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When the earth transitioned to an oxygen-containing atmosphere, many bacterial species were killed by the free radicals that developed in their cytoplasm. New life forms took advantage of this change by evolving to use oxygen as the final resting place for electrons involved in the Krebs cycle. Animals today rely on getting oxygen into the blood stream and getting carbon dioxide out by ventilation through sequentially smaller and smaller tubes until diffusion takes over, finally reaching the terminal respiratory bronchiole and its associated alveoli for gas exchange. All animals are obligate aerobes. One group has estimated that there are 274 to 790 million alveoli in the healthy adult lung. In this issue of Radiology, Kim et al describe a visualization method to study the invisible small airways (seven to 30th generation) that move air from the trachea to the peripheral airways and back again for normal ventilation.
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