Effect of convective stretching and folding on aerosol mixing deep in the lung, assessed by approximate entropy

Recent advances in the understanding of alveolar flow

Understanding the dynamics of airflow in alveoli and its effect on the behavior of particle transport and deposition is important for understanding lung functions and the cause of many lung diseases. The studies on these areas have drawn substantial attention over the last few decades. This Review discusses the recent progress in the investigation of behavior of airflow in alveoli. The information obtained from studies on the structure of the lung airway tree and alveolar topology is provided first. The current research progress on the modeling of alveoli is then reviewed. The alveolar cell parameters at different generation of branches, issues to model real alveolar flow, and the current numerical and experimental approaches are discussed. The findings on flow behavior, in particular, flow patterns and the mechanism of chaotic flow generation in the alveoli are reviewed next. The different flow patterns under different geometrical and flow conditions are discussed. Finally, developments on microfluidic devices such as lung-on-a-chip devices are reviewed. The issues of current devices are discussed.

Pulmonary challenges of prolonged journeys to space: taking your lungs to the moon

Space flight presents a set of physiological challenges to the space explorer which result from the absence of gravity (or in the case of planetary exploration, partial gravity), radiation exposure, isolation and a prolonged period in a confined environment, distance from Earth, the need to venture outside in the hostile environment of the destination, and numerous other factors. Gravity affects regional lung function, and the human lung shows considerable alteration in function in low gravity; however, this alteration does not result in deleterious changes that compromise lung function upon return to Earth. The decompression stress associated with extravehicular activity, or spacewalk, does not appear to compromise lung function, and future habitat (living quarter) designs can be engineered to minimise this stress. Dust exposure is a significant health hazard in occupational settings such as mining, and exposure to extraterrestrial dust is an almost inevitable consequence of planetary exploration. The combination of altered pulmonary deposition of extraterrestrial dust and the potential for the dust to be highly toxic likely makes dust exposure the greatest threat to the lung in planetary exploration.

Effects of Partial Gravity on the Function and Particle Handling of the Human Lung

Purpose of Review

The challenges presented to the lung by the space environment are the effects of prolonged absence of gravity, the challenges of decompression stress associated with spacewalking, and the changes in the deposition of inhaled particulate matter.

Recent Findings

Although there are substantial changes in the function of the lung in partial gravity, the lung is largely unaffected by sustained exposure, returning rapidly to a normal state after return to 1G. Provided there is adequate denitrogenation prior to a spacewalk, avoiding the development of venous gas emboli, the lung copes well with the low pressure environment of the spacesuit. Particulate deposition is reduced in partial gravity, but where that deposition occurs is likely in the more peripheral airspaces, with associated longer retention times, potentially raising the toxicological potential of toxic dusts.

Summary

Despite its delicate structure the lung performs well in partial gravity, with the greatest threat likely arising from inhaled particulate matter (extra-terrestrial dusts).

Dynamics of Particle Size on Inhalation of Environmental Aerosol and Impact on Deposition Fraction

Inhalation of elevated levels of particulate air pollution has been shown to elicit the onset of adverse health effects in humans, where the magnitude of the response is a product of where in the lung the particulate dose is delivered. At any point in time during inhalation the depositional flux of the aerosol is a function of the radius of the droplet, thus a detailed understanding of the rate and magnitude of the mass flux of water to the droplet during inhalation is crucial. In this study, we assess the impact of aerosol hygroscopicity on deposited dose through the inclusion of a detailed treatment of the mass flux of water to account for the dynamics of particle size in a modified version of the standard International Commission on Radiological Protection (ICRP) whole lung deposition model. The ability to account for the role of the relative humidity (RH) of the aerosol prior to, and during, inhalation on the deposition pattern is explored, and found to have a significant effect on the deposition pattern. The model is verified by comparison to previously published measurements, and used to demonstrate that ambient RH affects where in the lung indoor particulate air pollution is delivered.

