Search results for: one lung ventilation

Authors: Devendra Gupta, S. P. Ambesh, P. K Singh

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Introduction: Minimally invasive coronary artery bypass grafting (MICABG) is a less invasive method of performing surgical revascularization. Minimally invasive direct coronary artery bypass (MIDCAB) provides many anesthetic challenges including one lung ventilation (OLV), managing myocardial ischemia, and pain. We present an early and midterm result of the use of this technique with OLV. Method: We enrolled 62 patients for analysis operated between 2008 and 2012. Patients were anesthetized and left endobronchial tube was placed. During the procedure left lung was isolated and one lung ventilation was maintained through right lung. Operation was performed utilizing off pump technique of coronary artery bypass grafting through a minimal invasive incision. Left internal mammary artery graft was done for single vessel disease and radial artery was utilized for other grafts if required. Postoperative ventilation was done with single lumen endotracheal tube. Median follow-up is 2.5 years (6 months to 4 years). Results: Median age was 58.5 years (41-77) and all were male. Single vessel disease was present in 36, double vessel in 24 and triple vessel disease in 2 patients. All the patients had normal left ventricular size and function. In 2 cases difficulty were encounter in placement of endobronchial tube. In 1 case cuff of endobronchial tube was ruptured during intubation. High airway pressure was developed on OLV in 1 case and surgery was accomplished with two lung anesthesia with low tidal volume. Mean postoperative ventilation time was 14.4 hour (11-22). There was no perioperative and 30 day mortality. Conversion to median sternotomy to complete the operation was done in 3.23% (2 out of 62 patients). One patient had acute myocardial infarction postoperatively and there were no deaths during follow-up. Conclusion: MICABG is a safe and effective method of revascularization with OLV in low risk candidates for coronary artery bypass grafting.

Keywords: MIDCABG, one lung ventilation, coronary artery bypass grafting, endobronchial tube

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Authors: Ying-Chang Yu, Yuan-Lung Lo

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Building ventilation performance is an important indicator of indoor comfort. However, in addition to the geometry of the building or the proportion of the opening, the ventilation performance is also very much related to the actual wind pressure of the building. There are more and more contemporary building designs built with multi-layer exterior envelope. Due to ventilation and view observatory requirement, the porous outer layer of the building is commonly adopted and has a significant wind damping effect, causing the phenomenon of actual wind pressure loss. However, the relationship between the wind damping effect and the actual wind pressure is not linear. This effect can make the indoor ventilation of the building rationalized to reasonable range under the condition of high wind pressure, and also maintain a good amount of ventilation performance under the condition of low wind pressure. In this study, wind tunnel experiments were carried out to simulate the different wind pressures flow through the porous outer layer, and observe the actual wind pressure strength engage with the window layer to find the decreasing relationship between the damping effect of the porous shell and the wind pressure. Experiment specimen scale was designed to be 1:50 for testing real-world building conditions; the study found that the porous enclosure has protective shielding without affecting low-pressure ventilation. Current study observed the porous skin may damp more wind energy to ease the wind pressure under high-speed wind. Differential wind speed may drop the pressure into similar pressure level by using porous skin. The actual mechanism and value of this phenomenon will need further study in the future.

Keywords: multi-layer facade, porous media, wind damping, wind tunnel test, building ventilation

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Authors: Qian Zhang, Dongkai Shen, Yan Shi

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A new mechanical ventilator with automatic secretion clearance function can improve the secretion clearance safely and efficiently. However, in recent modeling studies on various mechanical ventilators, it was considered that human had one lung, and the coupling effect of double lungs was never illustrated. In this paper, to expound the coupling effect of double lungs, a mathematical model of a ventilation system of a bi-level positive airway pressure (BiPAP) controlled ventilator with secretion clearance was set up. Moreover, an experimental study about the mechanical ventilation system of double lungs on BiPAP ventilator was conducted to verify the mathematical model. Finally, the coupling effect of double lungs of the mathematical ventilation was studied by simulation and orthogonal experimental design. This paper adds to previous studies and can be referred to optimization methods in medical researches.

Keywords: double lungs, coupling effect, secretion clearance, orthogonal experimental design

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Authors: Maha Salah Abdullah Ismail, Mahmoud M. Alsagheir, Mohammed Salah Abd Allah

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Acute respiratory distress syndrome (ARDS) is characterized by permeability pulmonary edema and refractory hypoxemia. Lung-protective ventilation is still the key of better outcome in ARDS. Prone position reduces the trans-pulmonary pressure gradient, recruiting collapsed regions of the lung without increasing airway pressure or hyperinflation. Prone ventilation showed improved oxygenation and improved outcomes in severe hypoxemic patients with ARDS. This study evaluates the effect of prone positioning on mechanically ventilated patients with ARDS. A quasi-experimental design was carried out at Critical Care Units, on 60 patients. Two tools were utilized to collect data; Socio demographic, medical and clinical outcomes data sheet. Results of the present study indicated that prone position improves oxygenation in patients with severe respiratory distress syndrome. The study recommended that use prone position in patients with severe ARDS, as early as possible and for long sessions. Also, replication of this study on larger probability sample at the different geographical location is highly recommended.

