340 research outputs found
On the 3D distribution and size fractionation of microparticles in a serpentine microchannel
Suitable methods to realize a multi-dimensional fractionation of microparticles smaller than 10 μm diameter are still rare. In the present study, size and density fractionation is investigated for 3.55 μm and 9.87 μm particles in a sharp-corner serpentine microchannel of cross-sectional aspect ratio h∕w = 0.25 . Experimental results are obtained through Astigmatism
Particle Tracking Velocimetry (APTV) measurements, from which three-dimensional particle distributions are reconstructed for Reynolds numbers between 100 and 150. The 3D reconstruction shows for the first time that equilibrium trajectories do not only develop over the channel width, i.e. in-plane equilibrium positions but also over the channel height at different
out-of-plane positions. With increasing Reynolds number, 9.87 μm polystyrene (PS = 1.05 g cm−3) and melamine (MF = 1.51 g cm−3) particles focus on two trajectories near the channel bisector. In contrast to this, it is shown that 3.55 μm polystyrene particles develop four equilibrium trajectories at different in-plane and out-of-plane positions up to a critical
Reynolds number. Beyond this critical Reynolds number, also these particles merge to two trajectories at different channel heights. While the rearrangement of 3.55 μm polystyrene particles just starts beyond Re > 140 , 9.87 μm polystyrene particles undergo this rearrangement already at Re = 100 . As the equilibrium trajectories of these two particle groups are located
at similar out-of-plane positions, outlet geometries that aim to separate particles along the channel width turn out to be a good choice for size fractionation. Indeed, polystyrene particles of different size assume laterally well-separated equilibrium trajectories such that a size fractionation of nearly 100% at Re = 110 can be achieved
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Relationship between diffusion capacity and small airway abnormality in COPDGene.
Impaired single breath carbon monoxide diffusing capacity (DLCO) is associated with emphysema. Small airways disease (SAD) may be a precursor lesion to emphysema, but the relationship between SAD and DLCO is undescribed. We hypothesized that in mild COPD, functional SAD (fSAD) defined by computed tomography (CT) and Parametric Response Mapping methodology would correlate with impaired DLCO. Using data from ever-smokers in the COPDGene cohort, we established that fSAD correlated significantly with lower DLCO among both non-obstructed and GOLD 1-2 subjects. The relationship between DLCO with CT-defined emphysema was present in all GOLD stages, but most prominent in severe disease. TRIAL REGISTRATION: NCT00608764. Registry: COPDGene. Registered 06 February 2008, retrospectively registered
Idiopathic pulmonary fibrosis: Prognostic value of changes in physiology and six minute hallwalk.
Rationale and Hypothesis: Idiopathic pulmonary fibrosis is a fatal
disease with a variable rate of progression. We hypothesized that
changes in distance walked and quantity of desaturation during a
six-minute-walk test (6MWT) would add prognostic information to
changes in FVC or diffusing capacity for carbon monoxide.
Methods: One hundred ninety-seven patients with idiopathic pulmonary
fibrosis were evaluated. Desaturation during the 6MWT was
associated with increased mortality even if a threshold of 88%
was not reached. Baseline walk distance predicted subsequent walk
distance but was not a reliable predictor of subsequent mortality
in multivariate survival models. The predictive ability of serial
changes in physiology varied when patients were stratified by the
presence/absence of desaturation 88% during a baseline 6MWT.
For patients with a baseline saturation 88% during a 6MWT,
the strongest observed predictor of mortality was serial change in
diffusing capacity for carbon monoxide. For patients with saturation
88% during their baseline walk test, serial decreases in FVC
and increases in desaturation area significantly predicted subsequent
mortality, whereas decreases in walk distance and in diffusing
capacity for carbon monoxide displayed less consistent statistical
evidence of increasing mortality in our patients.
Conclusion: These data highlight the importance of stratifying patients
by degree of desaturation during a 6MWT before attributing
prognostic value to serial changes in other physiologic variables.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/91940/1/2006 AJRCCM Idiopathic pulmonary fibrosis - Prognostic value of changes in physiology and six minute hallwalk.pd
Prognostic implications of physiologic and radiographic changes in idiopathic interstitial pneumonia
Idiopathic interstitial pneumonias are a diverse group of lung diseases
with varied prognoses. We hypothesized that changes in
physiologic and radiographic parameters would predict survival.
We retrospectively examined 80 patients with usual interstitial
pneumonia and 29 patients with nonspecific interstitial pneumonia.
