Inlet Extension Research Articles

Hardware and software solutions for implementing nanospray desorption electrospray ionization (nano-DESI) sources on commercial mass spectrometers.

Nanospray desorption electrospray ionization (nano-DESI) is an ambient ionization mass spectrometry imaging (MSI) approach that enables spatial mapping ofbiological and environmental samples with high spatial resolution and throughput. Because nano-DESI has not yet been commercialized, researchers develop their own sources and interface them with different commercial mass spectrometers. Previously, several protocols focusing on the fabrication of nano-DESI probes have been reported. In this tutorial, we discuss different hardware requirements for coupling the nano-DESI source to commercial mass spectrometers, such as the safety interlock, inlet extension, and contact closure. In addition, we describe the structure of our custom software for controlling the nano-DESI MSI platform and provide detailed instructions for its usage. With this tutorial, interested researchers should be able to implement nano-DESI experiments in their labs.

Branched nozzle oblique angle flow for initiated chemical vapor deposition

Monomer precursor flow was introduced at an oblique angle to the substrate at two locations during the initiated chemical vapor deposition (iCVD) process using a branched nozzle inlet extension. The polymerization of methacrylic acid was systematically studied as a function of the nozzle length and the monomer flow rate. Our experimental data showed the evolution of two distinct symmetrical thickness profiles as the flow rate and nozzle length increased. The maximum thickness moved downstream along the axes of both nozzles as the flow rate and nozzle length increased. Computational models were used to study the effects of the nozzle length and the monomer flow rate on the velocity profile within the reactor. Increasing the monomer flow rate and the nozzle length resulted in increases in the velocity profile ranges and the movement of the location of the maximum velocity and local minimum velocity associated with the stagnation point. These velocity data provided insight for explaining the trends found in the experimental results. The data demonstrate the ability to use a branched nozzle inlet extension to control the location of polymer deposition during the iCVD process.

Extended sternotomy with lateral neck incision: An alternative approach for children with large apical chest masses with thoracic inlet involvement

Pediatric tumors in the apex of the thoracic cavity are often diagnosed late due to the absence of symptoms. These tumors can be quite large at presentation with involvement of the chest wall, sympathetic chain, spine, and aortic arch. The tumors can also extend into the thoracic inlet and encircle the brachial plexus. Depending on the diagnosis, treatment may involve chemotherapy with subsequent surgery or require primary resection. Optimal exposure to resect large apical tumors with thoracic inlet extension is a surgical challenge. To date, several surgical techniques have been described to resect these tumors – including both anterior and posterior thoracic approaches. Each of these techniques can be limited by inadequate exposure of the mass. We describe an alternative approach to surgical resection of these masses that employs an extended sternotomy with a lateral neck incision. This report details two successful resections of large left apical masses with thoracic inlet involvement in children using this technique (Level of evidence 4).

Unusual coronary artery arrangement in D-transposition of the great arteries with ventricular septal defect.

A term female with prenatally diagnosed D-Transposition of the great arteries, large membranous ventricular septal defect with inlet extension, moderate secundum atrial septal defect, and large patent ductus arteriosus (Fig1) was born by scheduled caesarean section. Transthoracic echocardiogram confirmed the anatomy with both coronary arteries arising from a single sinus with separate ostia. The right coronary artery arose from right posterior facing sinus (Fig2). The left coronary artery arose anomalously from the same sinus adjacent to the right coronary artery ostium, coursing posterior to the aorta, with brief intramural and interarterial course before bifurcating into the left anterior descending and left circumflex coronary arteries (Figs3 and 4). As a result of this unique coronary pattern, she underwent unroofing of the intramural left coronary artery noted on opening the aortic root to the coronary ostium. Both coronary buttons were harvested and this large button was then divided into two buttons. The left coronary artery button was implanted with a trapdoor technique, right coronary artery button was implanted, and the remainder of the arterial switch procedure along with LeCompte maneuver was completed uneventfully, with closure of the atrial and ventricular septal defects. The post-operative course was uneventful and the patient was discharged on the seventh post-operative day. At discharge, the patient had normal biventricular systolic function, no residual intracardiac shunt, and robust antegrade flow in the reimplanted coronary arteries. The patient was growing well at the fourth month post-operative visit with normal biventricular function, patent coronaries, and outflow tracts.