Keywords: acute respiratory distress syndrome, critical care, mechanical ventilation, prone position

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Authors: Andres Gonzalez, Adam Boies, Jacob Swanson, David Kittelson

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The concern of the indoor air quality (IAQ) has been increasing due to its risk to human health. The smoking, sweeping, and stove and stovetop use are the activities that have a major contribution to the indoor air pollution. Outdoor air pollution also affects IAQ. The most important factors over IAQ from cooking activities are the materials, fuels, foods, and ventilation. The low-cost, mobile air quality monitoring (LCMAQM) sensors, is reachable technology to assess the IAQ. This is because of the lower cost of LCMAQM compared to conventional instruments. The IAQ was assessed, using LCMAQM, during cooking activities in a University of Minnesota graduate-housing evaluating different ventilation systems. The gases measured are carbon monoxide (CO) and carbon dioxide (CO₂). The particles measured are particle matter (PM) _2.5 micrometer (µm) and lung deposited surface area (LDSA). The measurements are being conducted during April 2019 in Como Student Community Cooperative (CSCC) that is a graduate housing at the University of Minnesota. The measurements are conducted using an electric stove for cooking. The amount and type of food and oil using for cooking are the same for each measurement. There are six measurements: two experiments measure air quality without any ventilation, two using an extractor as mechanical ventilation, and two using the extractor and windows open as mechanical and natural ventilation. 3The results of experiments show that natural ventilation is most efficient system to control particles and CO₂. The natural ventilation reduces the concentration in 79% for LDSA and 55% for PM_2.5, compared to the no ventilation. In the same way, CO₂ reduces its concentration in 35%. A well-mixed vessel model was implemented to assess particle the formation and decay rates. Removal rates by the extractor were significantly higher for LDSA, which is dominated by smaller particles, than for PM_2.5, but in both cases much lower compared to the natural ventilation. There was significant day to day variation in particle concentrations under nominally identical conditions. This may be related to the fat content of the food. Further research is needed to assess the impact of the fat in food on particle generations.

Keywords: cooking, indoor air quality, low-cost sensor, ventilation

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Authors: Yousif Mohamed Y. Abdallah, Khalid H. Eltom

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This is an experimental study deals with measurement of the periodic physiological organ motion during lung external irradiation in order to reduce the exposure of healthy tissue during radiation treatments. The results showed for left lung displacement reading (4.52+1.99 mm) and right lung is (8.21+3.77 mm) which the radiotherapy physician should take suitable countermeasures in case of significant errors. The motion ranged between 2.13 mm and 12.2 mm (low and high). In conclusion, the calculation of tumour mobility can improve the accuracy of target areas definition in patients undergo Sterostatic RT for stage I, II and III lung cancer (NSCLC). Definition of the target volume based on a high resolution CT scan with a margin of 3-5 mm is appropriate.

Keywords: physiological motion, lung, external irradiation, radiation medicine

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Authors: S. B. R. Slagmulder

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Monitoring inspiratory effort and dynamic lung stress in patients on pressure support ventilation in the ICU is important for protecting against self inflicted lung injury (P-SILI) and diaphragm dysfunction. Strategies to address the detrimental effects of respiratory drive and effort can lead to improved patient outcomes. Two non-invasive estimation methods, occlusion pressure (Pocc) and P0.1, have been proposed for achieving lung and diaphragm protective ventilation. However, their relationship and interpretation in neuro ICU patients is not well understood. P0.1 is the airway pressure measured during a 100-millisecond occlusion of the inspiratory port. It reflects the neural drive from the respiratory centers to the diaphragm and respiratory muscles, indicating the patient's respiratory drive during the initiation of each breath. Occlusion pressure, measured during a brief inspiratory pause against a closed airway, provides information about the inspiratory muscles' strength and the system's total resistance and compliance. Research Objective: Understanding the relationship between Pocc and P0.1 in brain-injured patients can provide insights into the interpretation of these values in pressure support ventilation. This knowledge can contribute to determining extubation readiness and optimizing ventilation strategies to improve patient outcomes. The central goal is to asses a study protocol for determining the relationship between Pocc and P0.1 in brain-injured patients on pressure support ventilation and their ability to predict successful extubation. Additionally, comparing these values between brain-damaged and non-brain-damaged patients may provide valuable insights. Key Areas of Inquiry: 1. How do Pocc and P0.1 values correlate within brain injury patients undergoing pressure support ventilation? 2. To what extent can Pocc and P0.1 values serve as predictive indicators for successful extubation in patients with brain injuries? 3. What differentiates the Pocc and P0.1 values between patients with brain injuries and those without? Methodology: P0.1 and occlusion pressures are standard measurements for pressure support ventilation patients, taken by attending doctors as per protocol. We utilize electronic patient records for existing data. Unpaired T-test will be conducted to compare P0.1 and Pocc values between both study groups. Associations between P0.1 and Pocc and other study variables, such as extubation, will be explored with simple regression and correlation analysis. Depending on how the data evolve, subgroup analysis will be performed for patients with and without extubation failure. Results: While it is anticipated that neuro patients may exhibit high respiratory drive, the linkage between such elevation, quantified by P0.1, and successful extubation remains unknown The analysis will focus on determining the ability of these values to predict successful extubation and their potential impact on ventilation strategies. Conclusion: Further research is pending to fully understand the potential of these indices and their impact on mechanical ventilation in different patient populations and clinical scenarios. Understanding these relationships can aid in determining extubation readiness and tailoring ventilation strategies to improve patient outcomes in this specific patient population. Additionally, it is vital to account for the influence of sedatives, neurological scores, and BMI on respiratory drive and occlusion pressures to ensure a comprehensive analysis.