Increase in relative deposition of fine particles in the rat lung periphery in the absence of gravity

While it is well recognized that pulmonary deposition of inhaled particles is lowered in microgravity (μG) compared with gravity on the ground (1G), the absence of sedimentation causes fine particles to penetrate deeper in the lung in μG. Using quantitative magnetic resonance imaging (MRI), we determined the effect of gravity on peripheral deposition (DEPperipheral) of fine particles. Aerosolized 0.95-μm-diameter ferric oxide particles were delivered to spontaneously breathing rats placed in plethysmographic chambers both in μG aboard the NASA Microgravity Research Aircraft and at 1G. Following exposure, lungs were perfusion fixed, fluid filled, and imaged in a 3T MR scanner. The MR signal decay rate, R2*, was measured in each voxel of the left lung from which particle deposition (DEP) was determined based on a calibration curve. Regional deposition was assessed by comparing DEP between the outer (DEPperipheral) and inner (DEPcentral) areas on each slice, and expressed as the central-to-peripheral ratio. Total lung deposition tended to be lower in μG compared with 1G (1.01 ± 0.52 vs. 1.43 ± 0.52 μg/ml, P = 0.1). In μG, DEPperipheral was larger than DEPcentral (P < 0.03), while, in 1G, DEPperipheral was not significantly different from DEPcentral. Finally, central-to-peripheral ratio was significantly less in μG than in 1G (P ≤ 0.05). These data show a larger fraction of fine particles depositing peripherally in μG than in 1G, likely beyond the large- and medium-sized airways. Although not measured, the difference in the spatial distribution of deposited particles between μG and 1G could also affect particle retention rates, with an increase in retention for particles deposited more peripherally.

Transport of gases between the environment and alveoli--theoretical foundations

The transport of oxygen and carbon dioxide in the gas phase from the ambient environment to and from the alveolar gas/blood interface is accomplished through the tracheobronchial tree, and involves mechanisms of bulk or convective transport and diffusive net transport. The geometry of the airway tree and the fluid dynamics of these two transport processes combine in such a way that promotes a classical fractionation of ventilation into dead space and alveolar ventilation, respectively. This simple picture continues to capture much of the essence of gas phase transport. On the other hand, a more detailed look at the interaction of convection and diffusion leads to significant new issues, many of which remain open questions. These are associated with parallel and serial inhomogeneities especially within the distal acinar units, velocity profiles in distal airways and terminal spaces subject to moving boundary conditions, and the serial transport of respiratory gases within the complex acinar architecture. This article focuses specifically on the theoretical foundations of gas transport, addressing two broad areas. The first deals with the reasons why the classical picture of alveolar and dead space ventilation is so successful; the second examines the underlying assumptions within current approximations to convective and diffusive transport, and how they interact to effect net gas exchange.

Particle transport and deposition: basic physics of particle kinetics

The human body interacts with the environment in many different ways. The lungs interact with the external environment through breathing. The enormously large surface area of the lung with its extremely thin air-blood barrier is exposed to particles suspended in the inhaled air. The particle-lung interaction may cause deleterious effects on health if the inhaled pollutant aerosols are toxic. Conversely, this interaction can be beneficial for disease treatment if the inhaled particles are therapeutic aerosolized drugs. In either case, an accurate estimation of dose and sites of deposition in the respiratory tract is fundamental to understanding subsequent biological response, and the basic physics of particle motion and engineering knowledge needed to understand these subjects is the topic of this article. A large portion of this article deals with three fundamental areas necessary to the understanding of particle transport and deposition in the respiratory tract. These are: (i) the physical characteristics of particles, (ii) particle behavior in gas flow, and (iii) gas-flow patterns in the respiratory tract. Other areas, such as particle transport in the developing lung and in the diseased lung are also considered. The article concludes with a summary and a brief discussion of areas of future research.

Aerosol bolus dispersion in acinar airways--influence of gravity and airway asymmetry

The aerosol bolus technique can be used to estimate the degree of convective mixing in the lung; however, contributions of different lung compartments to measured dispersion cannot be differentiated unambiguously. To estimate dispersion in the distal lung, we studied the effect of gravity and airway asymmetry on the dispersion of 1 μm-diameter particle boluses in three-dimensional computational models of the lung periphery, ranging from a single alveolar sac to four-generation (g4) structures of bifurcating airways that deformed homogeneously during breathing. Boluses were introduced at the beginning of a 2-s inhalation, immediately followed by a 3-s exhalation. Dispersion was estimated by the half-width of the exhaled bolus. Dispersion was significantly affected by the spatial orientation of the models in normal gravity and was less in zero gravity than in normal gravity. Dispersion was strongly correlated with model volume in both normal and zero gravity. Predicted pulmonary dispersion based on a symmetric g4 acinar model was 391 ml and 238 ml under normal and zero gravity, respectively. These results accounted for a significant amount of dispersion measured experimentally. In zero gravity, predicted dispersion in a highly asymmetric model accounted for ∼20% of that obtained in a symmetric model with comparable volume and number of alveolated branches, whereas normal gravity dispersions were comparable in both models. These results suggest that gravitational sedimentation and not geometrical asymmetry is the dominant factor in aerosol dispersion in the lung periphery.