Towards optimal aerodynamic design of wind catchers: Impact of geometrical characteristics

This paper presents a detailed parametric analysis of the impact of geometrical characteristics of wind catchers on their flow features to enhance the effectiveness of cross-ventilation strategies of buildings. The following geometrical characteristics are evaluated in detail: (i) ceiling tilt angle, (ii) radius of the outer-corner bend, (iii) leeward-side tilt angle, (iv) straight inlet extension length, (v) nozzle-shaped inlet extension radius, and (vi) radius of the inner-corner bend. In addition, the impact of using guide vanes in the bend of wind catchers is systematically investigated. High-resolution coupled (outdoor wind flow and indoor airflow) 3D steady RANS CFD simulations are performed for 40 different wind catcher geometries. The CFD simulations are based on a grid-sensitivity analysis and are validated by comparing with two wind-tunnel measurements. The results show that the use of straight and nozzle-shaped inlet extensions can significantly increase the airflow rate. The maximum increase is about 23%, which is achieved for the straight inlet extension length S/D = 1 (D is wind-catcher depth). Guide vanes are also found to effectively improve the flow uniformity inside wind catchers and significantly enhance the airflow rate. This enhancement can go up to 29% when guide vanes are implemented in combination with a straight inlet extension with S/D = 0.375. The results of the present study support the optimal aerodynamic design of wind catchers.

Oblique angle initiated chemical vapor deposition for patterning film growth

Initiated chemical vapor deposition (iCVD) can be used to deposit thin polymer films on a variety of substrates. In this work, the monomer precursor was introduced at an oblique angle to the substrate using an inlet extension, and the pattern of the resulting polymer film was studied as a function of deposition time, substrate temperature, monomer flow rate, reactor pressure, and vapor flow angle. The polymerizations of n-butyl acrylate, methacrylic acid, and 2-hydroxyethyl methacrylate were examined to determine the generality of the trends across several monomers. It was found that the monomer flow rate significantly affected the pattern of the deposited polymer by shifting the location of the thickest point in the films. Increasing the deposition time, decreasing the substrate temperature, and increasing the reactor pressure all increased the polymer deposition rate consistent with conventional iCVD; however, the pattern of the deposited polymer did not vary with these parameters. Computational analysis was used to determine how the inlet extension affects the pressure and velocity profiles within the reactor. The data demonstrate that the introduction of a monomer precursor at an oblique angle can be used to pattern polymer films during iCVD.

Major Septal Defects: Comparative Study of Down Syndrome and Non-Down Syndrome Infants, Before and After Surgery.

Objective:To compare pre-operative, intra-operative, and post-operative parameters in Down syndrome (DS) and non-DS patients with atrioventricular septal defects (AVSD) and inlet ventricular septal defects (VSD) in a tertiary care hospital in Pakistan.Methods:We conducted a retrospective study at Aga Khan University, Pakistan. All complete atrioventricular septal defect (CAVSD), partial atrioventricular septal defect (PAVSD), and VSD with inlet extension surgical cases from January 2007 to January 2019 were included. Patients with congenital heart diseases other than those listed above were excluded.Results:In 61 cases, 18 had DS. Median age, mean body surface area (BSA), and height were lower in DS patients compared to non-DS patients: 7.0 vs 23.0 months, 0.311 vs 0.487 m2, and 63 vs 82 cm, respectively. Bypass duration, aortic cross clamp time, post-operative ventilator hours, dose of inotropes, CICU stay, and total hospital stay were all significantly higher in the DS group. The odds ratio (955% CI) for mortality in DS babies was 6.2 (1.4, 27.1), p=0.015, after adjusting for age, weight, and height. The overall morbidity was comparable between the two groups, demonstrating no significant difference after adjusting for confounders.Conclusion:DS babies with AVSD and inlet VSD are at a greater risk of mortality compared to non-DS babies, particularly those with CAVSD. Furthermore, DS babies undergo surgery at a younger age and require more aggressive post-operative therapy and monitoring due to the development of complications.

Incidental Finding of a Tricuspid Valve Cyst in a Patient with a Ventricular Septal Defect

A 14-month-old male presented electively for repair of double-chambered right ventricle and ventricular septal defect after remote repair of aortic coarctation. Pre-operative echocardiogram showed a restrictive ventricular septal defect with inlet extension and partial occlusion by transformational tricuspid valve tissue. Upon visualization of the tricuspid valve intraoperatively, a clear yellow, fluid-filled cyst was found on the septal leaflet which was partially occluding the ventricular septal defect. Pathology examination showed that the cyst was contained within fibrous valve tissue and lined by endothelial cells which has not, to our knowledge, been described before in the literature.

