MODIFLOW. A FLOW MODIFICATION DEVICE. CONTENTS. Asthma and other respiratory illnesses Inhalable medications Forms of delivery to the lungs Spacer devices Fractal geometry Fractality in living systems Turbulence How do the biological systems deal with it? ModiFlow The Patent CIP
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A FLOW MODIFICATION DEVICE
• The number of people with asthma continues to grow. One in 12 people (about 25 million, or 8% of the U.S. population) had asthma in 2009, compared with 1 in 14 (about 20 million, or 7%) in 2001.2• More than half (53%) of people with asthma had an asthma attack in 2008. More children (57%) than adults (51%) had an attack. 185 children and 3,262 adults died from asthma in 2007.2• About 1 in 10 children (10%) had asthma and 1 in 12 adults (8%) had asthma in 2009. Women were more likely than men and boys more likely than girls to have asthma.2• In 2010, 3 out of 5 children who have asthma had one or more asthma attacks in the previous 12 months.6
• Asthma cost the US about $3,300 per person with asthma each year from 2002 to 2007 in medical expenses, missed school and work days, and early deaths.2• Asthma costs in the US grew from about $53 billion in 2002 to about $56 billion in 2007, about a 6% increase.2• More than half (59%) of children and one-third (33%) of adults who had an asthma attack missed school or work because of asthma in 2008. On average, in 2008 children missed 4 days of school and adults missed 5 days of work because of asthma.2
• More than half (53%) of people with asthma had an asthma attack in 2008. More children (57%) than adults (51%) had an attack. 185 children and 3,262 adults died from asthma in 2007.2• Asthma was linked to 3,447 deaths (about 9 per day) in 2007.
• The prevalence of asthma in different countries varies widely, but the disparity is narrowing due to rising prevalence in low and middle income countries and plateauing in high income countries.3• An estimated 300 million people worldwide suffer from asthma, with 250,000 annual deaths attributed to the disease.1• It is estimated that the number of people with asthma will grow by more than 100 million by 2025.1• Workplace conditions, such as exposure to fumes, gases or dust, are responsible for 11% of asthma cases worldwide.1• About 70% of asthmatics also have allergies.1• Approximately 250,000 people die prematurely each year from asthma. Almost all of these deaths are avoidable.1• Occupational asthma contributes significantly to the global burden of asthma, since the condition accounts for approximately 15% of asthma amongst adults.
Activated by inspiration
Metered-dose inhalers with spacers produced outcomes that were at least equivalent to nebulizer delivery
Adrenal suppression in asthmatic children receiving low-dose inhaled budesonide: comparison between dry powder inhaler and pressurized metered-dose inhaler attached to a spacer
Treatment of asthmatic children with budesonide 400 mcg daily given via a DPI for 1 month was associated with hypothalamic-pituitary-adrenal axis suppression. This effect was not observed with the same dose of budesonide administered via pMDI + spacer. This indicates that systemic absorption might be reduced with pMDI + spacer therapy
HCs made from electrically conductive materials emit significantly greater fine-particle mass, with either a 2-s or 5-s delay, than do HCs made from nonconducting materials, even with wash/rinse pretreatment.
In stable asthmatic children, albuterol administered through MDI using a non-valved spacer produces a bronchodilator response similar to that of a spacer with a valve that requires an inhalatory opening pressure (with flows between 2 and 32 l/min) that even toddlers with bronchial obstruction can easily generate.
The lungs are naturally irregular and asymmetrical organ in anatomy. The conducting bronchial trees in the lungs display complex self-similar structure. We have established the host mesh coordinates of the right lung on the basis of the anatomical data from the literature. A three-dimensional fractal model of the conducting airways was set up by calculating the coordinates of the mass centers of the divided blocks, searching the branch direction and determining branch lengths with the use of the drawing tool OpenGL. Specific data of the lengths at various grades, branching angles, and capillary diameters were obtained. As a result, the computed data were identical with those of the existing statistical data. The fractal covering dimensionality obtained in the computation of this model was 2.19, which is very close to the ideal dimensionality, 2.17, from the literature. The present model has laid the foundation for further research of the gas diffusion and transfer performance in the lungs using the fractal concept, and furthermore, it helps to save the computer memories and fastening the graphic transfer.