Steady streaming: A key mixing mechanism in low-Reynolds-number acinar flows

Study of mixing is important in understanding transport of submicron sized particles in the acinar region of the lung. In this article, we investigate transport in view of advective mixing utilizing Lagrangian particle tracking techniques: tracer advection, stretch rate and dispersion analysis. The phenomenon of steady streaming in an oscillatory flow is found to hold the key to the origin of kinematic mixing in the alveolus, the alveolar mouth and the alveolated duct. This mechanism provides the common route to folding of material lines and surfaces in any region of the acinar flow, and has no bearing on whether the geometry is expanding or if flow separates within the cavity or not. All analyses consistently indicate a significant decrease in mixing with decreasing Reynolds number (Re). For a given Re, dispersion is found to increase with degree of alveolation, indicating that geometry effects are important. These effects of Re and geometry can also be explained by the streaming mechanism. Based on flow conditions and resultant convective mixing measures, we conclude that significant convective mixing in the duct and within an alveolus could originate only in the first few generations of the acinar tree as a result of nonzero inertia, flow asymmetry, and large Keulegan-Carpenter (K(C)) number.

Aerosol deposition characteristics in distal acinar airways under cyclic breathing conditions

Although the major mechanisms of aerosol deposition in the lung are known, detailed quantitative data in anatomically realistic models are still lacking, especially in the acinar airways. In this study, an algorithm was developed to build multigenerational three-dimensional models of alveolated airways with arbitrary bifurcation angles and spherical alveolar shape. Using computational fluid dynamics, the deposition of 1- and 3-μm aerosol particles was predicted in models of human alveolar sac and terminal acinar bifurcation under rhythmic wall motion for two breathing conditions (functional residual capacity = 3 liter, tidal volume = 0.5 and 0.9 liter, breathing period = 4 s). Particles entering the model during one inspiration period were tracked for multiple breathing cycles until all particles deposited or escaped from the model. Flow recirculation inside alveoli occurred only during transition between inspiration and expiration and accounted for no more than 1% of the whole cycle. Weak flow irreversibility and convective transport were observed in both models. The average deposition efficiency was similar for both breathing conditions and for both models. Under normal gravity, total deposition was ~33 and 75%, of which ~67 and 96% occurred during the first cycle, for 1- and 3-μm particles, respectively. Under zero gravity, total deposition was ~2-5% for both particle sizes. These results support previous findings that gravitational sedimentation is the dominant deposition mechanism for micrometer-sized aerosols in acinar airways. The results also showed that moving walls and multiple breathing cycles are needed for accurate estimation of aerosol deposition in acinar airways.

The effects of geometry on airflow in the acinar region of the human lung

Understanding flow phenomena in the pulmonary acinus is important for predicting particle transport and deposition and hence, in designing effective drug delivery strategies for the lung. In the current study, a three-dimensional honeycomb-like geometry involving a central airspace and surrounding alveoli is used to represent an alveolar duct and sacs. Numerical results predict that flow in the presence of wall motion is characterized by the presence of a developing recirculation region within the cavity and by a flow entrainment region indicative of the weak nature of interaction between duct and cavity. Under the normal breathing condition (2.5 s) and volumetric expansion (approximately 25%) considered here, recirculation disappears for Re<0.6. Alveolar flow in higher generations (at lower Reynolds number) results from significantly higher entrainment of the ductal flow, and does not exhibit any recirculation. In an asymmetric arrangement of the alveolar cluster, topological differences in cavity result in significant differences in the size of recirculation and the size of entrainment region within the alveoli of the same acinar generation, indicative of a non-uniform alveolar ventilation. The flow in the terminal alveolar sac is non-recirculating and not affected by variation in geometrical features.