Inlet extensions for wind towers to improve natural ventilation in buildings

For centuries Wind Towers, also known as Windcatchers, have been used in hot and arid regions to naturally ventilate buildings. This study presents a solution to one problem of their functioning. It is known that at the top of the structure of the traditional wind tower there is a low-pressure zone, caused by boundary layer separation. This low-pressure zone is directly on top of the inlet opening, which has a much higher pressure. The proximity of this to key areas creates an ascending stream that forces the air out of the wind tower inlet opening. Inlet extensions are proposed in this work to force the air towards the inlet and to isolate the high-pressure zone from the low-pressure on top of the tower. Using CFD, 28 different designs of inlet extension have been tested. The results show that the great majority of designs increased air induction to the building by reducing to a minimum the ascending currents from inside the inlet opening to the outside of the towers. However, some of the designs tested formed vortexes inside the inlet openings that prevented the tower from getting more air induction. The present work can serve as a guide to what to do, and what not to do when designing a new wind tower, or when retrofitting an old one with inlet extensions.

Revisit on natural convection from vertical isothermal plate arrays--effects of extra plume buoyancy

In this study, natural convection from vertical isothermal parallel-plate arrays is examined using 2-D steady-state numerical analysis. Extended computation domains encompassing the single- or multi-channel plate arrays are adopted. Also investigated are the consequences of using computation domains without the inlet extension or/and the outlet extension. The plate height is fixed at 100 mm, the plate spacing is 7 mm, and the plate thickness is 1 mm. The Elenbaas Rayleigh number Ra’ is fixed at 62.8. The results show that setting the inlet boundary at the entrance of the channel would ignore the separation formed near the outer entrance corner and the associated flow resistance; while setting the outlet boundary at the exit of the channel would omit the extra buoyancy provided by the hot plume above the arrays. In multi-channel arrays, the average heat transfer coefficients in different individual channels (hs) are different from each other. The h is the highest in the central channel and the lowest in the edge channel. Except for the edge channels, the h values are higher than that of a single channel. The differences in h between the central and the edge channels increase with increasing number of channels. This phenomenon can be ascribed to (1) the stronger extra hot-plume buoyancy in the inner plume region and (2) the higher entrance-separation resistance in the outer channels. The overall convection heat transfer coefficients in the plate arrays increase with increasing number of plate channels. The conventional assumption that all the channels of a multi-plate array have similar heat transfer performance needs re-evaluation.

Transfer matrix methods for sound attenuation in resonators with perforated intruding inlets

A resonator with perforated intruding inlet (PII) is a superior silencer element, since the use of perforated inlet extensions can dramatically improve the acoustic performance. In this work, both a one-dimensional (1D) and a two-dimensional (2D) transfer matrix methods are developed to predict the transmission loss of the resonator without considering the mean flow. Based on the two groups of comparisons with tests, it is found out that the applicability of 1D method is limited by the resonator geometry even when the frequency is below the cut-off value of plane wave. Whereas the 2D approach is much more accurate while predicting the transmission losses within entire frequency range. Subsequently, five groups of resonators are chosen to determine the effects of structure parameters to transmission loss based on the 2D approach. The resonant frequency decreases and more resonant peaks appear when the length of inlet extension increases. A higher perforation rate leads to a shift of resonant peak towards higher frequencies. Besides, better acoustic performance could be obtained with the perforation being properly designed. Reducing the inlet/outlet radius can obviously improve the transmission loss without changing the frequency of resonant peak. The theories and conclusions in this study can be used for the design and optimization of resonators in various engineering applications.

Succesful transcatheter closure of perimembranous ventricular septal defect with inlet extension using ADOI

