the effect of positive end-expiratory pressure (PEEP) on right ventricular hemodynamics and ejection fraction in patients with chronic obstructive pulmonary disease and positive alveolar pressure throughout expiration by dynamic hyperinflation (auto-PEEP). Open, prospective, controlled trial. General intensive care unit of a community hospital. Ten patients sedated and paralyzed with an acute exacerbation of chronic obstructive pulmonary disease undergoing mechanical ventilation. Insertion of a pulmonary artery catheter modified with a rapid response thermistor and a radial arterial catheter. PEEP was then increased from 0 (PEEP 0) to auto-PEEP level (PEEP = auto-PEEP) and 5 cm H2O above that (PEEP = auto-PEEP +5). At each level of PEEP, airway pressures, flow and volume, hemodynamic variables (including right ventricular ejection fraction by thermodilution technique), and blood gas analyses were recorded. The mean auto-PEEP was 6.6 +/- 2.8 cm H2O and the total PEEP reached was 12.2 +/- 2.4 cm H2O. The degree of lung inflation induced by PEEP averaged 145 +/- 87 mL with PEEP = auto-PEEP and 495 +/- 133 mL with PEEP = auto-PEEP + 5. The PEEP = auto-PEEP caused a right ventricular end-diastolic pressure increase, but there was no other significant hemodynamic change. With PEEP = auto-PEEP + 5, there was a significant increase in intravascular pressures; this amount of PEEP reduced cardiac output (from 4.40 +/- 1.38 L/min at PEEP 0 to 4.13 +/- 1.48 L/min; p 10% in only five cases and this group of patients had significantly lower right ventricular volumes than the group with less cardiac output variation (right ventricular end-diastolic volume: 64 +/- 9 vs. 96 +/- 26 mL/m2; right ventricular end-systolic volume: 38 +/- 6 vs. 65 +/- 21 mL/m2; p < .05) without significant difference in the other variables that were measured. Neither right ventricular ejection fraction nor right ventricle volumes changed as PEEP increased, but there were marked interpatient

Asymptomatic tracheal MALT lymphoma discovered on spirometric findings presenting with elevated respiratory resistance.

Science.gov (United States)

Kadota, Naoki; Shinohara, Tsutomu; Machida, Hisanori; Nakanishi, Hirofumi; Suehiro, Fumie; Toda, Hiroko; Yoshino, Tadashi; Ogushi, Fumitaka

2015-06-06

Central airway obstruction (CAO) may be caused by various etiologies. However, conventional chest X-rays are rarely diagnostic for patients with CAO. We here described a 64-year-old asymptomatic female with tracheal mucosa-associated lymphoid tissue lymphoma discovered on spirometric findings during a complete physical examination. The plateau of forced expiratory flow was consistent with CAO. A decreased peak expiratory flow rate was noted at least 3 years before the diagnosis, and was attributed to an insufficient effort by the patient. Impulse oscillometric measurements, which were taken during quiet breathing and were effort-independent, suggested elevated respiratory resistance. These abnormalities completely disappeared after radiation therapy. The addition of impulse oscillometry to spirometry may be useful for screening CAO in routine health examinations.

Inhaled indacaterol for the treatment of COPD patients with destroyed lung by tuberculosis and moderate-to-severe airflow limitation: results from the randomized INFINITY study.

Science.gov (United States)

Kim, Cheong-Ju; Yoon, Hyoung-Kyu; Park, Myung-Jae; Yoo, Kwang-Ha; Jung, Ki-Suck; Park, Jeong-Woong; Lim, Seong Yong; Shim, Jae Jeong; Lee, Yong Chul; Kim, Young-Sam; Oh, Yeon-Mok; Kim, Song; Yoo, Chul-Gyu