Keywords: brain damage, diaphragm dysfunction, occlusion pressure, p0.1, respiratory drive

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Authors: An-Shik Yang, Chiang-Ho Cheng, Jen-Hao Wu, Yu-Hsuan Juan

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Natural ventilation has played an important role for many low energy-building designs. It has been also noticed as a essential subject to persistently bring the fresh cool air from the outside into a building. This study carried out the computational fluid dynamics (CFD)-based simulations to examine the natural ventilation development of a work area in a public building. The simulated results can be useful to better understand the indoor microclimate and the interaction of wind with buildings. Besides, this CFD simulation procedure can serve as an effective analysis tool to characterize the airing performance, and thereby optimize the building ventilation for strengthening the architects, planners and other decision makers on improving the natural ventilation design of public buildings.

Keywords: CFD simulations, natural ventilation, microclimate, wind environment

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Authors: Bakr Gomaa

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Cross ventilation is an important and practical mean to achieve thermal comfort and conserve energy. This is especially true in the breezy waterfront settings. However, due to a number of factors, cross ventilation in buildings is usually studied by using oversimplified scenarios. It is then reasonable to study the impact of complex set of factors on the accuracy of predicting air flow rate because of wind driven cross ventilation. The objective of this paper is to provide architects with the tools necessary to achieve natural ventilation for cooling purposes in a waterfront urban canyon context. Also, urban canyons have not received much attention in terms of their impact on cross ventilation, and while we know how the wind flows between buildings in different urban canyon settings, the effect of the parallel-to-the-wind urban canyon on cross ventilation in buildings remains unclear. For this, we use detailed weather data, boundary layer correction factor, and CFD simulations to study the pressure patterns that form on the canyons surfaces in the case study of Alexandria. We found that the simplified numerical methods of calculating the cross ventilation in buildings can lead to inaccurate design decisions.

Keywords: cross ventilation, Alexandria, CFD, urban canyon

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Authors: Rubab Z. Kahlon, Ibtisam Butt, Isma Younis, Aamer G. Mufti

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Worldwide lung cancer 1.61 million cases were seen in both genders. Lung carcinoma is the major cause of both morbidity and mortality in the world. Purpose of the present study was to describe the spatio- temporal trends of lung cancer in both genders. A retrospective study was conducted. Total 1498 patients of lung carcinoma were examined. Only lung cancer patients from all over the Punjab were included in the present study. MS Excel 2010 was used for data tabulation and calculation while the Arc GIS version 9.3 was used for geographical representation of the data. 1498 cases of Lung cancer were found from 2008-2012. The number of male patients was 1236 and female was 262. Majority of the patients were from Lahore districts with 807 patients. Lung cancer was more prevalent in male as compared to female in our region. Increase in the prevalence of lung cancer was prominently seen in the most populated and industrial areas of the Punjab province. Time trend of five years showed fluctuation in the lung cancer incidence during the study period.

Keywords: districts, gender, lung cancer trends, Punjab province of Pakistan

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Authors: Wu Xingchun, Chen Xi

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Nowadays, China's building energy consumption constitutes 25% of the total energy consumption, half of which was caused by air conditioning in both summer and winter. The ventilation system in Chinese traditional residence, which is totally passive and environmentally friendly, works effectively to create comfortable indoor environment. The research on the ventilation system in Chinese traditional residence can provide advancements to architecture design and energy savings to the society. Through field investigation, case analysis, strategy proposing and other methods, it comes out that the location and layout, the structure system and the design of atrium are the most important elements for a good ventilation system. Taking every factor into consideration, techniques are deployed extensively such as the organization of draught, the design of the thermal pressure ventilation system and the application of modern materials. With the enlightenment of the ventilation system in Chinese traditional residence, we can take effective measures to achieve low energy consumption and sustainable architecture.

Keywords: ventilation system, chinese traditional residence, energy consumption, sustainable architecture

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Authors: Shweh Fern Loo, Jun Yin Ong, Than Zaw Oo

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Acute respiratory distress syndrome (ARDS) is a common serious condition of bilateral lung infiltrates that develops secondary to various underlying conditions such as diseases or injuries. ARDS with severe hypercapnia is associated with higher ICU mortality and morbidity. Venovenous Extracorporeal membrane oxygenation (VV-ECMO) support has been established to avert life-threatening hypoxemia and hypercapnic respiratory failure despite optimal conventional mechanical ventilation. However, VV-ECMO is relatively not advisable in particular groups of patients, especially in multi-organ failure, advanced age, hemorrhagic complications and irreversible central nervous system pathology. We presented a case of a 79-year-old Chinese lady without any pre-existing lung disease admitted to our hospital intensive care unit (ICU) after acute presentation of breathlessness and chest pain. After extensive workup, she was diagnosed with rapidly progressing acute interstitial pneumonia with ARDS and hypercapnia respiratory failure. The patient received lung protective strategies of mechanical ventilation and neuromuscular blockage therapy as per clinical guidelines. However, hypercapnia respiratory failure was refractory, and she was deemed not a good candidate for VV-ECMO support given her advanced age and high vasopressor requirements from shock. Alternative therapy with extracorporeal CO2 removal (ECCO2R) was considered and implemented. The patient received 12 days of ECCO2R paired with muscle paralysis, optimization of lung-protective mechanical ventilation and dialysis. Unfortunately, the patient still had refractory hypercapnic respiratory failure with dual vasopressor support despite prolonged therapy. Given failed and futile medical treatment, the family opted for withdrawal of care, a conservative approach, and comfort care, which led to her demise. The effectivity of extracorporeal CO2 removal may depend on disease burden, involvement and severity of the disease. There is insufficient data to make strong recommendations about its benefit-risk ratio for ECCO2R devices, and further studies and data would be required. Nonetheless, ECCO2R can be considered an alternative treatment for refractory hypercapnic respiratory failure patients who are unsuitable for initiating venovenous ECMO.