Semi-empirical stochastic model of aerosol bolus dispersion in the human lung

Aerosol bolus dispersion, that is, the broadening of an inhaled narrow aerosol bolus upon exhalation, was simulated by Monte Carlo methods using a stochastic, asymmetric morphometric model of the human lung. Physical mechanisms considered to contribute to bolus dispersion were (1) axial diffusion in conductive airways, approximated by effective diffusivities, (2) convective mixing at airway bifurcation sites, (3) differences in inspiratory and expiratory velocity profiles, (4) mixing with residual air in alveoli, and (5) inhomogeneous ventilation of the lung lobes due to asymmetric flow spitting at bifurcations and asymmetric and asynchronous filling of the five lung lobes. Theoretical predictions of the bolus dispersion model were compared to experimental data for 79 healthy volunteers, which provide detailed information on statistical bolus parameters (half-width, standard deviation, skewness, and mode shift) and total bolus deposition as a function of the depth of bolus penetration into the airway system. Predicted bolus dispersion and deposition data show excellent agreement with the published experimental data, suggesting that axial diffusion in conductive airways and convective mixing in alveoli, resulting in irreversible particle transport, are the major determinants of bolus dispersion. The variability and asymmetry of the branching airway network, leading to asymmetric flow splitting at airway bifurcations, greatly enhances the effect of irreversibility and the resulting dispersion of the inhaled bolus.

Hamiltonian Chaos in a Model Alveolus

In the pulmonary acinus, the airflow Reynolds number is usually much less than unity and hence the flow might be expected to be reversible. However, this does not appear to be the case as a significant portion of the fine particles that reach the acinus remains there after exhalation. We believe that this irreversibility is at large a result of chaotic mixing in the alveoli of the acinar airways. To test this hypothesis, we solved numerically the equations for incompressible, pulsatile, flow in a rigid alveolated duct and tracked numerous fluid particles over many breathing cycles. The resulting Poincaré sections exhibit chains of islands on which particles travel. In the region between these chains of islands, some particles move chaotically. The presence of chaos is supported by the results of an estimate of the maximal Lyapunov exponent. It is shown that the streamfunction equation for this flow may be written in the form of a Hamiltonian system and that an expansion of this equation captures all the essential features of the Poincaré sections. Elements of Kolmogorov–Arnol’d–Moser theory, the Poincaré–Birkhoff fixed-point theorem, and associated Hamiltonian dynamics theory are then employed to confirm the existence of chaos in the flow in a rigid alveolated duct.

Gas and aerosol mixing in the acinus

This review is concerned with mixing and transport in the human pulmonary acinus. We first examine the current understanding of the anatomy of the acinus and introduce elements of fluid mechanics used to characterize the transport of momentum, gas and aerosol particles. We then review gas transport in more detail and highlight some areas of current research. Next we turn our attention to aerosol transport and in particular to mixing within the alveoli. We examine the factors influencing the level of mixing, review the concept of chaotic convective mixing, and make some brief comments on how mixing affects particle deposition. We end with a few comments on some issues unique to the neonatal and developing lung.

A novel technique to evaluate fluctuations of mood: implications for evaluating course and treatment effects in bipolar/affective disorders

OBJECTIVES

Several psychiatric conditions are associated with frequent fluctuations of affect. In this study, we propose a new technique to uniformly score depression and mania objectively and use a new mathematical technique to model the frequent fluctuations in mood using simulated data. Our main aim is to examine the usefulness of this measure for evaluating treatment effects or course of illness, especially in bipolar or unipolar affective illness to quantify mood fluctuations.

METHODS

We use a prototypical model, which takes into account the mean, the standard deviation (SD) and the coefficient of variation (CV = SD*100/mean) of the mood scores of the subjects over a user-defined period. We utilize simulated data of subjects for euthymia, minor depression, minor mania, severe depression, severe mania and cyclic bipolar illness (manic depression, MDP). We propose an objective method to quantify the mood of the subjects at weekly intervals (the interval can be user-defined) using a scale of 1-9 (1-4 = degrees of depression, 5 = euthymia, 6-9 = degrees of mania). These scores can be sampled according to the convenience and feasibility of the measurements, which can be derived from various clinical scales or by observation of the subjects in hospitals or other environments. We derive a new mathematical technique to arrive at a normalized measure for each of these conditions of simulated data in addition to the mean, SD and approximate entropy (ApEn).

RESULTS

We utilize three sets of data, one to train the model to classify the condition of the subjects and the other two to test the reliability of the technique. We are able to successfully classify the condition of the subjects over a 52-timepoint period (length can be days or weeks depending upon the sampling rate). The New Index (NI) correlates significantly only with the mean (r(2) = 0.78), but not with the SD or ApEn score.