2017-01-01

Pulmonary tuberculosis (TB) is a risk factor for chronic obstructive pulmonary disease (COPD); however, few clinical studies have investigated treatment effectiveness in COPD patients with destroyed lung by TB. The Indacaterol effectiveness in COPD patients with Tuberculosis history (INFINITY) study assessed the efficacy and safety of once-daily inhaled indacaterol 150 µg for the treatment of Korean COPD patients with destroyed lung by TB and moderate-to-severe airflow limitation. This was a multicenter, double-blind, parallel-group study, in which eligible patients were randomized (1:1) to receive either once-daily indacaterol 150 µg or placebo for 8 weeks. The primary efficacy endpoint was change from baseline in trough forced expiratory volume in 1 s at Week 8; the secondary endpoints included changes in transition dyspnea index score and St George's Respiratory Questionnaire for COPD score at Week 8. Safety was evaluated over 8 weeks. Of the 136 patients randomized, 119 (87.5%) completed the study treatment. At Week 8, indacaterol significantly improved trough forced expiratory volume in 1 s versus placebo (treatment difference [TD] 140 mL, P <0.001). Statistically significant improvement in transition dyspnea index score (TD =0.78, P <0.05) and numerical improvement in St George's Respiratory Questionnaire for COPD score (TD =-2.36, P =0.3563) were observed with indacaterol versus placebo at Week 8. Incidence of adverse events was comparable between the treatment groups. Indacaterol provided significantly superior bronchodilation, significant improvement in breathlessness and improved health status with comparable safety versus placebo in Korean COPD patients with destroyed lung by TB and moderate-to-severe airflow limitation.

The flow field structure of highly stabilized partially premixed flames in a concentric flow conical nozzle burner with coflow

KAUST Repository

Elbaz, Ayman M.; Zayed, M.F.; Samy, M.; Roberts, William L.; Mansour, Mohy S.

2015-01-01

The stability limits, the stabilization mechanism, and the flow field structure of highly stabilized partially premixed methane flames in a concentric flow conical nozzle burner with air co-flow have been investigated and presented in this work

Upper limit of cerebral blood flow autoregulation in experimental renovascular hypertension in the baboon

DEFF Research Database (Denmark)

Strandgaard, S; Jones, J V; MacKenzie, E T

1975-01-01

The effect of arterial hypertension on cerebral blood flow was studied by the intracarotid 133Xe clearance method in baboons. The arterial blood pressure was raised in gradual steps with angiotensin. Baboons with renal hypertension of 8-12 weeks duration were studied along with normotensive baboons....... In initially normotensive baboons, cerebral blood flow remained constant until the mean arterial blood pressure had risen to the range of 140 to 154 mm Hg; thereafter cerebral blood flow increased with each rise in mean arterial blood pressure. In the chronically hypertensive baboons, cerebral blood flow...... remained constant until the mean arterial blood pressure had been elevated to the range of 155 to 169 mm Hg. Thus, in chronic hypertension it appears that there are adaptive changes in the cerebral circulation which may help to protect the brain from further increases in arterial blood pressure....

Benefits and limitations of using the weather radar for the definition of rainfall thresholds for debris flows. Case study from Catalonia (Spain).

Science.gov (United States)

Abancó, C.; Hürlimann, M.; Sempere, D.; Berenguer, M.

2012-04-01

Torrential processes such as debris flows or hyperconcentrated flows are fast movements formed by a mix of water and different amounts of unsorted solid material. They occur in steep torrents and suppose a high risk for the human settlements. Rainfall is the most common triggering factor for debris flows. The rainfall threshold defines the rainfall conditions that, when reached or exceeded, are likely to provoke one or more events. Many different types of empirical rainfall thresholds for landslide triggering have been defined. Direct measurements of rainfall data are normally not available from a point next to or in the surroundings of the initiation area of the landslide. For this reason, most of the thresholds published for debris flows have been established by data measured at the nearest rain gauges (often located several km far from the landslide). Only in very few cases, the rainfall data to analyse the triggering conditions of the debris flows have been obtained by weather (Doppler) radar. Radar devices present certain limitations in mountainous regions due to undesired reboots, but their main advantage is that radar data can be obtained for any point of the territory. The objective of this work was to test the use of the weather radar data for the definition of rainfall thresholds for debris-flow triggering. Thus, rainfall data obtained from 3 to 5 rain gauges and from radar were compared for a dataset of events occurred in Catalonia (Spain). The goal was to determine in which cases the description of the rainfall episode (in particular the maximum intensity) had been more accurate. The analysed dataset consists of: 1) three events occurred in the Rebaixader debris-flow monitoring station (Axial Pyrenees) including two hyperconcentrated flows and one debris flow; 2) one debris-flow event occurred in the Port Ainé ski resort (Axial Pyrenees); 3) one debris-flow event in Montserrat (Mediterranean Coastal range). The comparison of the hyetographs from the

Bronchial effects of leukotriene D4 inhalation in normal human lung

DEFF Research Database (Denmark)

