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Biomedical subjects

C S Poon

Publications and source records attributed to C S Poon.

At least 19 recordsLinked to original sources
PubMed1992

Quantitative magnetic resonance imaging parameters and their relationship to mammographic pattern.

BACKGROUND: Breast cancer exhibits wide international variation in incidence, which has led to the identification of several factors correlating with the risk of the disease. Magnetic resonance imaging (MRI) techniques can provide quantitative information about the biological and physical properties of tissue. PURPOSE: This work tested several magnetic resonance tissue parameters for their ability to distinguish quantitatively between breast tissues in subjects at substantially different risk for breast cancer as defined indirectly by their parenchymal pattern on mammograms. METHODS: Quantitative MRI parameters (relative water content, longitudinal relaxation time [T1], and transverse relaxation time [T2]) were measured for breast tissue using newly developed techniques in two groups of women with mammographic parenchymal appearance associated with high (Dy pattern [i.e., extensive nodular or diffuse density]; n = 12) or low (N1 pattern [i.e., breast containing mainly fat]; n = 11) risk of breast cancer. RESULTS: The two groups have significantly different average relative water content (P less than .0001) and average T1 (P less than .0001). Pixel histograms of T2 values show marked differences between the two groups which can be characterized with a fourth moment parameter. CONCLUSIONS: Quantitative MRI techniques exhibit good potential for assessing tissue characteristics in the breast that are associated with risk of breast cancer. IMPLICATIONS: Future work will address the direct correlation of MRI parameters with risk of breast cancer.

Adult↗
PubMed1992

Sudden death associated with solitary intracavitary right atrial metastatic tumour deposit.

We report a case of cardiac metastasis of primary adrenal cortical carcinoma to the endocardium of the right atrium resulting in an intracavitary mass which we believe caused sudden death by blocking the tricuspid valve orifice. We have been unable to find a similar case previously reported although primary atrial myxoma is well known to be a rare cause of sudden cardiac death by the same mechanism. Modern non-invasive imaging techniques have facilitated recognition of intracavitary cardiac metastases, and with surgical intervention, when feasible, the risk of sudden cardiac death can be reduced.

Adrenal Cortex Neoplasms↗
PubMed1992

Optimization character of inspiratory neural drive.

A previous optimal chemical-mechanical model (C.-S. Poon. J. Appl. Physiol. 62: 2447-2459, 1987) suggested that the normal ventilatory responses to CO2 and exercise inputs and mechanical loading can be predicted by the minimization of a controller objective function consisting of the total chemical and mechanical costs of breathing. In this study the model was generalized to include a description of the inspiratory neuromuscular drive as the control output. With a mechanical work rate index for both inspiration and expiration, the general optimization model accurately reproduced the observed responses in the waveshape of inspiratory drive, breathing pattern, and total ventilation under differing conditions of CO2 inhalation, exercise, and inspiratory/expiratory mechanical loads. The simulation results are in general agreement with a wide range of respiratory phenomena, including exercise hyperpnea, CO2 chemoreflex, and post-inspiratory (postinflow) inspiratory activity, as well as respiratory neural compensations for mechanical loading, respiratory muscle fatigue, and muscle weakness.

Animals↗
PubMed1992

Potentiation of exercise ventilatory response by airway CO2 and dead space loading.

We examined the effects of different modes of airway CO2 load on the ventilation-CO2 output (VE-VCO2) relationship during mild to moderate exercise. Four young and three older male subjects underwent incremental steady-state treadmill exercise while breathing a mixture of CO2 in O2 (CO2 loading) or 100% O2 with and without a large external dead space [DS loading and control (C), respectively]. During DS loading, the elevated arterial PCO2 (PaCO2) remained constant from rest to mild exercise and began to increase only at higher work rates. To achieve similar chemical drive, the same PaCO2 levels were established during CO2 loading by external PCO2 forcing. In the young group, CO2 loading resulted in a steepening of the VE-VCO2 relationship compared with C, whereas in the older group the reverse pattern was found. DS loading resulted in a consistent increase in the VE-VCO2 slope compared with C and CO2 loading [39.1 +/- 5.6 (mean +/- SD) vs. 24.9 +/- 5.0 and 26.7 +/- 4.4, respectively] in all subjects. The difference in potentiation of VE-VCO2 by CO2 and DS loading was not due to differences in mean chemical drive or changes in breathing pattern. Thus changes in the profile of airway CO2 influx may have an independent influence on ventilatory CO2-exercise interaction. Peripheral chemoreceptors mediation, although important, is not obligatory for this behavior.