Introduction Transcatheter closure of perimembranous ventricular septal defect (PM VSD) is abandoned in many center and in some became restricted to certain age and criteria because of the risk of complete heart block (CHB). The risk of damaging the tricuspid valve (TV) in the presence of inlet extension is another risk. I am presenting successful closure of such defect using Amplatzer occlude device for PDA with reasonable follow up period in Prince Sultan Cardiac Center PSCC. Method Through 2011 4 patients underwent transcatheter closure of PM VSD with inlet extension , all patients were consented and procedure were done under general anesthesia , Transesophageal echocardiography was done in all, one has 3D assessment Hemodynamics were assessed pre procedural, A-V loop was applied in 2 patients, ADOI were used in all, heparin and antibiotics were giving during and 24 hr post procedure, 3 patients were extubated same day and one the following day, all patients were kept on aspirin for 6 months. Result Median age 17 kg , 3 female and 1 male , median age 7 year, Median ventilatory duration is one day, Median hospital stay is 2 days, Median Follow up is 10 months, No immediate or early complication or deaths, normal ECG immediately and during follow up period , normal Echocardiography with no residual leak during follow up period. Conclusion In selected patients with PM VSD and inlet extension ADOI device can be used safely and effectively to close the defect with no immediate or early complications.

Impact of perioperative transesophageal echocardiography on tetralogy of fallot total repair

Introduction Previous studies have suggested that in cardiac surgical patients, TEE provides essential information before and after cardiopulmonary bypass regarding cardiac performance, valve function, and congenital anomalies. Significant residual abnormalities may be missed during TOF surgical repair. The result is often post-operative morbidity and mortality and sometimes the need for reoperation. Objectives To determine impact and accuracy of perioperative TEE in assessment of patients undergoing TOF total repair. Methods The study included 50 patients with TOF referred to Cardiothoracic Surgery Department Ain Shams University Hospitals for total repair. Each patient was subjected to history taking, clinical examination, routine preoperative investigations, preoperative TTE, perioperative TEE and Post recovery TTE. Results Our study population included 45 (90%) pediatric patients and 5(10%) adults. Youngest was 1year 2 months old and oldest was 25 years old. Their weight ranged from 8 to 85 Kg. TEE was feasible in 49 cases (98%) while the pediatric probe failed to be introduced in only one patient. TEE was able to visualize LM coronary artery in 96% of cases, and visualized RCA in 70% of cases. TEE newly detected a case with separate ostea of LAD and LCX. Only one patient developed non sustained runs of SVT There was significant difference between TEE and TTE as regard IAS visualization (P value 0.0001). All our patients had only subaortic VSD except 4 patients. Three had doubly commited subarterial VSD seen by both TTE and TEE, while one patient had subaortic VSD with inlet extension, which was visualized only by TEE. Postoperative TEE detected residual small VSD in 29 cases of whom 14 cases had the VSD closed spontaneously by the time of TTE. TEE missed small residual VSD in 3 cases. In one case postoperative TEE showed a serpignous mid muscular VSD which was not detected preoperatively. There was moderate agreement between TEE and TTE regarding overriding of aortic valve (weighted Kappa 0.580). There was strong agreement between TTE and TEE in assessment of postoperative PR (r o.8594, P 0.0001). Preoperative TEE showed major impact in 2 cases (4%). In one case total repair was decided instead of shunt operation. While in the other TEE newly detected TV chordae attached to IVS crest with inlet extension of VSD. Preoperative TEE had minor impact in 29 cases (59%) by adding new information which did not alter surgical plan, as visualization of coronaries and IAS. TEE showed major postoperative impact in 2 cases (4%) in the form of second run of CPB and RVOT reconstruction. Minor impact in the form of detection of relieved RVOT obstruction, absence of residual shunts, preserved biventricular function in 47 cases (94%). Conclusion TEE imaging is a safe, feasible, and accurate tool for anatomical, hemodynamic, and functional assessment in patients with TOF during surgical repair. TEE offers the advantage of permitting visualization of the operative procedure in real time and provides guidance for the surgeon in making decisions inside the operating room.

Closure of a large perimembranous ventricular septal defect in a 4.8 kg baby with Down syndrome using a duct occluder

A 9.5-month-old boy with Down syndrome, weighing 4.8kg, presented with history of failure to thrive. Clinically, he had symptoms and signs of congestive heart failure. His echocardiogram showed a large perimembranous ventricular septal defect (pmVSD) with some inlet extension covered by a large aneurysmal tissue with multiple right ventricular (RV) exits. Additionally, he had hypothyroidism and Hirschsprung disease. Instead of closing the VSD surgically, the VSD was successfully closed utilizing an 8×6mm duct occluder. The baby remained in the intensive care unit for one night. The day after the procedure, the infant was stable and showed clinical improvement. Electrocardiogram (ECG) showed normal sinus rhythm with no evidence of heart block. Twenty-four hours later, echocardiography showed the device was in an excellent position, with a small residual leak. There was normal tricuspid valve inflow and normal aortic valve outflow with no significant valvar insufficiency. The baby was discharged after 3days in stable condition. We believe infants with such co-morbidities which might complicate their post-operative course and prolong the intensive care unit admission, might benefit from such alternative management.