Bisgaard, H; Groth, S

1987-01-01

airways in asthmatic patients out of attack. LTD4 caused a dose-dependent obstruction of the airways as measured by partial flow-volume curves and volume of trapped gas, yet only minor changes in forced expiratory volume in 1 s (FEV1) and peak expiratory flow rate. LTD4 was 1900-7000 times more potent......The aim of the study was to investigate whether inhaled leukotriene (LT) D4 could mimic the characteristics of asthmatic patients after allergen-induced attack, i.e. a prolonged subclinical bronchial obstruction, an increased reactivity of the airways and a late reaction. The effects of LTD4 were...... than histamine. LTD4 inhalations were almost symptomless as opposed to the irritative and dyspnoeic symptoms seen after inhalation of histamine. The time duration for the induced change in partial flow-volume curves was the same for the two drugs. Approximately 30 min elapsed until the bronchial...

Does attenuated skin blood flow lower sweat rate and the critical environmental limit for heat balance during severe heat exposure?

Science.gov (United States)

Cramer, Matthew N; Gagnon, Daniel; Crandall, Craig G; Jay, Ollie

2017-02-01

What is the central question of this study? Does attenuated skin blood flow diminish sweating and reduce the critical environmental limit for heat balance, which indicates maximal heat loss potential, during severe heat stress? What is the main finding and its importance? Isosmotic hypovolaemia attenuated skin blood flow by ∼20% but did not result in different sweating rates, mean skin temperatures or critical environmental limits for heat balance compared with control and volume-infusion treatments, suggesting that the lower levels of skin blood flow commonly observed in aged and diseased populations may not diminish maximal whole-body heat dissipation. Attenuated skin blood flow (SkBF) is often assumed to impair core temperature (T c ) regulation. Profound pharmacologically induced reductions in SkBF (∼85%) lead to impaired sweating, but whether the smaller attenuations in SkBF (∼20%) more often associated with ageing and certain diseases lead to decrements in sweating and maximal heat loss potential is unknown. Seven healthy men (28 ± 4 years old) completed a 30 min equilibration period at 41°C and a vapour pressure (P a ) of 2.57 kPa followed by incremental steps in P a of 0.17 kPa every 6 min to 5.95 kPa. Differences in heat loss potential were assessed by identifying the critical vapour pressure (P crit ) at which an upward inflection in T c occurred. The following three separate treatments elicited changes in plasma volume to achieve three distinct levels of SkBF: control (CON); diuretic-induced isosmotic dehydration to lower SkBF (DEH); and continuous saline infusion to maintain SkBF (SAL). The T c , mean skin temperature (T sk ), heart rate, mean laser-Doppler flux (forearm and thigh; LDF mean ), mean local sweat rate (forearm and thigh; LSR mean ) and metabolic rate were measured. In DEH, a 14.2 ± 5.7% lower plasma volume resulted in a ∼20% lower LDF mean in perfusion units (PU) (DEH, 139 ± 23 PU; CON, 176 ± 22 PU; and SAL

Positive end-expiratory pressure improves gas exchange and pulmonary mechanics during partial liquid ventilation.

Science.gov (United States)

Kirmse, M; Fujino, Y; Hess, D; Kacmarek, R M

1998-11-01

Partial liquid ventilation (PLV) with perflubron (PFB) has been proposed as an adjunct to the current therapies for the acute respiratory distress syndrome (ARDS). Because PFB has been also referred to as "liquid PEEP," distributing to the most gravity-dependent regions of the lung, less attention has been paid to the amount of applied positive end-expiratory pressure (PEEP). We hypothesized that higher PEEP levels than currently applied are needed to optimize gas exchange, and that the lower inflection point (LIP) of the pressure-volume curve could be used to estimate the amount of PEEP needed when the lung is filled with PFB. Lung injury was induced in 23 sheep by repeated lung lavage with warmed saline until the PaO2/FIO2 ratio fell below 150. Five sheep were used to investigate the change of the LIP when the lung was filled with PFB in increments of 5 ml/kg/body weight to a total of 30 ml/kg/body weight. To evaluate the impact of PEEP set at LIP +1 cm H2O we randomized an additional 15 sheep to three groups with different doses (7.5 ml, 15 ml, 30 ml/kg/body weight) of PFB. In random order a PEEP of 5 cm H2O or PEEP at LIP +1 cm H2O was applied. The LIP decreased with incremental filling of PFB to a minimum at 10 ml (p PFB shifts the LIP to the left, and that setting PEEP at LIP +1 cm H2O improves gas exchange at moderate to high doses of PFB.