CONCLUSIONS

These results indicate that it may be beneficial to reduce data according to the techniques we propose so that there is greater uniformity within which to compare future studies to evaluate treatment effects, not only in rapid-cycling MDP but also in other affective disorders. This method may be suitable for the meta-analysis of several studies, although different scales have been used in each of those studies. Our measure derived from simulated data has shown sufficient deviation of all the abnormal states from the euthymic state. The advantages and pitfalls of these techniques are further discussed to evaluate affect in various disorders. However, future prospective studies must address the importance of this measure in comparison with mean, SD and ApEn scores or other nonlinear measures of these time series. We are evaluating other nonlinear dynamic models, which may provide a continuous measure with which to identify different degrees of fluctuation of mood.

Aerosols in the study of convective acinar mixing

Convective mixing (CM) refers to the different transport mechanisms except Brownian diffusion that irreversibly transfer inspired air into resident air and can be studied using aerosol bolus inhalations. This paper provides a review of the present understanding of how each of these mechanisms contributes to CM. Original data of the combined effect of stretch and fold and gravitational sedimentation on CM are also presented. Boli of 0.5 microm-diameter particles were inhaled at penetration volumes (V(p)) of 300 and 1200 ml in eight subjects. Inspiration was followed by a 10-s breath hold, during which small flow reversals (FR) were imposed, and expiration. There was no physiologically significant dependence in dispersion and deposition with increasing FR. The results were qualitatively similar to those obtained in a previous study in microgravity in which it was speculated that the phenomenon of stretch and fold occurred during the first breathing cycle without the need of any subsequent FR.

Logistic trajectory maps and aerosol mixing due to asynchronous flow at airway bifurcations

Aerosols too large for significant Brownian transport, and too small for significant inertial transport, are nonetheless known to deposit deep in the lung, and are associated with increased risk of pulmonary disease. Classical models fail to explain such transport. We hypothesized that kinematic irreversibility in ventilation, arising from velocity saddle-points or from flow asynchrony at airway bifurcations, may be the fundamental transport mechanism. Our experimental evidence shows striking trajectory irreversibility in rat lungs ventilated with 2-color polymerizable silicones, representing resident and tidal gas. The striated patterns in small airways, even after one ventilatory cycle, support our hypothesis. Here we analyze bifurcating flow asynchrony in a simplified one-dimensional model. We find: unexpected richness and chaos in particle trajectories; almost all trajectories visit all spatial positions; surprisingly, there is complete mixing-the limiting concentration is spatially uniform. This is a new finding supporting the idea that kinematic irreversibility is a potent mixing and transport mechanism for aerosols deep in the lung.

Effect of small flow reversals on aerosol mixing in the alveolar region of the human lung

It has been suggested that irreversibility of alveolar flow combined with a stretched and folded pattern of streamlines can lead to a sudden increase in mixing in the lung. To determine whether this phenomenon is operative in the human lung in vivo, we performed a series of bolus studies with a protocol designed to induce complex folding patterns. Boli of 0.5- and 1-microm-diameter particles were inhaled at penetration volumes (V(p)) of 300 and 1,200 ml in eight subjects during short periods of microgravity aboard the National Aeronautics and Space Administration Microgravity Research Aircraft. Inspiration was from residual volume to 1 liter above 1 G functional residual capacity. This was followed by a 10-s breathhold, during which up to seven 100-ml flow reversals (FR) were imposed at V(p) = 300 ml and up to four 500-ml FR at V(p) = 1,200 ml, and by an expiration to residual volume. Bolus dispersion and deposition were calculated from aerosol concentration and flow rate continuously monitored at the mouth. There was no significant increase in dispersion and deposition with increasing FR except for dispersion between 0 and 7 FR at V(p) = 300 ml with 0.5-microm-diameter particles, and this increase was small. This suggested that either the phenomenon of stretch and fold did not occur within the number of FR we performed or that it had already occurred during the one breathing cycle included in the basic maneuver. We speculate that the phenomenon occurred during the basic maneuver, which is consistent with the high degree of dispersion and deposition observed previously in microgravity.

