The Human Respiratory System: An Analysis of the Interplay between Anatomy, Structure, Breathing and Fractal Dynamics

233 Pages·2013·8.21 MB·English

by  Clara Mihaela Ionescu (auth.)

Series in BioEngineering
Clara Mihaela Ionescu
The Human
Respiratory System
An Analysis of the Interplay between
Anatomy, Structure, Breathing and
Fractal Dynamics
Series in BioEngineering
Forfurthervolumes:
www.springer.com/series/10358
Clara Mihaela Ionescu
The Human
Respiratory System
An Analysis of the Interplay between
Anatomy, Structure, Breathing and
Fractal Dynamics
ClaraMihaelaIonescu
DepartmentofElectricalEnergy,Systems
andAutomation
GhentUniversity
Gent,Belgium
ISSN2196-8861 ISSN2196-887X(electronic)
SeriesinBioEngineering
ISBN978-1-4471-5387-0 ISBN978-1-4471-5388-7(eBook)
DOI10.1007/978-1-4471-5388-7
SpringerLondonHeidelbergNewYorkDordrecht
LibraryofCongressControlNumber:2013947158
©Springer-VerlagLondon2013
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“To raisenew questions,newpossibilities,to
regard oldproblemsfroma newangle,
requires creativeimaginationandmarksthe
real advanceinscience”
A.Einstein
Asaresultoftheabovethought,Idedicate
thisbooktoallthosewhoare curious,
critical,and challenging.
Foreword
Fractional Calculus (FC) was originated in 1695 based on the genial ideas of the
GermanmathematicianandphilosopherGottfriedLeibniz(1646–1716).Uptothe
endofthe19thcentury,thistopicremainedmainlyabstractwithprogresscentered
in pure mathematics. The application of FC started with Oliver Heaviside (1850–
1925), an English electrical engineer, mathematician,and physicist. Heaviside ap-
pliedconceptsofFCinisoperationalcalculusandelectricalsystems.Nevertheless,
FCremainedamathematicaltoolunknownformostresearchers.Intheareaoflife
sciencesthefirstcontributionsarecreditedtotheAmericanscientistsKennethStew-
art Cole (1900–1984) and Robert Hugh Cole (1914–1990), who published several
papers by the end of the 1930s. They proposed the so-called Cole–Cole empirical
model,whichhasbeensuccessfullyapplieduptotoday,inalargevarietyoftissues.
These pioneering applications of FC were apparently forgotten in the decades
that followed. There is no historical record, social event, or scientific explanation,
for the ‘oblivium’ phenomenon. Three decades later Bertram Ross organized the
First Conference on Fractional Calculus and its Applications at the University of
New Haven in 1974. Also, Keith Oldham and Jerome Spanier published the first
monographdevotedtoFC.Again,theseimportantcontributionsremainedwithFC
focused on pure mathematics, but in 1983 the French engineer Alain Ousaloup
developed the CRONE (acronym for ‘Commande Robuste d’Ordre Non Entier’)
method, which is used since then in control and identification algorithms. We can
saythatthemoderneraofapplicationofFCinphysicsandengineeringstartedthere.
In 1998 Virginia Kiryakova initiated the publication of the journal Fractional Cal-
culus&AppliedAnalysis.WeshouldmentionthevisionofAliNayfehandMurat
Kunt, editors-in-chief of journals ‘Nonlinear Dynamics’ and ‘Signal Processing’,
respectively, that supported a sustained growth of the new–old field by means of
severalspecialissues.
Intheareaofbiologyandmedicinethefirstbook,authoredbyRichardMagin,
was published in 2006. By 2004 a young researcher, Clara Ionescu, started an in-
tensive work in modeling respiratory systems using FC. I called her the ‘atomic
woman’giventheintensityofherworkthatculminatedwithherPh.D.bytheend
of 2009. Clara continued improving the models, getting more results and publish-
vii
viii Foreword
ingherresearch.Thisbookformulates,inacomprehensivework,hervisiononthe
applicationofFCinthemodelingofrespiratorysystems.Iamcertainthatthebook
willconstituteanovellandmarkintheprogressintheareaandthatitsreaderswill
berewardedbynewperspectivesandwiderconceptualavenues.