Adult↗
PubMed1991

Optimization behavior of brainstem respiratory neurons. A cerebral neural network model.

A recent model of respiratory control suggested that the steady-state respiratory responses to CO2 and exercise may be governed by an optimal control law in the brainstem respiratory neurons. It was not certain, however, whether such complex optimization behavior could be accomplished by a realistic biological neural network. To test this hypothesis, we developed a hybrid computer-neural model in which the dynamics of the lung, brain and other tissue compartments were simulated on a digital computer. Mimicking the "controller" was a human subject who pedalled on a bicycle with varying speed (analog of ventilatory output) with a view to minimize an analog signal of the total cost of breathing (chemical and mechanical) which was computed interactively and displayed on an oscilloscope. In this manner, the visuomotor cortex served as a proxy (homolog) of the brainstem respiratory neurons in the model. Results in 4 subjects showed a linear steady-state ventilatory CO2 response to arterial PCO2 during simulated CO2 inhalation and a nearly isocapnic steady-state response during simulated exercise. Thus, neural optimization is a plausible mechanism for respiratory control during exercise and can be achieved by a neural network with cognitive computational ability without the need for an exercise stimulus.

Brain Stem↗
PubMed1991

Spectral vs. compartmental averaging of VA/Q distributions: confidence limits.

We have investigated the method of statistical averaging as a nonparametric approach to obtain a representative ventilation-perfusion (VA/Q) distribution that exemplifies the family of compatible solutions for multiple inert gas elimination data. The variability of the compatible solutions was examined by determining the standard deviation of the statistical average. For six inert gases, it can be predicted that a distribution with up to seven contiguous nonzero VA/Q compartments can be uniquely recovered, whereas the compatible family becomes more diverse, the broader the distribution. For a given compatible family consisting of multimodal distributions with various phase relationships, the average distribution was found to display an uncharacteristically unimodal shape as a result of modal smoothing. To avoid this possible artifact, an alternative approach was adopted in which statistical averaging was performed in the frequency domain. For both deterministic and empirical data, the energy spectra of all feasible VA/Q distributions displayed a well-defined low-frequency band that was invariant within the compatible family and with a bandwidth that approximated the predicted sampling cutoff frequency. The nonuniqueness of the result was ascribable to a variable high-frequency band that was due to an aliasing effect. For a wide range of clinical data, the representative distributions resulting from compartmental and spectral averaging were indistinguishable from each other and had little variability both in the VA/Q and frequency domains. For these cases, therefore, the resolving power of the recovery algorithm was not critical. Finally, an efficient method of finding the average distribution was proposed.

Biometry↗
PubMed1991

Optimization of prostatic magnetic resonance imaging technique.

With a 1.5-T magnetic resonance imager the authors systematically varied a large number of technical factors to obtain an optimum balance between high image quality and reasonable imaging time for the prostate gland. Each parameter was adjusted relative to benchmark images of very high quality to achieve a reasonable acquisition time with as little loss of the signal-to-noise ratio (SNR) as possible. Image quality was judged subjectively by magnetic resonance radiologists and objectively by measurements of SNR for the prostate. The authors recommend multislice, multiecho spin-echo pulse sequences with dual surface coils, fat suppression, reduced bandwidth, a repetition time of 1500 ms, echo times of 30 and 60 ms, a flip angle of 60 degrees, two excitations, a slice thickness of 5 mm with a 1.5-mm gap and 192 phase-encoding steps. The acquisition time for one such series was 9.6 minutes.

Humans↗
PubMed1989

Projection flow imaging by bolus tracking using stimulated echoes.