Gravitational deposition in a rhythmically expanding and contracting alveolus

In a previous simulation, our laboratory demonstrated that the flow induced by a rhythmically expanding and contracting alveolus is highly complex (Haber S, Butler JP, Brenner H, Emanuel I, and Tsuda A, J Fluid Mech 405: 243-268, 2000). Based on these earlier findings, we hypothesize that the trajectories and deposition of aerosols inside the alveoli differ substantially from those previously predicted. To test this hypothesis, trajectories of fine particles (0.5-2.5 microm in diameter) moving in the foregoing alveolar flow field and simultaneously subjected to the gravity field were simulated. The results show that alveolar wall motion is crucial in determining the enhancement of aerosol deposition inside the alveoli. In particular, 0.5- to 1-microm-diameter particles are sensitive to the detailed alveolar flow structure (e.g., recirculating flow), as they undergo gravity-induced convective mixing and deposition. Accordingly, deposition concentrations within each alveolus are nonuniform, with preferentially higher densities near the alveolar entrance ring, consistent with physiological observations. Deposition patterns along the acinar tree are also nonuniform, with higher deposition in the first half of the acinar generations. This is a result of the combined effects of enhanced alveolar deposition in the proximal region of the acinus due to alveoli expansion and contraction and reduction in the number of particles remaining in the gas phase down the acinar tree. We conclude that the cyclically expanding and contracting motion of alveoli plays an important role in determining gravitational deposition in the pulmonary acinus.

Approximate entropy of symptoms of mood: an effective technique to quantify regularity of mood

OBJECTIVES

Several psychiatric conditions are associated with lability of affect. In this study, we investigated regularity of mood using APEN (Approximate Entropy) on daily subjective ratings using a Visual Analog Scale with 11 items pertaining to mood.

METHODS

APEN was applied to the data in a double-blind placebo controlled investigation on the effects of fluoxetine (n=19), pemoline (n=18) and placebo (n=20) in normal controls. These subjects rated their subjective feelings daily at the end of each day. We analysed 56 data point time series (each value was obtained on each day) after the three experimental conditions.

RESULTS

While the mean or the SD of all the 56 points was not significantly different among the three conditions, APEN was highly and significantly lower for pemoline compared with fluoxetine and placebo. There was no significant correlation between average APEN and mean or SD (standard deviation). The one symptom that explained most of this difference among the groups after drug administration was the feeling of 'happiness'.

CONCLUSIONS

This result indicates that there was a more consistent subjective sense of happiness during the 8-week period of pemoline administration compared with the other two drugs. Though this study was not designed to address the efficacy of mood stabilizing drugs, such daily subjective ratings may be useful in future studies that evaluate the stability of mood. APEN has been used in several different fields of research with small data sets and this study extends its possible use to evaluate changes in mood in certain populations such as patients with bipolar disorders.

Effect of gravitational sedimentation on simulated aerosol dispersion in the human acinus

We studied the effect of gravitational sedimentation on the dispersion of 0.5 and 1 micrometer-diameter particle boluses within a two-dimensional symmetric six-generation model of the human acinus. Boluses were introduced at the beginning of a 2-s inspiration immediately followed by a 4-s expiration, in normal gravity (1 G) and in the absence of gravity (0 G). The flow corresponded to a flow rate at the mouth of 500 ml/s. In 0 G, simulated dispersion (Hsim) was 16 ml for both particle sizes. In 1 G, Hsim was 71 and 242 ml for 0.5 and 1 micrometer-diameter particles, respectively, showing the effect of gravitational sedimentation. The difference between experimental data (J. Appl. Physiol. 86 (1999) 1402) and simulations was independent of particle size. This suggests that the residual dispersion was independent of the intrinsic properties of the particles and was more likely due to other mechanisms such as ventilation inhomogeneities, cardiogenic oscillations and alveolar wall motion.

Chaotic mixing deep in the lung

Our current understanding of the transport and deposition of aerosols (viruses, bacteria, air pollutants, aerosolized drugs) deep in the lung has been grounded in dispersive theories based on untested assumptions about the nature of acinar airflow fields. Traditionally, these have been taken to be simple and kinematically reversible. In this article, we apply the recently discovered fluid mechanical phenomenon of irreversible low-Reynolds number flow to the lung. We demonstrate, through flow visualization studies in rhythmically ventilated rat lungs, that such a foundation is false, and that chaotic mixing may be key to aerosol transport. We found substantial alveolar flow irreversibility with stretched and folded fractal patterns, which lead to a sudden increase in mixing. These findings support our theory that chaotic alveolar flow--characterized by stagnation saddle points associated with alveolar vortices--governs gas kinematics in the lung periphery, and hence the transport, mixing, and ultimately the deposition of fine aerosols. This mechanism calls for a rethinking of the relationship of exposure and deposition of fine inhaled particles.