Keywords: extracorporeal CO2 removal (ECCO2R), acute respiratory distress syndrome (ARDS), acute interstitial pneumonia (AIP), hypercapnic respiratory failure

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Authors: Sasidhar B., Bhaskar Rao N., Ramesh Babu D. R., Ravi Shankar M.

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Segmentation of lung pleura is a preprocessing step in Computer-Aided Diagnosis (CAD) which helps in reducing false positives in detection of lung cancer. The existing methods fail in extraction of lung regions with the nodules at the pleura of the lungs. In this paper, a new method is proposed which segments lung regions with nodules at the pleura of the lungs based on curvature analysis and morphological operators. The proposed algorithm is tested on 06 patient’s dataset which consists of 60 images of Lung Image Database Consortium (LIDC) and the results are found to be satisfactory with 98.3% average overlap measure (AΩ).

Keywords: curvature analysis, image segmentation, morphological operators, thresholding

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Authors: Diana Islam, Juan Fang, Vito Fanelli, Bing Han, Julie Khang, Jianfeng Wu, Arthur S. Slutsky, Haibo Zhang

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Introduction: MSC delivery in preclinical models of ARDS has demonstrated significant improvements in lung function and recovery from acute injury. However, the role of MSC delivery in ARDS associated pulmonary fibrosis is not well understood. Some animal studies using bleomycin, asbestos, and silica-induced pulmonary fibrosis show that MSC delivery can suppress fibrosis. While other animal studies using radiation induced pulmonary fibrosis, liver, and kidney fibrosis models show that MSC delivery can contribute to fibrosis. Hypothesis: The beneficial and deleterious effects of MSC in ARDS are modulated by the lung microenvironment at the time of MSC delivery. Methods: To induce ARDS a two-hit mouse model of Hydrochloric acid (HCl) aspiration (day 0) and mechanical ventilation (MV) (day 2) was used. HCl and injurious MV generated fibrosis within 14-28 days. 0.5x106 mouse MSCs were delivered (via both intratracheal and intravenous routes) either in the active inflammatory phase (day 2) or during the remodeling phase (day 14) of ARDS (mouse fibroblasts or PBS used as a control). Lung injury accessed using inflammation score and elastance measurement. Pulmonary fibrosis was accessed using histological score, tissue collagen level, and collagen expression. In addition alveolar epithelial (E) and mesenchymal (M) marker expression profile was also measured. All measurements were taken at day 2, 14, and 28. Results: MSC delivery 2 days after HCl exacerbated lung injury and fibrosis compared to HCl alone, while the day 14 delivery showed protective effects. However in the absence of HCl, MSC significantly reduced the injurious MV-induced fibrosis. HCl injury suppressed E markers and up-regulated M markers. MSC delivery 2 days after HCl further amplified M marker expression, indicating their role in myofibroblast proliferation/activation. While with 14-day delivery E marker up-regulation was observed indicating their role in epithelial restoration. Conclusions: Early MSC delivery can be protective of injurious MV. Late MSC delivery during repair phase may also aid in recovery. However, early MSC delivery during the exudative inflammatory phase of HCl-induced ARDS can result in pro-fibrotic profiles. It is critical to understand the interaction between MSC and the lung microenvironment before MSC-based therapies are utilized for ARDS.

Keywords: acute respiratory distress syndrome (ARDS), mesenchymal stem cells (MSC), hydrochloric acid (HCl), mechanical ventilation (MV)

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Authors: A. Kaddour, S. M. A. Bekkouche

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Limiting heat losses during ventilation of indoor building spaces has become a basic aim for architects. Much experience has been gained in terms of ventilation of indoor spaces. Nevertheless, due to the complex applications, attempts to create a theoretical base for solving the problems related to the issue are limited, especially determining the minimum ventilation period required within a designated space. In this paper we have approached this matter, both theoretically and computationally. The conclusion we reached was that controlled ventilation of spaces through vent holes that successively open and close at regular time intervals can limit the excessive circulation of air masses, which in turn limits heat losses. Air change rates through open and tilted windows in rooms of residential buildings driven by atmospheric motions are investigated to evaluate natural ventilation concepts. Model of thermal building simulations is used. A separated sample storey and a sample single room in larger scales were used to measure air transport through window openings under the influence of the external pressure distribution.