Previous investigators have employed the concept of bolus tracking using either spin echoes or gradient echoes. In this paper we introduce two methods of bolus tracking using planar- and volume-selective stimulated echoes. The planar method employs a selective 90 degrees rf pulse which tags all spins in a particular plane. At a time tau 1 later, a nonselective 90 degrees rf pulse is employed, followed after a time tau 2, by another nonselective rf pulse. Only spins which experience all three rf pulses form a stimulated echo at time tau 1 after the third rf pulse. A balanced pair of flow-compensated dephasing (crusher) gradients further ensures that the stimulated echo is due only to the effect of all three rf pulses while minimizing flow dephasing. The first part of this gradient pair is applied after the initial rf pulse in the first tau 1 period to dephase the tagged spins. The second part of this gradient pair is applied after the third rf pulse to rephase the spins. Since the plane of the excited slice is orthogonal to the readout direction, flowing spins are imaged in an angiographic manner as they move away from the excited slice. A modification to this basic sequence excites only a small volume. In this manner, the suppression of stationary spins is effected by volume-selective excitation. In both the planar- and the volume-selective techniques, the excited spins undergo T1 and T2 relaxation during the tau 1 period but only T1 relaxation in the tau 2 period. In blood, where T1 is much greater than T2, keeping tau 1 as short as possible minimizes signal loss due to T2 dephasing. These methods demonstrate increased sensitivity compared to similar bolus tracking methods using either spin echoes or gradient echoes.

Blood Flow Velocity↗
PubMed1989

Effects of inspiratory resistive load on respiratory control in hypercapnia and exercise.

Eight healthy young men underwent two separate steady-state incremental exercise runs within the aerobic range on a treadmill with alternating periods of breathing with no load (NL) and with an inspiratory resistive load (IRL) of approximately 12 cmH2O.1-1.s. End-tidal PCO2 was maintained constant throughout each run at the eucapnic or a constant hypercapnic level by adding 0-5% CO2 to the inspired O2. Hypercapnia caused a steepening, as well as upward shift, relative to the corresponding eucapnic ventilation-CO2 output (VE - VCO2) relationship in NL and IRL. Compared with NL, the VE - VCO2 slope was depressed by IRL, more so in hypercapnic [-19.0 +/- 3.4 (SE) %] than in eucapnic exercise (-6.0 +/- 2.0%), despite a similar increase in the slope of the occlusion pressure at 100 ms - VCO2 (P100 - VCO2) relationship under both conditions. The steady-state hypercapnic ventilatory response at rest was markedly depressed by IRL (-22.6 +/- 7.5%), with little increase in P100 response. For a given inspiratory load, breathing pattern responses to separate or combined hypercapnia and exercise were similar. During IRL, VE was achieved by a greater tidal volume (VT) and inspiratory duty cycle (TI/TT) along with a lower mean inspiratory flow (VT/TI). The increase in TI/TT was solely because of a prolongation of inspiratory time (TI) with little change in expiratory duration for any given VT. The ventilatory and breathing pattern responses to IRL during CO2 inhalation and exercise are in favor of conservation of respiratory work.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1989

Effects of inspiratory elastic load on respiratory control in hypercapnia and exercise.

Five healthy young men underwent two separate steady-state incremental exercise runs within the aerobic range on a treadmill with alternating periods of breathing with no load (NL) and with a discontinuous inspiratory elastic load (IEL) of approximately 10 cmH2O/l. End-tidal PCO2 was maintained constant throughout each run at the eucapnic or a constant hypercapnic level by adding 0-5% CO2 to the inspired O2. Hypercapnia caused a steepening, as well as upward shift, relative to the corresponding eucapnic ventilation-CO2 output (VE-VCO2) relationship in NL and IEL. Compared with NL, the VE-VCO2 slope was depressed by IEL, more so in hypercapnic [-28.7 +/- 7.2 (SE) %] than in eucapnic exercise (-16.0 +/- 2.8%). The steady-state hypercapnic ventilatory response at rest was also markedly depressed (-32.1 +/- 11.2%). Occlusion pressure response was augmented in response to IEL during eucapnic exercise (88.7 +/- 13.3%) but not during CO2 inhalation at rest or during exercise. Breathing pattern characteristics were similar regardless of the type of stimulus input and the level of inspiratory load. Results are consistent with the notion that the control of VE and breathing pattern may both be influenced by a balance between the prevailing chemical drive and a propensity of the controller to reduce respiratory effort.