Boolean logic analysis for flow regime recognition of gas–liquid horizontal flow

International Nuclear Information System (INIS)

Ramskill, Nicholas P; Wang, Mi

2011-01-01

In order to develop a flowmeter for the accurate measurement of multiphase flows, it is of the utmost importance to correctly identify the flow regime present to enable the selection of the optimal method for metering. In this study, the horizontal flow of air and water in a pipeline was studied under a multitude of conditions using electrical resistance tomography but the flow regimes that are presented in this paper have been limited to plug and bubble air–water flows. This study proposes a novel method for recognition of the prevalent flow regime using only a fraction of the data, thus rendering the analysis more efficient. By considering the average conductivity of five zones along the central axis of the tomogram, key features can be identified, thus enabling the recognition of the prevalent flow regime. Boolean logic and frequency spectrum analysis has been applied for flow regime recognition. Visualization of the flow using the reconstructed images provides a qualitative comparison between different flow regimes. Application of the Boolean logic scheme enables a quantitative comparison of the flow patterns, thus reducing the subjectivity in the identification of the prevalent flow regime

First pump limiter experiments in Tore Supra

International Nuclear Information System (INIS)

Chatelier, M.; Bruneau, J.L.; Chappuis, P.; Gil, C.; Guilhem, D.; Lipa, M.; Rodriguez, L.; Vallet, J.C.; Van Houtte, D.; Watkins, J.G.

1989-01-01

The thermal load and the particle pumping effects on the outboard pump limiters (OPL), in Tore Supra are analyzed. The investigations are performed for the plasma either in contact with the OPL/ONPL (outboard non pumped limiters) alone or with the OPL and the vertical limiters together. Calorimetric measurements provide estimates of the time-integrated balance of the energy flow at the plasma edge. Radiated and charge exchange energy losses are deduced from the inner vessel calorimetry (R=242cm, a=94cm). Conductive/convective losses on the OPL and vertical (top and bottom) limiters are independently measured, as well as the integrated energy flow on the ergodic divertors. The calorimetric results, the bolometric measurements of the radiated power and the Ohmic power estimates, are indicated. The central line density from interferometric measurement for the two successive shots, with the ONPL and with the OPL, are given

Comparative study of incompressible and isothermal compressible flow solvers for cavitating flow dynamics

Energy Technology Data Exchange (ETDEWEB)

Park, Sun Ho [Korea Maritime and Ocean University, Busan (Korea, Republic of); Rhee, Shin Hyung [Seoul National University, Seoul (Korea, Republic of)

2015-08-15

Incompressible flow solvers are generally used for numerical analysis of cavitating flows, but with limitations in handling compressibility effects on vapor phase. To study compressibility effects on vapor phase and cavity interface, pressure-based incompressible and isothermal compressible flow solvers based on a cell-centered finite volume method were developed using the OpenFOAM libraries. To validate the solvers, cavitating flow around a hemispherical head-form body was simulated and validated against the experimental data. The cavity shedding behavior, length of a re-entrant jet, drag history, and the Strouhal number were compared between the two solvers. The results confirmed that computations of the cavitating flow including compressibility effects improved the reproduction of cavitation dynamics.

Efficiency of osmotic pipe flows

DEFF Research Database (Denmark)

Haaning, Louise Sejling; Jensen, Kaare Hartvig; Helix Nielsen, Claus

2013-01-01

efficiency of these flows is limited by the presence of “unstirred” concentration boundary layers near the tube walls, and our primary aim is to understand and quantify these layers and their effect on the flow. We measure the outlet flow rate Qout while varying the inlet flow rate Q*, concentration c......We present experiments and theory for flows of sugar or salt solutions in cylindrical tubes with semipermeable walls (hollow fiber membranes) immersed in water, quantifying the strength of the osmotic driving force in relation to the dimensionless parameters that specify the system. The pumping...

Limiting Factors for External Reactor Vessel Cooling

International Nuclear Information System (INIS)

Cheung, F.B.