Lung inflammation induced by concentrated ambient air particles is related to particle composition

The objectives of this study were (1) to determine whether short-term exposures to concentrated air particles (CAPs) cause pulmonary inflammation in normal rats and rats with chronic bronchitis (CB); (2) to identify the site within the lung parenchyma where CAPs-induced inflammation occurs; and (3) to characterize the component(s) of CAPs that is significantly associated with the development of the inflammatory reaction. Four groups of animals were studied: (1) air treated, filtered air exposed (air-sham); (2) sulfur dioxide treated (CB), filtered air exposed (CB-sham); (3) air treated, CAPs exposed (air-CAPs); and (4) sulfur dioxide treated, CAPs exposed (CB-CAPs). CB and normal rats were exposed by inhalation either to filtered air or CAPs during 3 consecutive days (5 hours/day). Pulmonary inflammation was assessed by bronchoalveolar lavage (BAL) and by measuring the numerical density of neutrophils (Nn) in the alveolar walls at the bronchoalveolar junction and in more peripheral alveoli. CAPs (as a binary exposure term) and CAPs mass (in regression correlations) induced a significant increase in BAL neutrophils and in normal and CB animals. Nn in the lung tissue significantly increased with CAPs in normal animals only. Greater Nn was observed in the central compared with peripheral regions of the lung. A significant dose-dependent association was found between many CAPs components and BAL neutrophils or lymphocytes, but only vanadium and bromine concentrations had significant associations with both BAL neutrophils and Nn in CAPs-exposed groups analyzed together. Results demonstrate that short-term exposures to CAPs from Boston induce a significant inflammatory reaction in rat lungs, with this reaction influenced by particle composition.

Kinematically irreversible acinar flow: a departure from classical dispersive aerosol transport theories

Current theories describe aerosol transport in the lung as a dispersive (diffusion-like) process, characterized by an effective diffusion coefficient in the context of reversible alveolar flow. Our recent experimental data, however, question the validity of these basic assumptions. In this study, we describe the behavior of fluid particles (or bolus) in a realistic, numerical, alveolated duct model with rhythmically expanding walls. We found acinar flow exhibiting multiple saddle points, characteristic of chaotic flow, resulting in substantial flow irreversibility. Computations of axial variance of bolus spreading indicate that the growth of the variance with respect to time is faster than linear, a finding inconsistent with dispersion theory. Lateral behavior of the bolus shows fine-scale, stretch-and-fold striations, exhibiting fractal-like patterns with a fractal dimension of 1.2, which compares well with the fractal dimension of 1.1 observed in our experimental studies performed with rat lungs. We conclude that kinematic irreversibility of acinar flow due to chaotic flow may be the dominant mechanism of aerosol transport deep in the lungs.

In vivo measurement of lung capillary-alveolar macromolecule permeability by saturation bronchoalveolar lavage

OBJECTIVE

Measurement of capillary-alveolar permeability to fluorescein isothiocyanate-dextran (FITC-D) (molecular mass, 71,300 daltons) by a sequential bronchoalveolar lavage (BAL) technique.

DESIGN

Animal research.

SETTING

The Department of Physiology at a scientific and medical university.

SUBJECTS

Nine anesthetized and mechanically ventilated dogs.

INTERVENTIONS

Two separate experiments were performed in each subject-an initial control experiment followed by an oleic acid-induced lung injury. The indicator was administered at constant blood concentration before serial BAL including eight fluid instillation-recovery cycles.

MEASUREMENTS

Plasma to BAL solute clearance at saturation (capillary-alveolar clearance at saturation, mL/min) was calculated and normalized to lavage fluid volume (measured by 1251 serum albumin dilution) to obtain a transport rate (TR) constant.

MAIN RESULTS

TR for FITC-D70 was 4.0+/-0.8 and 46.1+/-18.1 x 10(-5) x min(-1) in control and injured lung, respectively (p < .02). Capillary-alveolar clearance of FITC-D70 was not affected by the lavage procedure itself. TR reflected essentially epithelial permeability in normal lung and combined epithelial and endothelial permeability in injured lung. A significant correlation was found between cardiac output and TR in injured lung.