The bronchial, arterial, and venous trees of the lung are complex interwoven structures. Their geometries are created during fetal development through common processes of branching morphogenesis. Insights from fractal geometry suggest that these extensively arborizing trees may be created through simple recursive rules. Mathematical models of Turing have demonstrated how only a few proteins could interact to direct this branching morphogenesis. Development of the airway and vascular trees could, therefore, be considered an example of emergent behavior as complex structures are created from the interaction of only a few processes. However, unlike inanimate emergent structures, the geometries of the airway and vascular trees are highly stereotyped. This review will integrate the concepts of emergence, fractals, and evolution to demonstrate how the complex branching geometries of the airway and vascular trees are ideally suited for gas exchange in the lung. The review will also speculate on how the heterogeneity of blood flow and ventilation created by the vascular and airway trees is overcome through their coordinated construction during fetal development.
The branching pattern of the conducting airways is significantly asymmetrical in the human, and even more so in other species. Although this asymmetry is believed to have an important effect on air flow and other transport processes in the bronchial tree, both experimental and theoretical studies have predominantly employed symmetrical model bifurcations. In this paper, published morphometric data for four species (human, dog, rat and hamster) is used to calculate the frequencies with which different degrees of asymmetry occur, and to examine the relationships between four of its manifestations, asymmetry of the cross-sectional areas, the lengths, the branching angles and the flow rates of the daughter branches. The observed characteristics are compared with some of the theoretical 'branching laws' which have been proposed. Quantification of the correlations between the different manifestations of asymmetry allows the geometrical characteristics to be specified for a range of realistic asymmetrical bifurcations, for use in either theoretical or experimental studies of transport in the bronchial tree.
High-resolution measurements of pulmonary perfusion reveal substantial spatial heterogeneity that is fractally distributed. This observation led to the hypothesis that the vascular tree is the principal determinant of regional blood flow. Recent studies using aerosol deposition show similar ventilation heterogeneity that is closely correlated with perfusion. We hypothesize that ventilation has fractal characteristics similar to blood flow. We measured regional ventilation and perfusion with aerosolized and injected fluorescent microspheres in six anesthetized, mechanically ventilated pigs in both prone and supine postures. Adjacent regions were clustered into progressively larger groups. Coefficients of variation were calculated for each cluster size to determine fractal dimensions. At the smallest size lung piece, local ventilation and perfusion are highly correlated, with no significant difference between ventilation and perfusion heterogeneity. On average, the fractal dimension of ventilation is 1.16 in the prone posture and 1. 09 in the supine posture. Ventilation has fractal properties similar to perfusion. Efficient gas exchange is preserved, despite ventilation and perfusion heterogeneity, through close correlation. One potential explanation is the similar geometry of bronchial and vascular structures.
"the most important unsolved problem of classical physics“
“a butterfly in Korea can cause a tsunami in the US”
the total alveolar surface area is the size of a tennis court
the entire vascular system comprises only 3% of the total volume of the body..
it bleeds if you puncture anywhere in the body !
if you put together the lengths of all the blood vessels in the body including the tiniest capillaries, they would line up from Earth to the Moon..
yet the heart is able to pump the blood through them for 100 years !
Subdivision of the main flow into two sub-flows iterated multiple times (a tree) seems to disrupt the cycle of growth of the lateral force, preventing the emergence of a high Reynolds number turbulence.
At the same time it allows for a large “exchange” surface area to be fitted into a relatively small volume, making the exchange of substances, energy, information extremely efficient.
A distribution to a large number of elements without major losses is best achieved via a fractal tree-like hierarchic structure.
For the flow in the tree to remain continuous and relatively laminar, and for the turbulence not to emerge at every subdivision, it is important for certain “preservation” rules to be employed.
The total cross-sectional area of the sub-flows should be equal to the cross-sectional area of the preceding flow.
That area should in fact remain constant throughout the entire tree structure and at every cross-sectional level
A NEW GENERATION SPACER DEVICE
But it’s also a Flow Modification Device
The principles of flow modification described here have universality that is applicable in any device concerned with transfer of fluid, gas, or information