2005-01-01

The method of external reactor vessel cooling (ERVC) that involves flooding of the reactor cavity during a severe accident has been considered a viable means for in-vessel retention (IVR). For high-power reactors, however, there are some limiting factors that might adversely affect the feasibility of using ERVC as a means for IVR. In this paper, the key limiting factors for ERVC have been identified and critically discussed. These factors include the choking limit for steam venting (CLSV) through the bottleneck of the vessel/insulation structure, the critical heat flux (CHF) for downward-facing boiling on the vessel outer surface, and the two-phase flow instabilities in the natural circulation loop within the flooded cavity. To enhance ERVC, it is necessary to eliminate or relax these limiting factors. Accordingly, methods to enhance ERVC and thus improve margins for IVR have been proposed and demonstrated, using the APR1400 as an example. The strategy is based on using two distinctly different methods to enhance ERVC. One involves the use of an enhanced vessel/insulation design to facilitate steam venting through the bottleneck of the annular channel. The other involves the use of an appropriate vessel coating to promote downward-facing boiling. It is found that the use of an enhanced vessel/insulation design with bottleneck enlargement could greatly facilitate the process of steam venting through the bottleneck region as well as streamline the resulting two-phase motions in the annular channel. By selecting a suitable enhanced vessel/insulation design, not only the CLSV but also the CHF limits could be significantly increased. In addition, the problem associated with two-phase flow instabilities and flow-induced mechanical vibration could be minimized. It is also found that the use of vessel coatings made of microporous metallic layers could greatly facilitate downward-facing boiling on the vessel outer surface. With vessel coatings, the local CHF limits at

Rarefaction wave in relativistic steady magnetohydrodynamic flows

Energy Technology Data Exchange (ETDEWEB)

Sapountzis, Konstantinos, E-mail: ksapountzis@phys.uoa.gr; Vlahakis, Nektarios, E-mail: vlahakis@phys.uoa.gr [Faculty of Physics, University of Athens, 15784 Zografos, Athens (Greece)

2014-07-15

We construct and analyze a model of the relativistic steady-state magnetohydrodynamic rarefaction that is induced when a planar symmetric flow (with one ignorable Cartesian coordinate) propagates under a steep drop of the external pressure profile. Using the method of self-similarity, we derive a system of ordinary differential equations that describe the flow dynamics. In the specific limit of an initially homogeneous flow, we also provide analytical results and accurate scaling laws. We consider that limit as a generalization of the previous Newtonian and hydrodynamic solutions already present in the literature. The model includes magnetic field and bulk flow speed having all components, whose role is explored with a parametric study.

Ultrasonic 3-D Vector Flow Method for Quantitative In Vivo Peak Velocity and Flow Rate Estimation

DEFF Research Database (Denmark)

Holbek, Simon; Ewertsen, Caroline; Bouzari, Hamed

2017-01-01

Current clinical ultrasound (US) systems are limited to show blood flow movement in either 1-D or 2-D. In this paper, a method for estimating 3-D vector velocities in a plane using the transverse oscillation method, a 32×32 element matrix array, and the experimental US scanner SARUS is presented...... is validated in two phantom studies, where flow rates are measured in a flow-rig, providing a constant parabolic flow, and in a straight-vessel phantom ( ∅=8 mm) connected to a flow pump capable of generating time varying waveforms. Flow rates are estimated to be 82.1 ± 2.8 L/min in the flow-rig compared...

Acoustic bubble enhanced pinched flow fractionation for microparticle separation

International Nuclear Information System (INIS)

Zhou, Ran; Wang, Cheng

2015-01-01

Pinched flow fractionation is a simple method for separating micron-sized particles by size, but has certain intrinsic limitations, e.g. requirement of a pinched segment similar to particle size and limited separation distance. In this paper, we developed an acoustic bubble enhanced pinched flow fractionation (PFF) method for microparticle separation. The proposed technique utilized microbubble streaming flows to overcome the limitations of conventional PFF. Our device has demonstrated separation of different sized microparticles (diameters 10 and 2 μm) with a larger pinched segment (60 μm) and at different buffer/particle solution flow rate ratios (5–25). The separation distances between particles are larger (as much as twice as large) than those achieved with conventional PFF. In addition, the separation position and distance can be adjusted by changing the driving voltage. The robust performance is due to the unique features of the flow field inside the pinched segment. We investigated several factors, including flow rate ratio, total flow rate and driving voltage, that affect the separation performance. (paper)

Some comments on combusting flows and instrumentation for two-phase flows

International Nuclear Information System (INIS)

Whitelaw, J.H.