CONCLUSIONS

Saturation BAL allowed us to estimate capillary-alveolar macromolecule permeability in vivo in dogs. Further study may allow bedside evaluation of lung injury by BAL in patients.

Acinar flow irreversibility caused by perturbations in reversible alveolar wall motion

Mixing associated with "stretch-and-fold" convective flow patterns has recently been demonstrated to play a potentially important role in aerosol transport and deposition deep in the lung (J. P. Butler and A. Tsuda. J. Appl. Physiol. 83: 800-809, 1997), but the origin of this potent mechanism is not well characterized. In this study we hypothesized that even a small degree of asynchrony in otherwise reversible alveolar wall motion is sufficient to cause flow irreversibility and stretch-and-fold convective mixing. We tested this hypothesis using a large-scale acinar model consisting of a T-shaped junction of three short, straight, square ducts. The model was filled with silicone oil, and alveolar wall motion was simulated by pistons in two of the ducts. The pistons were driven to generate a low-Reynolds-number cyclic flow with a small amount of asynchrony in boundary motion adjusted to match the degree of geometric (as distinguished from pressure-volume) hysteresis found in rabbit lungs (H. Miki, J. P. Butler, R. A. Rogers, and J. Lehr. J. Appl. Physiol. 75: 1630-1636, 1993). Tracer dye was introduced into the system, and its motion was monitored. The results showed that even a slight asynchrony in boundary motion leads to flow irreversibility with complicated swirling tracer patterns. Importantly, the kinematic irreversibility resulted in stretching of the tracer with narrowing of the separation between adjacent tracer lines, and when the cycle-by-cycle narrowing of lateral distance reached the slowly growing diffusion distance of the tracer, mixing abruptly took place. This coupling of evolving convective flow patterns with diffusion is the essence of the stretch-and-fold mechanism. We conclude that even a small degree of boundary asynchrony can give rise to stretch-and-fold convective mixing, thereby leading to transport and deposition of fine and ultrafine aerosol particles deep in the lung.

Aerosol probes of lung injury in a 28-wk longitudinal study of mild experimental emphysema in dogs

After baseline measurements of lung mechanics, effective air space diameter (EAD), and aerosol dispersion (AD), three dogs were exposed to two treatments of aerosolized papain (3 ml of a 4% solution), and measurements were repeated during a 28-wk follow-up period. EAD and AD were measured with boluses of 0.7-micrometer particles of di-2-ethylhexl sebacate, with Pen (i.e., volumetric bolus penetration/total lung capacity) between 0.1 and 0.4. After papain exposure, EAD increased a mean of 28% (P < 0.0001) and AD (Pen = 0.3, 0.4) increased 4-7% (P < 0.03). The progression of injury was indicated by increasing trends in total lung capacity (P < 0.05), residual volume (P < 0.05), and EAD (P = 0.06) through week 18. There was no evidence of disease progression between weeks 18 and 28, whereas some of the data for individual dogs suggested partial recovery from lung injury at week 28. The results show that aerosol probes can detect and characterize mild lung injury in experimental emphysema.

In vivo quantitation of epithelial lining fluid in dog lung

We used an original saturation bronchoalveolar lavage (SBAL) technique (Eur. Respir. J. 1995;8[Suppl. 19]398S) to quantitate lung epithelial lining fluid volume (VELF) in dogs in two separate experiments: control and after oleic-acid-induced injury. We confirmed the hypothesis that 99mTc-DTPA, infused at constant plasma activity, reaches equilibrium with epithelial lining fluid after 90 min. We performed eight sequential lavages 215 min after beginning the infusion of 99mTc-DTPA. 99mTc-DTPA activity (Qn) in the lavage fluid increased linearly with time, suggesting transport from the plasma into the alveoli during lavage. We extrapolated Qn to time zero (Q0), when 99mTc-DTPA was not affected by lavage. VELF was calculated from: VELF = Q0/Cp, (Cp: 99mTc-DTPA mean plasma activity). 125I-albumin was used as a nondiffusible alveolar indicator to measure the fluid volume present in the lavaged segment (Vt,n). Vt,n plateaud for n >= 4. VELF/Vt,n(n = 5,8) was 1.7 +/- 0.4 and 25.0 +/- 4.4% (p < 0.05) in control and injury experiments, respectively. SBAL allowed reliable measurements of VELF and detection of alveolar edema fluid in the injured lung.