Keywords: natural ventilation, temperature factor, air change rates, air circulation

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Authors: Yong-Il Lee, Do-Yeon Hwang, Won-Seog Jeong, Duckshin Park

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Recently, because of the high-speed trains forced ventilation, it is important to control the ventilation. The ventilation is for controlling various contaminants, temperature, and humidity. The high-speed train route is straight to a destination having a high speed. And there are many mountainous areas in Korea. So, tunnel rate is higher then other country. KTX HVAC block off the outdoor air, when entering tunnel. So the high tunnel rate is an effect of ventilation in the KTX cabin. It is important to reduction rate in CO2 concentration prediction. To meet the air quality of the public transport vehicles recommend standards, the KTX cabin of CO2 concentration should be managed. In this study, the concentration change was predicted by CO2 prediction simulation in route to be opened.

Keywords: CO2 prediction, KTX, ventilation, infrastructure and transportation engineering

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Authors: Bakr Gomaa

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Wind driven Cross ventilation is achieved when air moves indoors due to the pressure difference on the building envelope. This is especially important in breezy moderate to humid settings in which fast air flow can promote thermal comfort. Studies have shown that the use of simple building forms or ignoring the urban context when studying natural ventilation can lead to inaccurate results. In this paper, the impact of the urban form of a regular array of buildings is investigated to define the impact of this urban setting on cross ventilation potential. The objective of this paper is to provide the necessary tools to achieve natural ventilation for cooling purposes in an array of building blocks context. The array urban form has been studied before for natural ventilation purposes yet to the best of our knowledge no study has considered the relationship between the urban form and the pressure patterns that develop on the buildings envelope for cross ventilation. For this we use detailed weather data for a case study city of Alexandria (Egypt), as well as a validated CFD simulations to investigate the cross ventilation potential in terms of pressure patterns in waterfront as well as in-city wind flows perpendicular to the buildings array. it was found that for both waterfront and in-city wind speeds the windows needed for cross ventilation in rear raws of the array are significantly larger than those needed for front raw.

Keywords: Alexandria, CFD, cross ventilation, pressure coefficient

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Authors: Ashraf Ali, Kriti Upadhyay, Puja Sohal, Anant Mohan, Randeep Guleria

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Background: Gene silencing by aberrant promoter hypermethylation is common in lung cancer and is an initiating event in its development. Aim: To evaluate the gene promoter hypermethylation frequency in serum and tissue of lung cancer patients. Method: 95 newly diagnosed untreated advance stage lung cancer patients and 50 cancer free matched controls were studied. Bisulfite modification of tissue and serum DNA was done; modified DNA was used as a template for methylation-specific PCR analysis. Survival was assessed for one year. Results: Of 95 patients, 82% were non-small cell lung cancer (34% squamous cell carcinoma, 34% non-small cell lung cancer and 14% adenocarcinoma) and 18% were small cell lung cancer. Biopsy revealed that tissue of 89% and 75% of lung cancer patients and 85% and 52% of controls had promoter hypermethylated for MGMT (p=0.35) and p16(p<0.001) gene, respectively. In serum, 33% and 49% of lung cancer patients and 28% and 43% controls were positive for MGMT and p16 gene. No significant correlation was found between survival and clinico-pathological parameters. Conclusion: High gene promoter methylation frequency of p16 gene in tissue biopsy may be linked with early stages of carcinogenesis. Appropriate follow-up is required for confirmation of this finding.

Keywords: lung cancer, MS- PCR, methylation, molecular biology

Procedia PDF Downloads 159

Authors: M. Toygar, I. Aydin, M. Agilli, F. N. Aydin, M. Oztosun, H. Gul, E. Macit, Y. Karslioglu, T. Topal, B. Uysal, M. Honca

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Paraquat (PQ) is a well-known quaternary nitrogen herbicide. The major target organ in PQ poisoning is the lung. Reactive oxygen species (ROS) and inflammation play a crucial role in the development of PQ-induced pulmonary injury. Neopterin is synthesized in macrophage by interferon g and other cytokines. We aimed to evaluate the utility of neopterin as a diagnostic marker in PQ-induced lung toxicity. Sprague Dawley rats were randomly divided into two groups (sham and PQ), administered intraperitoneally 1 mL saline and PQ (15 mg/kg/mL) respectively. Blood samples and lungs were collected for analyses. Lung injury and fibrosis were seen in the PQ group. Serum total antioxidant capacity, lactate dehydrogenase (LDH), and lung transforming growth factor-1 (TGF-1) levels were significantly higher than the sham group (in all, p< 0.001). In addition, in the PQ group, serum neopterin and lung malondialdehyde (MDA) levels were also significantly higher than the sham group (in all, p 1/4 0.001). Serum neopterin levels were correlated with LDH activities, lung MDA, lung TGF-1 levels, and the degree of lung injury. These findings demonstrated that oxidative stress, reduction of antioxidant capacity, and inflammation play a crucial role in the PQ-induced lung injury. Elevated serum neopterin levels may be a prognostic parameter to determine extends of PQ-induced lung toxicity. Further studies may be performed to clarify the role of neopterin by different doses of PQ.