Porto J.A.TenreiroMachado
May2013
Preface
Theobjectiveofthebookistoputforwardemergingideasfrombiologyandmath-
ematics into biomedical engineering applications in general with special attention
to the analysis of the human respiratory system. The field of fractional calculus is
mature in mathematics and chemistry, but still in infancy in engineering applica-
tions.However,thelasttwodecadeshavebeenveryfruitfulinproducingnewideas
and concepts with applications in biomedical engineering. The reader should find
the book a revelation of the latest trends in modeling and identification of the hu-
manrespiratoryparametersforthepurposeofdiagnosticandmonitoring.Ofspecial
interesthereisthenotionoffractalstructure,whichtellsussomethingaboutthebi-
ological efficiency of the human respiratory system. Related to this notion is the
fractal dimension, relating the adaptation of the fractal structure to environmental
changes(i.e.disease).Finally,wehavethedynamicalpatternofbreathing,whichis
thentheresultofboththestructureandtheadaptabilityoftherespiratorysystem.
The distinctive feature of the book is that it offers a bottom-up approach, start-
ing from the basic anatomical structure of the respiratory system and continuing
with the dynamic pattern of the breathing. The relations between structure (or the
specific changes within it) and fundamental working of the system as a whole are
pinnedsuchthatthereadercanunderstandtheirinterplay.Moreover,thisinterplay
becomescrucialwhenalterationsatthestructurallevelintheairwaycausedbydis-
easemayrequireadaptationofthebodytothefunctionalrequirementsofbreathing
(i.e.toensurethenecessaryamountofoxygentotheorgans).Adaptationofthehu-
manbody,andspeciallyoftherespiratorysystem,tovariousconditionscanbethus
explainedandjustifiedintermsofbreathingefficiency.
The motivation for putting together this book is to give by means of the exam-
ple chosen(i.e. the respiratory system) an impulseto the engineeringand medical
community in embracing these new ideas and becoming aware of the interaction
betweenthesedisciplines.Thenetbenefitofreadingthisbookistheadvantageof
anyresearcherwhowantstostayuptodatewiththenewemergingresearchtrends
in biomedical applications. The book offers the reader an opportunity to become
awareofanovel,unexplored,andyetchallengingresearchdirection.
ix
x Preface
Myintentionwastobuildabridgebetweenthemedicalandengineeringworlds,
tofacilitatecross-fertilization.Inordertoachievethis,Itriedtoorganizethebook
inthetraditionalstructureofatextbook.
Abriefintroductionwillpresenttheconceptoffractionalsignalsandsystemsto
thereader,includingashorthistoryofthefractionalcalculusanditsapplicationsin
biology and medicine. In this introductory chapter, the notions of fractal structure
andfractaldimensionwillbedefinedaswell.
The second chapter describes the anatomy of the respiratory system with mor-
phological and structural details, as well as lung function tests for evaluating the
respiratoryparameterswiththeaimofdiagnosisandmonitoring.Thethirdchapter
willpresentthenotionofrespiratoryimpedance,howitismeasured,whyitisuseful
andhowwearegoingtouseitintheremainderofthebook.
A mathematical basis for modeling air-pressure and air-flow oscillations in the
airways is given in the fourth chapter. This model will then be used as a basis for
furtherdevelopmentsofladdernetworkmodelsinChap.5,thuspreservinganatomy
andstructureoftherespiratorysystem.Simulationsoftheeffectsoffractalsymme-
try and asymmetry on the respiratory properties and the evaluation of respiratory
impedanceinthefrequencydomainarealsoshown.
Chapter6willintroducetheequivalentmechanicalmodeloftherespiratorytree
anditsimplicationsforevaluatingviscoelasticity.Ofspecialimportanceisthefact
thatchangesintheviscoelasticeffectsareclearlyseeninpatientswithrespiratory
insufficiency, hence markers are developed to evaluate these effects and provide
insightintothemonitoringofthediseaseevolution.Measurementsonrealdatasets
arepresentedanddiscussed.
Chapter 7 discusses models which can be used to model the respiratory
impedance over a broad range of frequencies, namely ladder network model and
amodelexistingintheliterature,forcomparisonpurposes.Theupperairwayshunt
(notpartoftheactualrespiratorysystemwithairwaysandparenchyma)anditsbias
effectintheestimatedvaluesfortherespiratoryimpedanceispresented,alongwith
acharacterizationonhealthypersonsandpredictionvalues.Measurementsonreal
datasetsarepresentedanddiscussed.