1985-01-01

Measurements of the velocity characteristics of combusting flows have been reported over the past 15 years and have Encompassed an extensive range of flows configurations. Difficulties in applying instrumentation and interpreting results are, however, still experienced and this presentation describes two experiments which are useful examples of successful applications. The first is concerned with a gas-turbine combustion chamber which involves limited optical access with high heat release but does not require measurement accuracy such as that of, for example, external aerodynamic flows. The second combines laser velocimetry with digitally compensated thermocouples to provide detailed information of a premixed, bluff-body stabilized flame and involves conditionally sampled results so as to determine the separate flow characteristics of products and reactants

Comparison of five portable peak flow meters

Directory of Open Access Journals (Sweden)

Glaucia Nency Takara

2010-01-01

Full Text Available OBJECTIVE: To compare the measurements of spirometric peak expiratory flow (PEF from five different PEF meters and to determine if their values are in agreement. Inaccurate equipment may result in incorrect diagnoses of asthma and inappropriate treatments. METHODS: Sixty-eight healthy, sedentary and insufficiently active subjects, aged from 19 to 40 years, performed PEF measurements using Air Zone®, Assess®, Galemed®, Personal Best® and Vitalograph® peak flow meters. The highest value recorded for each subject for each device was compared to the corresponding spirometric values using Friedman's test with Dunn's post-hoc (p<0.05, Spearman's correlation test and Bland-Altman's agreement test. RESULTS: The median and interquartile ranges for the spirometric values and the Air Zone®, Assess®, Galemed®, Personal Best® and Vitalograph® meters were 428 (263-688 L/min, 450 (350-800 L/min, 420 (310-720 L/min, 380 (300-735 L/min, 400 (310-685 L/min and 415 (335-610 L/min, respectively. Significant differences were found when the spirometric values were compared to those recorded by the Air Zone® (p<0.001 and Galemed ® (p<0.01 meters. There was no agreement between the spirometric values and the five PEF meters. CONCLUSIONS: The results suggest that the values recorded from Galemed® meters may underestimate the actual value, which could lead to unnecessary interventions, and that Air Zone® meters overestimate spirometric values, which could obfuscate the need for intervention. These findings must be taken into account when interpreting both devices' results in younger people. These differences should also be considered when directly comparing values from different types of PEF meters.

Obesity disproportionately impacts lung volumes, airflow and exhaled nitric oxide in children.

Science.gov (United States)

Yao, Tsung-Chieh; Tsai, Hui-Ju; Chang, Su-Wei; Chung, Ren-Hua; Hsu, Jing-Ya; Tsai, Ming-Han; Liao, Sui-Ling; Hua, Man-Chin; Lai, Shen-Hao; Chen, Li-Chen; Yeh, Kuo-Wei; Tseng, Yu-Lun; Lin, Wan-Chen; Chang, Su-Ching; Huang, Jing-Long

2017-01-01

The current literature focusing on the effect of obesity and overweight on lung function and fraction of exhaled nitric oxide (FeNO) in children, particularly among healthy children of non-European descent, remains controversial. Furthermore, whether the relationship of obesity and overweight with lung function and FeNO in children is modified by atopy is unclear. The objective of this study was to examine the effect of excess weight on lung function parameters and FeNO among Asian children, with a particular focus on exploring the potential effect modification by atopy. We investigated the effect of excess weight on lung function and FeNO in a population sample of 1,717 children aged 5 to 18 years and explored the potential modifying effect of atopy. There were positive associations of body mass index (BMI) z-score with forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), peak expiratory flow (PEF), and forced expiratory flow at 25-75% (FEF25-75) (all Pchildren from the general population, independent of atopic status. Excess weight inversely affects FeNO in atopic but not in non-atopic children.

Prevalence and features of advanced asbestosis (ILO profusion scores above 2/2). International Labour Office.