Baseline characteristics were examined together with 6-month
change in forced vital capacity, diffusing capacity for carbon monoxide,
and ground glass infiltrate and fibrosis on high resolution computed
tomography. Patients with usual interstitial pneumonia were
more likely to have a statistically significant or marginally significant
decline in lung volume, diffusing capacity for carbon monoxide,
and an increase in ground glass infiltrates (p <= 0.08) compared
with patients with nonspecific interstitial pneumonia. For patients
with usual interstitial pneumonia, change in forced vital capacity
was the best physiologic predictor of mortality (p = 0.05). In a
multivariate Cox proportional hazards model controlling for histopathologic
diagnosis, gender, smoking history, baseline forced vital
capacity, and 6-month change in forced vital capacity, a decrease
in forced vital capacity remained an independent risk factor for
mortality (decrease > 10%; hazard ratio 2.47; 95% confidence interval
1.29, 4.73; p = 0.006). We conclude that a 6-month change
in forced vital capacity gives additional prognostic information to
baseline features for patients with idiopathic interstitial pneumonia.Supported by National Institutes of Health NHLBI grants P50HL46487, NIH/NCRR
3 MO1 RR00042-33S3, NIH/NIA P60 AG08808-06, NHLBI, 1 K24 HL04212, and
1 K23 HL68713.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/91973/1/2003 AJRCCM - Prognostic Implications of Physiologic and Radiographic Changes in Idiopathic Interstitial Pneumonia.pd
The prognostic value of Cardiopulmonary Exercise Testing in Idiopathic Pulmonary Fibrosis
Rationale: Idiopathic pulmonary fibrosis (IPF) is characterized by progressive
dyspnea, impaired gas exchange, and ultimate mortality.
Objectives: To test the hypothesis that maximal oxygen uptake
during cardiopulmonary exercise testing at baseline and with
short-term longitudinal measures would predict mortality in
patients with idiopathic pulmonary fibrosis.
Methods: Data from 117 patients with IPF and longitudinal cardiopulmonary
exercise tests were examined retrospectively. Survival
was calculated from the date of the first cardiopulmonary exercise
test.
Measurements and Main Results: Patients with baseline maximal
oxygen uptake less than 8.3 ml/kg/min had an increased risk of
death (n=8; hazard ratio, 3.24; 95% confidence interval, 1.10–9.56;
P = 0.03) after adjusting for age, gender, smoking status, baseline
forced vital capacity, and baseline diffusion capacity for carbon
monoxide. We were unable to define a unit change in maximal
oxygen uptake that predicted survival in our cohort.
Conclusions: We conclude that a threshold maximal oxygen uptake of
8.3 ml/kg/min during cardiopulmonary exercise testing at baseline
adds prognostic information for patients with IPF.Supported by National Institute of Health NHLBI grant P50HL-56402, NHLBI, 2
K24 HL04212, 1 K23 HL68713, and 1K23 HL077719. C.D.F. was supported by
the Alberta Heritage Foundation for Medical Research.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/91965/1/2009 AJRCCM The prognostic value of Cardiopulmonary Exercise Testing in Idiopathic Pulmonary Fibrosis.pd
Prognostic value of desaturation during a six minute walk test in Idiopathic Interstitial Pneumonia
Exercise-induced hypoxia is an index of the severity of interstitial
lung disease. We hypothesized that desaturation during a 6-minute
walk test would predict mortality for patients with usual interstitial
pneumonia (n = 83) and nonspecific interstitial pneumonia (n =
22). Consecutive patients with biopsy-proven disease performed a
6-minute walk test between January 1996 and December 2001.