Keywords: paraquat, inflammation, oxidative stress, neopterin, lung toxicity

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Authors: Selma Bouasria, Mahi Abdelkader, Abbès Azzi, Herouz Keltoum

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Ventilation in buildings is a key element to provide high indoor air quality. Its efficiency appears as one of the most important factors in maintaining thermal comfort for occupants of buildings. Personal displacement ventilation is a new ventilation concept that combines the positive features of displacement ventilation with those of task conditioning or personalized ventilation. This work aims to study numerically the supply air flow in a room to optimize a comfortable microclimate for an occupant. The room is heated, and a dummy is designed to simulate the occupant. Two types of configurations were studied. The first consist of a room without windows; and the second one is a local equipped with a window. The influence of the blowing speed and the solar radiation coming from the window on the thermal comfort of the occupant is studied. To conduct this study we used the turbulence models, namely the high Reynolds k-e, the RNG and the SST models. The numerical tool used is based on the finite volume method. The numerical simulation of the supply air flow in a room can predict and provide a significant information about indoor comfort.

Keywords: local, comfort, thermique, ventilation, internal environment

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Authors: Minjeong Kim, Seungchul Lee, Iman Janghorban Esfahani, Jeong Tai Kim, ChangKyoo Yoo

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A trajectory of set-point of ventilation control systems plays an important role for efficient ventilation inside subway stations since it affects the level of indoor air pollutants and ventilation energy consumption. To maintain indoor air quality (IAQ) at a comfortable range with lower ventilation energy consumption, the optimal trajectory of the ventilation control system needs to be determined. The concentration of air pollutants inside the station shows a diurnal variation in accordance with the variations in the number of passengers and subway frequency. To consider the diurnal variation of IAQ, an iterative dynamic programming (IDP) that searches for a piecewise control policy by separating whole duration into several stages is used. When outdoor air is contaminated by pollutants, it enters the subway station through the ventilation system, which results in the deteriorated IAQ and adverse effects on passenger health. In this study, to consider the influence of outdoor air quality (OAQ), a new performance index of the IDP with the passenger health risk and OAQ is proposed. This study was carried out for an underground subway station at Seoul Metro, Korea. The optimal set-points of the ventilation control system are determined every 3 hours, then, the ventilation controller adjusts the ventilation fan speed according to the optimal set-point changes. Compared to manual ventilation system which is operated irrespective of the OAQ, the IDP-based ventilation control system saves 3.7% of the energy consumption. Compared to the fixed set-point controller which is operated irrespective of the IAQ diurnal variation, the IDP-based controller shows better performance with a 2% decrease in energy consumption, maintaining the comfortable IAQ range inside the station.

Keywords: indoor air quality, iterative dynamic algorithm, outdoor air information, ventilation control system

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Authors: Rhea Kapoor

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Fractal dimension provides a way to characterize non-geometric shapes like those found in nature. The purpose of this research is to estimate Minkowski fractal dimension of human lung images for early detection of lung cancer. Lung cancer is the leading cause of death among all types of cancer and an early histopathological analysis will help reduce deaths primarily due to late diagnosis. A Python application program, PathoPy2.0, was developed for analyzing medical images in pixelated format and estimating Minkowski fractal dimension using a new box-counting algorithm that allows windowing of images for more accurate calculation in the suspected areas of cancerous growth. Benchmark geometric fractals were used to validate the accuracy of the program and changes in fractal dimension of lung images to indicate the presence of issues in the lung. The accuracy of the program for the benchmark examples was between 93-99% of known values of the fractal dimensions. Fractal dimension values were then calculated for lung images, from National Cancer Institute, taken over time to correctly detect the presence of cancerous growth. For example, as the fractal dimension for a given lung increased from 1.19 to 1.27 due to cancerous growth, it represents a significant change in fractal dimension which lies between 1 and 2 for 2-D images. Based on the results obtained on many lung test cases, it was concluded that fractal dimension of human lungs can be used to diagnose lung cancer early. The ideas behind PathoPy2.0 can also be applied to study patterns in the electrical activity of the human brain and DNA matching.

Keywords: fractals, histopathological analysis, image processing, lung cancer, Minkowski dimension

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Authors: Prabir Patel, Eugene Ming Han Lim

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Introduction: Current literature shows that postoperative pulmonary complications following abdominal surgery may be reduced by using lower than conventional tidal volumes intraoperatively together with moderate levels of positive end expiratory pressure (PEEP). The recent studies demonstrated significant reduction demonstrated significant reduction in major complications in elective abdominal surgery through the use of lower tidal volumes (6-8 ml/kg predicted body weight), PEEP of 5 cmH20 and recruitment manoeuvres compared to higher ‘conventional’ volumes (10-12 mls/kg PBW) without lung recruitment. Our objective was to retrospectively audit current practice for patients undergoing major abdominal surgery in Sir Charles Gairdner Hospital. Methods: Patients over 18 undergoing elective general surgery lasting more than 3 hours and intubated during the duration of procedure were included in this audit. Data was collected over a 6 month period. Patients who had hepatic surgery, procedures necessitating one-lung ventilation, transplant surgery, documented history of pulmonary or intracranial hypertension were excluded. Results: 58 suitable patients were identified and notes were available for 54 patients. Key findings: Average peak airway pressure was 21cmH20 (+4), average peak airway pressure was less than 30 cmH20 in all patients, and less than 25 cmH20 in 80% of the cases. PEEP was used in 81% of the cases. Where PEEP was used, 75% used PEEP more than or equal to 5 cmH20. Average tidal volume per actual body weight was 7.1 ml/kg (+1.6). Average tidal volume per predicted body weight (PBW) was 8.8 ml/kg (+1.5). Average tidal volume was less than 10 ml/kg PBW in 90% of cases; 6-8 ml/kg PBW in 40% of the cases. There was no recorded use of recruitment manoeuvres in any cases. Conclusions: In the vast majority of patients undergoing prolonged abdominal surgery, a lung protective strategy using moderate levels of PEEP, peak airway pressures of less than 30 cmH20 and tidal volumes of less than 10 cmH20/kg PBW was utilised. A recent randomised control trial demonstrated benefit from utilising even lower volumes (6-8 mls/kg) based on findings in critical care patients, but this was compared to volumes of 10-12 ml/kg. Volumes of 6-8 ml/kg PBW were utilised in 40% of cases in this audit. Although theoretically beneficial, clinical benefit of lower volumes than what is currently practiced in this institution remains to be seen. The incidence of pulmonary complications was much lower than in the other cited studies and a larger data set would be required to investigate any benefit from lower tidal volume ventilation. The volumes used are comparable to results from published local and international data but PEEP utilisation was higher in this audit. Strategies that may potentially be implemented to ensure and maintain best practice include pre-operative recording of predicted body weight, adjustment of default ventilator settings and education/updates of current evidence.