Science.gov (United States)

Kilburn, K H

2000-01-01

In this study, the author addressed the following question: Do workers with advanced asbestosis have a restrictive pulmonary physiology, and, alternately, do those who have restrictive physiological tests have advanced asbestosis? One group was identified by obvious radiographic measurements, and the other group was defined via physiologic measurements. Total lung capacity, vital capacity, and flows were measured in 12,856 men exposed to asbestos, of whom 3,445 had radiographic signs of asbestosis, as defined by the International Labour Office criteria. Radiographically advanced asbestosis-International Labour Office criteria profusion greater than 2/2 was present in 85 (2.5%) of men. An additional 52 men had physiologically restrictive disease. The author, who compared pulmonary flows and volumes of these two groups, used mean percentage predicted, adjusted for height, age, and duration of cigarette smoking. Men with radiographically advanced asbestosis had normal total lung capacity (i.e., 105.5% predicted), reduced forced vital capacities (i.e., 82.7% predicted), air trapping (i.e., residual volume/total lung capacity increased to 54.4%), and reduced flows (i.e., forced expiratory flow [FEF25-75] = 60.6% predicted, forced expiratory volume in 1 s = 78.0% predicted, and forced expiratory volume in 1 s/forced vital capacity = 65.5%). In contrast, men selected from the same exposed population for restrictive disease (i.e., reduced total lung capacity [72.6% predicted] and forced vital capacity [61.5% predicted]) also had airflow obstruction (i.e., forced expiratory volume in 1 s/forced vital capacity of 74.5% predicted) and air trapping (i.e., residual volume/total lung capacity of 46.7%). Only half of these men had asbestosis--and it was of minimal severity. In summary, advanced asbestosis was characterized by airway obstruction and air trapping, both of which reduced vital capacity but not total lung capacity; therefore, it was not a restrictive disease. In

Effects of respiratory rate, plateau pressure, and positive end-expiratory pressure on PaO2 oscillations after saline lavage.

Science.gov (United States)

Baumgardner, James E; Markstaller, Klaus; Pfeiffer, Birgit; Doebrich, Marcus; Otto, Cynthia M

2002-12-15

One of the proposed mechanisms of ventilator-associated lung injury is cyclic recruitment of atelectasis. Collapse of dependent lung regions with every breath should lead to large oscillations in PaO2 as shunt varies throughout the respiratory cycle. We placed a fluorescence-quenching PO2 probe in the brachiocephalic artery of six anesthetized rabbits after saline lavage. Using pressure-controlled ventilation with oxygen, ventilator settings were varied in random order over three levels of positive end-expiratory pressure (PEEP), respiratory rate (RR), and plateau pressure minus PEEP (Delta). Dependence of the amplitude of PaO2 oscillations on PEEP, RR, and Delta was modeled by multiple linear regression. Before lavage, arterial PO2 oscillations varied from 3 to 22 mm Hg. After lavage, arterial PO2 oscillations varied from 5 to 439 mm Hg. Response surfaces showed markedly nonlinear dependence of amplitude on PEEP, RR, and Delta. The large PaO2 oscillations observed provide evidence for cyclic recruitment in this model of lung injury. The important effect of RR on the magnitude of PaO2 oscillations suggests that the static behavior of atelectasis cannot be accurately extrapolated to predict dynamic behavior at realistic breathing frequencies.

Power limit and quality limit of natural circulation reactor

International Nuclear Information System (INIS)

Zhao Guochang; Ma Changwen

1997-01-01

The circulation characteristics of natural circulation reactor in boiling regime are researched. It is found that, the circulation mass flow rate and the power have a peak value at a mass quality respectively. Therefore, the natural circulation reactor has a power limit under certain technological condition. It can not be increased steadily by continually increasing the mass quality. Corresponding to this, the mass quality of natural circulation reactor has a reasonable limit. The relations between the maximum power and the reactor parameters, such as the resistance coefficient, the working pressure and so on, are analyzed. It is pointed out that the power limit of natural circulation reactor is about 1000 MW at present technological condition. Taking the above result and low quality stability experimental result into account, the authors recommend that the reasonable mass quality of natural circulation reactor working in boiling regime is from 2% to 3% under the researched working pressure

Modelling information flow along the human connectome using maximum flow.