Chapter8presentstheanalysisofthebreathingpatternandrelationtothefractal
dimension. Additionally, a link between the fractal structure and the convergence
to fractional order models is shown, allowing also a link between the value of the
fractionalordermodelandthevaluesofthefractaldimension.Inthisway,theinter-
playbetweenstructureandbreathingpatternsisshown.Adiscussionofthisinter-
playpointstothefactthatwithdisease,changesinstructureoccur,thesestructural
changesimplyingchangesintheworknecessarytobreathatfunctionallevels.Mea-
surementsonrealdatasetsareagainpresentedanddiscussed.
Chapter9introducesmethodsandprotocolstoinvestigatewhethermovingfrom
the theory of linear system to nonlinear contributions can bring useful insight as
regards diagnosis. In this context, measuring frequencies close to the breathing of
the patient is more useful than measuring frequencies outside the range of tidal
breathing.Thisalsoimpliesthatviscoelasticitywillbemeasuredintermsofnonlin-
eareffects.Thenonlinearartifactsmeasuredintherespiratoryimpedance,arethen
Preface xi
linkedtotheviscousandelasticpropertiesinthelungparenchyma.Measurements
onrealdatasetsarepresentedanddiscussed.Chapter10summarizesthecontribu-
tionsofthebookandpointtofutureperspectivesintermsofresearchanddiagnosis
methods.IntheAppendix,someusefulinformationisgiventofurthersupportthe
readerinhis/herquestforknowledge.
Finally,Iwouldliketoendthisprefacesectionwithsomewordsofacknowledg-
ment.
IwouldliketothankOliverJacksonfortheinvitationtostartthisbookproject,
andMs.CharlotteCross ofSpringerLondonforherprofessionalsupportwiththe
review,editing,andproductionsteps.
Partoftheideasfromthisbookareduetothefollowingmen(tors):Prof.Robin
DeKeyser(GhentUniversity,Belgium),Prof.Jose-AntonioTenreiroMachado(In-
stituteof Engineering,Porto,Portugal),Prof. AlainOustaloup(Universityof Bor-
deaux1,France)andProf.ViorelDugan(UniversityofLowerDanube,Galati,Ro-
mania).ClinicalinsighthasbeengenerouslyprovidedtomebyProf.Dr.MDEric
Derom (Ghent University Hospital, Belgium) and Prof. Dr. MD Kristine Desager
(Antwerp University Hospital, Belgium). I thank them cordially for their continu-
oussupportandencouragement.
FurthertechnicalsupportisacknowledgedfromthefollowingMasterandPh.D.
studentsthroughoutthelastdecade:AlexanderCaicedo,IonutMuntean,NielsVan
Nuffel, Nele De Geeter, Mattias Deneut, Michael Muehlebach,Hannes Maes, and
DanaCopot.
Next,Iwouldliketoacknowledgethepersonswhosupportedmyworkadminis-
trativelyandtechnicallyduringtheclinicaltrials.
• Forthemeasurementsonhealthyadultsubjects,IwouldliketothankMr.Sven
Verschraegen for the technical assistance for pulmonary function testing at the
DepartmentofRespiratoryMedicineofGhentUniversityHospital,Belgium.
• For the measurements on healthy children, I would like to thank Mr. Raf Mis-
sorten from St. Vincentius school in Zwijnaarde, Principal, for allowing us to
perform tests and to Mr. Dirk Audenaert for providing the healthy volunteers.
IwouldalsoliketothankNeleDeGeeterandNielsVanNuffelforfurtherassis-
tanceduringtheFOT(ForcedOscillationsTechnique)measurements.
• For the measurements on COPD patients: many thanks to Prof. Dr. Dorin Isoc
from Technical University of Cluj-Napoca and to Dr. Monica Pop for the assis-
tance in the University of Pharmacy and Medicine “Iuliu Hatieganu” in Cluj-
Napoca,Romania.
• For the measurements on asthmatic children, I would like to thank Rita Claes,
HildeVaerenberg,KevinDeSooner,LutjeClaus,HildeCuypers,RiaHeyndrickx
andPieterDeHerdtfromthepulmonaryfunctionlaboratoryinUZAntwerp,for
the professional discussions, technical and amicable support during my stay in
theirlaboratory.
• Forthemeasurementsonkyphoscoliosisadults,IwouldliketothankMrs.Her-
mine Middendorp for the assistance with the Ethical Committee request; to
Philippe De Gryze, Frank De Vriendt, LucienneDaman,and Evelien De Burck