Keywords: anaesthesia, intraoperative ventilation, PEEP, tidal volume

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Authors: Satoshi Furukawa, Satomu Morita, Katsuji Nishi, Masahito Hitosugi

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A 75-year-old woman took thyroidectomy forty years previously. Enlarged masses were seen at autopsy just above and below the left clavicle. We proved the diagnosis of papillary thyroid cancer (PTC) and lung metastasis by histological examinations. The prognosis of PTC is excellent; the 10-year survival rate ranges between 85 and 99%. Lung metastases may be found in 10% of the patients with PTC. We report an unusual case of recurrence of PTC with metastasis to the lung.

Keywords: papillary thyroid cancer, lung metastasis, autopsy, histopathological findings

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Authors: A. Kamel Abd Elaziz Mohamed, B. Sameh Kamal el Maraghi

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Introduction: Adaptive support ventilation (ASV) is an improved closed-loop ventilation mode that provides both pressure-controlled ventilation and PSV according to the patient’s needs. Aim of the work: To compare the short-term effects of Adaptive support ventilation (ASV), with conventional Pressure support ventilation (PSV) in weaning of intubated COPD patients. Patients and methods: Fifty patients admitted in the intensive care with acute exacerbation of COPD and needing intubation were included in the study. All patients were initially ventilated with control/assist control mode, in a stepwise manner and were receiving standard medical therapy. Patients were randomized into two groups to receive either ASV or PSV. Results: Out of fifty patients included in the study forty one patients in both studied groups were weaned successfully according to their ABG data and weaning indices. APACHE II score showed no significant difference in both groups. There were statistically significant differences between the groups in term of, duration of mechanical ventilation, weaning hours and length of ICU stay being shorter in (group 1) weaned by ASV. Re-intubation and mortality rate were higher in (group 11) weaned by conventional PSV, however the differences were not significant. Conclusion: ASV can provide automated weaning and achieve shorter weaning time for COPD patients hence leading to reduction in the total duration of MV, length of stay, and hospital costs.

Keywords: COPD patients, ASV, PSV, mechanical ventilation (MV)

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Authors: Alaa Sarhan, Rania Abd El Gelil, Hana Awad

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Through the last decades, the impact of thermal comfort on the working performance of users and occupants of an indoor space has been a concern. Research papers concluded that natural ventilation quality directly impacts the levels of thermal comfort. Natural ventilation must be put into account during the design process in order to improve the inhabitant's efficiency and productivity. One example of daily long-term occupancy spaces is educational facilities. Many individuals spend long times receiving a considerable amount of knowledge, and it takes additional time to apply this knowledge. Thus, this research is concerned with user's level of thermal comfort in design studios of educational facilities. The natural ventilation quality in spaces is affected by a number of parameters including orientation, opening design, and many other factors. This research aims to investigate the conscious manipulation of the physical parameters of the spaces and its impact on natural ventilation performance which subsequently affects thermal comfort of users. The current research uses inductive and deductive methods to define natural ventilation design considerations, which are used in a field study in a studio in the university building in Alexandria (AAST) to evaluate natural ventilation performance through analyzing and comparing the current case to the developed framework and conducting computational fluid dynamics simulation. Results have proved that natural ventilation performance is successful by only 50% of the natural ventilation design framework; these results are supported by CFD simulation.

Keywords: educational buildings, natural ventilation, , mediterranean climate, thermal comfort

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Authors: Manoj Kumar Reddy Pulim, Lakshmi Muthukrishnan, Geetha Jayapathy, Radhika Raman