Science.gov (United States)

Lyoo, Youngwook; Kim, Jieun E; Yoon, Sujung

2018-01-01

The human connectome is a complex network that transmits information between interlinked brain regions. Using graph theory, previously well-known network measures of integration between brain regions have been constructed under the key assumption that information flows strictly along the shortest paths possible between two nodes. However, it is now apparent that information does flow through non-shortest paths in many real-world networks such as cellular networks, social networks, and the internet. In the current hypothesis, we present a novel framework using the maximum flow to quantify information flow along all possible paths within the brain, so as to implement an analogy to network traffic. We hypothesize that the connection strengths of brain networks represent a limit on the amount of information that can flow through the connections per unit of time. This allows us to compute the maximum amount of information flow between two brain regions along all possible paths. Using this novel framework of maximum flow, previous network topological measures are expanded to account for information flow through non-shortest paths. The most important advantage of the current approach using maximum flow is that it can integrate the weighted connectivity data in a way that better reflects the real information flow of the brain network. The current framework and its concept regarding maximum flow provides insight on how network structure shapes information flow in contrast to graph theory, and suggests future applications such as investigating structural and functional connectomes at a neuronal level. Copyright © 2017 Elsevier Ltd. All rights reserved.

Respiratory mechanics

CERN Document Server

Wilson, Theodore A

2016-01-01

This book thoroughly covers each subfield of respiratory mechanics: pulmonary mechanics, the respiratory pump, and flow. It presents the current understanding of the field and serves as a guide to the scientific literature from the golden age of respiratory mechanics, 1960 - 2010. Specific topics covered include the contributions of surface tension and tissue forces to lung recoil, the gravitational deformation of the lung, and the interdependence forces that act on pulmonary airways and blood vessels. The geometry and kinematics of the ribs is also covered in detail, as well as the respiratory action of the external and internal intercostal muscles, the mechanics of the diaphragm, and the quantitative compartmental models of the chest wall is also described. Additionally, flow in the airways is covered thoroughly, including the wave-speed and viscous expiratory flow-limiting mechanisms; convection, diffusion and the stationary front; and the distribution of ventilation. This is an ideal book for respiratory ...

Comparison of Miniaturized and Conventional Asymmetrical Flow Field-Flow Fractionation (AF4 Channels for Nanoparticle Separations

Directory of Open Access Journals (Sweden)

Zengchao You

2017-03-01

Full Text Available The performance of a miniaturized channel for the separation of polymer and metal nanoparticles (NP using Asymmetrical Flow Field-Flow Fractionation (AF4 was investigated and compared with a conventional AF4 system. To develop standard separation methods, experimental parameters like cross flow, gradient profile and injection time were varied and optimized. Corresponding chromatographic parameters were calculated and compared. Our results indicate that the chromatographic resolution in the miniaturized channel is lower, whereas significantly shorter analyses time and less solvent consumption were obtained. Moreover, the limit of detection (LOD and limit of quantification (LOQ obtained from hyphenation with a UV-detector are obviously lower than in a conventional channel, which makes the miniaturized channel interesting for trace analysis.

Three Dimensional Viscous Flow Field in an Axial Flow Turbine Nozzle Passage

Science.gov (United States)

Ristic, D.; Lakshminarayana, B.

1997-01-01

The objective of this investigation is experimental and computational study of three dimensional viscous flow field in the nozzle passage of an axial flow turbine stage. The nozzle passage flow field has been measured using a two sensor hot-wire probe at various axial and radial stations. In addition, two component LDV measurements at one axial station (x/c(sum m) = 0.56) were performed to measure the velocity field. Static pressure measurements and flow visualization, using a fluorescent oil technique, were also performed to obtain the location of transition and the endwall limiting streamlines. A three dimensional boundary layer code, with a simple intermittency transition model, was used to predict the viscous layers along the blade and endwall surfaces. The boundary layers on the blade surface were found to be very thin and mostly laminar, except on the suction surface downstream of 70% axial chord. Strong radial pressure gradient, especially close to the suction surface, induces strong cross flow components in the trailing edge regions of the blade. On the end-walls the boundary layers were much thicker, especially near the suction corner of the casing surface, caused by secondary flow. The secondary flow region near the suction-casing surface corner indicates the presence of the passage vortex detached from the blade surface. The corner vortex is found to be very weak. The presence of a closely spaced rotor downstream (20% of the nozzle vane chord) introduces unsteadiness in the blade passage. The measured instantaneous velocity signal was filtered using FFT square window to remove the periodic unsteadiness introduced by the downstream rotor and fans. The filtering decreased the free stream turbulence level from 2.1% to 0.9% but had no influence on the computed turbulence length scale. The computation of the three dimensional boundary layers is found to be accurate on the nozzle passage blade surfaces, away from the end-walls and the secondary flow region. On

Impact of L/D on 90 Degree Sharp-Edge Orifice Flow with Manifold Passage Cross Flow (Preprint)