Successful transcatheter closure of perimembranous ventricular septal defect with inlet extension using Amplatzer occlude device (ADOI)

Introduction Transcatheter closure of perimembranous ventricular septal defect (PM VSD) is abandoned in many center and in some became restricted to certain age and criteria because of the risk of complete heart block (CHB). The risk of damaging the tricuspid valve (TV) in the presence of inlet extension is another risk. I am presenting successful closure of such defect using Amplatzer occluder device for PDA with reasonable follow up period in Prince Sultan Cardiac Center PSCC. Method Through 2011 4 patients underwent transcatheter closure of PM VSD with inlet extension, all patients were consented and procedure were done under general anesthesia, Transesophageal echocardiography was done in all, one has 3D assessment Hemodynamics were assessed pre procedural, A–V loop was applied in 2 patients, ADOI were used in all,heparin and antibiotics were giving during and 24 h post procedure, 3 patients were extubated same day and one the following day, all patients were kept on aspirin for 6 months. Result Median age 17 kg, 3 female and 1 male, median age 7 year, Median ventilatory duration is one day, Median hospital stay is 2 days, Median Follow up is 16 months, No immediate or early complication or deaths, normal ECG immediately and during follow up period, normal Echocardiography with no residual leak during follow up period. Conclusion In selected patients with PM VSD and inlet extension ADOI device can be used safely and effectively to close the defect with no immediate or early complications.

Application of Heated Inlet Extensions to the TSI 3306/3321 System: Comparison with the Andersen Cascade Impactor and Next Generation Impactor

Pharmaceutical aerosol size distribution analysis based on multi-stage inertial impaction is well accepted, though laborious. The TSI 3306 Impactor Inlet/3321 time-of-flight (TOF) Aerodynamic Particle Size Analyzer (APS) has been evaluated for its ease of use and potential for time savings during product development. However, instrument inlet modifications may be necessary for increased correlation with equivalent measurements obtained by inertial impaction following pharmacopeial methods. A heated inlet extension tube was located between the USP/Ph.Eur. throat and the Single-Stage Impactor (SSI) to promote evaporation of residual ethanol from aerosol droplets, generated from two formulations containing ethanol as semi-volatile solubilizer (8 and 20% w/w) for the active pharmaceutical ingredient. As temperature and extension length increased, the SSI-measured fine particle fraction (aerosol < 4.7 microm aerodynamic diameter) also increased, for the aerosols used in this study. These values correlated quite closely with equivalent measures made by multi-stage cascade impactor equipped with the same throat. Particle size distribution profiles measured with the APS for either formulation did not significantly change utilizing the heated extensions, suggesting that ethanol evaporation was largely complete at any condition by the time the aerosol entered the measurement zone of the TOF analyzer. The addition of a heated inlet extension may be useful to facilitate evaporation of residual semi-volatile species, especially when an agreement of APS-derived particle size mass distribution data from the SSI with multi-stage cascade impactors is desired. However, complete evaporation of the semi-volatile species may not be necessary for SSI-generated mass distribution to match conventionally used cascade impactors.

Evaluation of the TSI aerosol impactor 3306/3321 system using a redesigned impactor stage with solution and suspension metered-dose inhalers.

The purpose of this research was to evaluate a redesigned impactor stage for the TSI Model 3306 Impactor Inlet with nozzles adjusted to obtain a target cut-point of 4.7 microm. It has been determined that the previous cut-point used in the Model 3306 was nominally closer to 4.14 microm, thus potentially impacting the characterization of aerosol mass. The reassessment of the Model 3306 was performed on 4 solution and 2 suspension metered-dose inhaler (MDI) formulations. The redesigned impactor stage resulted in a 5% to 6% increase in aerosol mass when compared with the previous impactor stage for the products Ventolin-HFA, Proventil-HFA, and 2 cyclosporin solution formulations with high ethanol concentrations (15% wt/wt). For the formulations with low ethanol concentrations (3% wt/wt), minimal differences were observed between the 2 cut-points. In addition, this study reevaluated the requirement of a vertical inlet extension length when using the TSI 3306/3321 system with the redesigned cut-point. It was shown that the use of a 20-cm extension provides mass and aerosol size distributions that are comparable to the Andersen 8-stage Cascade Impactor, for both solution and suspension MDIs. This work indicates that the TSI 3306/3321 system is suitable for preformulation studies of both suspension and solution MDI systems.