Desaturation was defined as a fall in oxygen saturation to 88% or
less during the 6-minute walk test. Desaturation was common (44
of 83 usual interstitial pneumonia and 8 of 22 nonspecific interstitial
pneumonia; chi square, p = 0.39). Patients with usual interstitial
pneumonia or nonspecific interstitial pneumonia who desaturated
had a significantly higher mortality than patients who did not desaturate
(respective log-rank tests, p = 0.0018, p = 0.0089). In patients
with usual interstitial pneumonia, the presence of desaturation was
associated with an increased hazard of death (hazard ratio, 4.2;
95% confidence interval, 1.40, 12.56; p = 0.01) after adjusting for
age, sex, smoking, baseline diffusion capacity for carbon monoxide,
FVC, and resting saturation.Weconclude that knowledge of desaturation
during a 6-minute walk test adds prognostic information for
patients with usual interstitial pneumonia and nonspecific interstitial
pneumonia.Supported in part by National Institutes of Health NHLBI Grant #P50HL46487,
NHLBI, 1 K24 HL04212, and 1 K23 HL68713.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/91972/1/2003 AJRCCM - Prognostic value of desaturation during a six minute walk test in Idiopathic Interstitial Pneumonia.pd
Fibroblastic Foci in Usual Interstitial Pneumonia: Idiopathic versus Collagen Vascular Disease
A histologic feature of usual interstitial pneumonia is the presence of fibroblastic foci. As some patients with usual interstitial pneumonia and an underlying collagen vascular disease have a better prognosis, we hypothesized that they would have fewer fibroblastic foci. Pathologists reviewed surgical lung biopsies from 108 patients with usual interstitial pneumonia (nine with collagen vascular disease) and assigned a score (absent 0, mild 1, moderate 2, and marked 3) for fibroblastic foci. Patients with idiopathic usual interstitial pneumonia had a higher median profusion of fibroblastic foci (1.75 vs. 1.0, p = 0.003). Baseline characteristics were similar, although patients with a collagen vascular disease were younger, had a shorter duration of symptoms, and had a higher percentage of predicted total lung capacity. Profusion of fibroblastic foci was the most discriminative feature for separating idiopathic from collagen vascular disease–associated usual interstitial pneumonia (odds ratio 8.31; 95% confidence interval, 1.98, 59.42; p = 0.002 for a one-unit increase in fibroblastic foci score). No deaths were noted in the collagen vascular disease–associated usual interstitial pneumonia group; 52 deaths occurred in the idiopathic usual interstitial pneumonia group (log rank; p = 0.005). We conclude that patients with collagen vascular disease–associated usual interstitial pneumonia have fewer fibroblastic foci and improved survival.Supported in part by National Institutes of Health National Heart, Lung, and Blood
Institute grant #P50HL46487, NIH/NCRR 3 MO1 RR00042–33S3, NIH/NIA P60 AG08808–06, NHLBI 1 K24 HL04212, and 1 K23 HL68713.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/91974/1/2003 AJRCCM - Fibroblastic Foci in Usual Interstitial Pneumonia -Idiopathic versus Collagen Vascular Disease.pd
Pulmonary function measures predict mortality differently in IPF versus combined pulmonary fibrosis and emphysema
The composite physiologic index (CPI) was derived to represent the extent of
fibrosis on high-resolution computed tomography (HRCT), adjusting for emphysema in patients
with idiopathic pulmonary fibrosis (IPF). We hypothesised that longitudinal change in CPI would
better predict mortality than forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC) or
diffusing capacity of the lung for carbon monoxide (DLCO) in all patients with IPF, and especially
in those with combined pulmonary fibrosis and emphysema (CPFE).
Cox proportional hazard models were performed on pulmonary function data from IPF patients at
baseline (n=321), 6 months (n=211) and 12 months (n=144). Presence of CPFE was determined by
HRCT.
A five-point increase in CPI over 12 months predicted subsequent mortality (HR 2.1, p=0.004). At
12 months, a 10% relative decline in FVC, a 15% relative decline in DLCO or an absolute increase in
CPI of five points all discriminated median survival by 2.1 to 2.2 yrs versus patients with lesser
change. Half our cohort had CPFE. In patients with moderate/severe emphysema, only a 10%
decline in FEV1 predicted mortality (HR 3.7, p=0.046).
In IPF, a five-point increase in CPI over 12 months predicts mortality similarly to relative
declines of 10% in FVC or 15% in DLCO. For CPFE patients, change in FEV1 was the best predictor
of mortality.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/91949/1/2011 ERJ - Pulmonary function measures predict mortality differently in IPF versus combined pulmonary fibrosis and emphysema.pd
Sex differences in physiological progression of idiopathic pulmonary fibrosis
In idiopathic pulmonary fibrosis, incidence is higher in males, and females may have
better survival. The aim of the present study was to determine whether the rate of increase in
desaturation during serial 6-min walk testing would be greater, and survival worse, for males
versus females.
Serial changes in the percentage of maximum desaturation area (DA) over 1 yr were estimated
using mixed models in 215 patients. DA was defined as the total area above the curve created
using desaturation percentage values observed during each minute of the 6-min walk test.
Multivariate Cox regression assessed survival differences.
Adjusting for baseline DA, 6-min walk distance, change in 6-min walk distance over time and
smoking history, the percentage of maximum DA increased by an average of 2.83 and 1.37% per
month for males and females, respectively. Females demonstrated better survival overall, which
was more pronounced in patients who did not desaturate below 88% on ambulation at baseline
and after additionally adjusting for 6-month relative changes in DA and forced vital capacity.
These data suggest that differences in disease progression contribute to, but do not completely
explain, better survival of females with idiopathic pulmonary fibrosis.This work was supported by National
Institutes of Health grants
5P50HL56402, U10HL080371,
2K24HL04212, K12RR024987 and
K23HL68713, and the Alberta
Heritage Medical Foundation.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/91966/1/2008 ERJ - Sex Differences in Physiologic Progression of Idiopathic Pulmonary Fibrosis.pd
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