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Introduction: In the past two decades, noninvasive positive pressure ventilation (NIPPV) emerged as one of the most important advances in the management of both acute and chronic respiratory failure in children. In the acute setting, it is an alternative to intubation with a goal to preserve normal physiologic functions, decrease airway injury, and prevent respiratory tract infections. There is a need to determine the clinical profile and parameters which point towards the need for NIV in the pediatric emergency setting. Objectives: i) To study the clinical profile of children who required non invasive ventilation and invasive ventilation, ii) To study the clinical parameters common to children who required non invasive ventilation. Methods: All children between one month to 18 years, who were intubated in the pediatric emergency department and those for whom decision to commence Non Invasive Ventilation was made in Emergency Room were included in the study. Children were transferred to the Paediatric Intensive Care Unit and started on Non Invasive Ventilation as per our hospital policy and followed up in the Paediatric Intensive Care Unit. Clinical profile of all children which included age, gender, diagnosis and indication for intubation were documented. Clinical parameters such as respiratory rate, heart rate, saturation, grunting were documented. Parameters obtained were subject to statistical analysis. Observations: Airway disease (Bronchiolitis 25%, Viral induced wheeze 22%) was a common diagnosis in 32 children who required Non Invasive Ventilation. Neuromuscular disorder was the common diagnosis in 27 children (78%) who were Intubated. 17 children commenced on Non Invasive Ventilation who later needed invasive ventilation had Neuromuscular disease. High frequency nasal cannula was used in 32, and mask ventilation in 17 children. Clinical parameters common to the Non Invasive Ventilation group were age < 1 year (17), tachycardia n = 7 (22%), tachypnea n = 23 (72%) and severe respiratory distress n = 9 (28%), grunt n = 7 (22%), SPO2 (80% to 90%) n = 16. Children in the Non Invasive Ventilation + INTUBATION group were > 3 years (9), had tachycardia 7 (41%), tachypnea 9(53%) with a male predominance n = 9. In statistical comparison among 3 groups,'p' value was significant for pH, saturation, and use of Ionotrope. Conclusion: Invasive ventilation can be avoided in the paediatric Emergency Department in children with airway disease, by commencing Non Invasive Ventilation early. Intubation in the pediatric emergency department has a higher association with neuromuscular disorders.

Keywords: clinical parameters, indications, non invasive ventilation, paediatric emergency room

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Authors: Paiwan Buachan, Maneekarn Namsa-Aid, Suchada Jongrungruangchok, Foengchat Jarintanan, Wanlaya Uthaisang-Tanechpongtamb

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Lung cancer or pulmonary carcinoma is the uncontrolled growth of abnormal cells in one or both of the lungs. These abnormal cells can spread to other organs of the body through lymphatic system or bloodstream which is called metastatic stage that leading cause of cancer death. Terrein (C₈H₁₀O₃; MW= 154.06 kDa) is a secondary bioactive fungal metabolite, which was isolated from the Aspergillus terreus. In this study, we investigated the effects of terrein on the inhibition of human lung cancer cell proliferation and metastasis. The A549 human non-small cell lung cancer cell line was used as a model. Terrein significantly inhibited lung cancer cell proliferation measuring by a colorimetric MTT assay (IC₅₀ 0.32 mM) and significantly inhibited metastatic processes including migration, invasion, and adhesion that determined by wound healing assay, transwell assay, and adhesion assay, respectively. These findings indicate that terrein could be a potential therapeutic agent for lung cancer.

Keywords: terrein, lung cancer, anticancer, antimetastatic

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Authors: Fulya Ozbey, Ecehan Ozmehmet

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Health and living in a healthy environment are important for all the living creatures. Healthy buildings are the part of the healthy environment and the ones that people and sometimes the animals spend most of their times in it. Therefore, healthy buildings are important subject for everybody. There are many elements of the healthy buildings from material choice to the thermal comfort including indoor air quality. The aim of this study is, to simulate two natural ventilation strategies which are used as a cooling method in Mediterranean climate, by applying to a residential building and compare the results for Asian climate. Fulltime natural and night-time ventilation strategies are simulated for three days during the summertime in Mediterranean climate. The results show that one of the chosen passive cooling strategies worked on both climates good enough without using additional shading element and cooling device, however, the other ventilation strategy did not provide comfortable indoor temperature enough. Finally, both of the ventilation strategies worked better on the Asian climate than the Mediterranean in terms of the total overheating hours during the chosen period of year.

Keywords: Asian climate, indoor air quality, Mediterranean climate, natural ventilation simulation, thermal comfort

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Authors: Ayşin Sev, Görkem Aslan

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Sustainable tall buildings that provide comfortable, healthy and efficient indoor environments are clearly desirable as the densification of living and working space for the world’s increasing population proceeds. For environmental concerns, these buildings must also be energy efficient. One component of these tasks is the provision of indoor air quality and thermal comfort, which can be enhanced with natural ventilation by the supply of fresh air. Working spaces can only be naturally ventilated with connections to the outdoors utilizing operable windows, double facades, ventilation stacks, balconies, patios, terraces and skygardens. Large amounts of fresh air can be provided to the indoor spaces without mechanical air-conditioning systems, which are widely employed in contemporary tall buildings. This paper tends to present the concept of natural ventilation for sustainable tall office buildings in order to achieve healthy and comfortable working spaces, as well as energy efficient environments. Initially the historical evolution of ventilation strategies for tall buildings is presented, beginning with natural ventilation and continuing with the introduction of mechanical air-conditioning systems. Then the emergence of natural ventilation due to the health and environmental concerns in tall buildings is handled, and the strategies for implementing this strategy are revealed. In the next section, a number of case studies that utilize this strategy are investigated. Finally, how tall office buildings can benefit from this strategy is discussed.

Keywords: tall office building, energy efficiency, double-skin façade, stack ventilation, air conditioning

Procedia PDF Downloads 478