Transcatheter closure of perimembranous ventricular septal defects using the amplatzer membranous VSD occluder: Immediate and midterm results of an international registry

To report the immediate and midterm results of transcatheter closure of perimembranous ventricular septal defect (PmVSD) using the Amplatzer membranous VSD occluder (AMVSD). Between April 2002 and August 2004, 100 patients underwent an attempt of percutaneous device closure of PmVSD using the AMVSD in 24 international centers. The median age was 9.0 years (0.7-58 years) and the median weight was 27.5 kg (7-121 kg). A device was successfully deployed in 93/100 (93%) patients. Reasons for procedural failure were an increased gradient across the left ventricle outflow tract in one patient, aortic regurgitation in 2 patients, and inability to securely position the device in 4 patients. The median VSD size by TEE was 7.0 mm (1.5-13 mm), median device size 10 mm (4-16 mm) and median fluoroscopy time 22.1 min (8.9-96.0 min). Weight below 10 kg (P = 0.0392), inlet extension of the VSD (P = 0.0139) and aortic cusp prolapse into the VSD (P = 0.0084) were significantly associated with a lower procedural success. Patients have been followed up for a median of 182 days (1-763 days). There were no procedure-related deaths. Complications were encountered in 29/100 (29%) patients, including rhythm or conduction anomalies in 13 patients (two with complete heart block requiring permanent pacemaker implantation), new or increased aortic (9 patients) or tricuspid (9 patients) regurgitation, most of which were classified as trivial or mild. Patients with a weight below 10 kg had a significantly higher incidence of adverse events than patients with a weight above 10 kg (58.3% versus 25.0%, P = 0.0285). Immediately after device release complete closure of the defect was present in 54/93 (58.1%) patients, increasing to 46/55 (83.6%) patients at 6-months follow-up (P = 0.0012). Left ventricle end-diastolic diameter decreased from a median of 44 mm prior to device closure to a median of 39 mm at 6-months postprocedure (P = 0.0015). Closure of PmVSDs using the AMVSD occluder is safe and effective. However, longer follow-up period is warranted prior to the wide spread use of this device.

Heart block and empirical therapy after transcatheter closure of perimembranous ventricular septal defect

Two patients with perimembranous ventricular septal defects (VSDs) and inlet extension have undergone uncomplicated transcatheter device closure using the Amplatzer membranous VSD device. Both patients developed complete heart block 2-4 days from the closure. Both patients responded well to high-dose intravenous therapy with steroids and high-dose oral anti-inflammatory aspirin. Both patients remain in normal sinus rhythm 8 weeks and 10 months, respectively, from the episode.

Application of USP Inlet Extensions to the TSI Impactor System 3306/3320 Using HFA 227 Based Solution Metered Dose Inhalers

ABSTRACTThe objective of this study was to further evaluate the need for a vertical inlet extension when testing solution metered dose inhalers using the TSI Model 3306 Impactor Inlet in conjunction with the TSI Model 3320 Aerodynamic Particle Sizer (APS). The configurations tested using the TSI system were compared to baseline measurements that were performed using the Andersen Mark II 8-stage cascade impactor (ACI). Seven pressurized solution metered dose inhalers were tested using varied concentrations of beclomethasone dipropionate (BDP), ethanol, and HFA 227 propellant. The inhalers were tested with the cascade impactor, and with the TSI system. The TSI system had three different configurations as the manufacturer provided (0 cm) or with inlet extensions of 20 and 40 cm. The extensions were located between the USP inlet and the Model 3306 Impactor Inlet. There were no practical differences between each system for the stem, actuator, or USP inlet. The fine particle mass (aerodynamic mass < 4.7 µm) was affected by extension length and correlated well with the ACI when an extension was present. APS particle size measurements were unaffected by the extension lengths and correlated well to particle size determined from the ACI analysis. It has been confirmed that an inlet extension may be necessary for the TSI system in order to give mass results that correlate to the ACI, especially for formulations having significant concentrations of low volatility excipients. Additionally, the results generated from this study were used to evaluate the product performance of HFA 227 based solution formulations that contain varying concentrations of ethanol as a cosolvent.