Adult↗
PubMed1988

Analysis of linear and mildly nonlinear relationships using pooled subject data.

The detection of mild nonlinearities and/or state-dependent variability in otherwise linear physiological relationships is generally difficult in the presence of significant measurement errors. Conventional approaches using pooled subject data to increase the degree of freedom for statistical inference are enervated by the resultant introduction of intersubject variability. This paper proposes a new, simple method of pooling multiple subject data for linearity analysis. With the use of a special standardization procedure for the individual response curves, this method allows sensitive detection of occult nonlinearities as well as any state-dependent variability in the underlying relationship. Application of this analytic approach to reported hypercapnic exercise-response data in eight healthy subjects showed that 1) the hypercapnic ventilation-CO2 output relationship is nonlinear with a downward concavity; and 2) the ventilation-tidal volume relationship, which is linear at low tidal volume values, is similar in hypercapnic exercise as in resting hypercapnia or eucapnic exercise.

Data Interpretation, Statistical↗
PubMed1988

Spectral analysis of inert gas elimination data: resolution limits.

A new method of analyzing inert gas data for recovery of the pulmonary ventilation-perfusion ration (VA/Q) distribution is proposed. It is shown that the conventional inert gas elimination equation takes the form of a convolution integral, and the relationship between VA/Q distribution and inert gas elimination resembles that of a noncausal low-pass filter with infinite zero-frequency gain. With the use of this formulation, characteristic features of VA/Q distribution may be represented in the frequency domain in terms of the corresponding energy spectrum. It is shown that the lack of resolution associated with finite data samples and measurement error is caused by distortions in the high-frequency contents of the resulting VA/Q distribution. With six inert gases, the technique cannot resolve a log SD less than 0.21 decade and a modal separation less than 0.87 decade. In the presence of measurement error, the degree of resolution is even less. It is suggested that for maximum resolution the number of discrete and duplicate data samples should be chosen so that the resulting noise and sampling cutoff frequencies are approximately equal.

Fourier Analysis↗
PubMed1987

Influence of inspiratory assistance on ventilatory control during moderate exercise.

In five healthy subjects, we studied the effects of controlled mechanical unloading of the respiratory system on ventilatory control during moderate exercise, utilizing a modified positive-pressure ventilator (IEEE Trans. Biomed. Eng. BME-33: 361-365, 1986). We were especially interested in whether isocapnia was maintained when a portion of the normal ventilatory response to constant-load cycling was subserved by the ventilator. The mechanical unloading was achieved by "assisting" airflow throughout inspiration in a constant proportion to instantaneous flow. Two modest degrees of assistance (A1 = 1.5 and A2 = 3.0 cmH2O X l-1 X s) were imposed. The assistance caused minute ventilation (VE) to increase immediately (inspiratory time shortening and tidal volume rising) and end-tidal PCO2 (PETCO2) to fall. Some 10-15 s later, inspiratory occlusion pressure (P100) decreased, and in the new steady-state VE and PETCO2 were virtually restored to their control exercise levels. The modest residual hyperventilation [delta PETCO2 = -0.9 Torr (A1) and -1.6 Torr (A2)], which was not significant statistically, contrasted markedly with the much larger increase predicted for VE had there been no compensatory reduction in ventilatory drive (as evidenced by the fall in P100). Consistent with earlier studies utilizing resistive loading (J. Appl. Physiol. 35: 361-366, 1973 and Acta Physiol. Scand. 120: 557-565, 1984), these observations suggest that ventilatory drive during moderate exercise is controlled to compensate for modest changes in respiratory-mechanical load, so that VE is preserved at a level appropriate to metabolic rate or nearly so.

Adult↗
PubMed1987

Ventilatory control in hypercapnia and exercise: optimization hypothesis.

A model of the respiratory control system incorporating both chemical and respiratory neuromechanical feedbacks is proposed to describe the steady-state ventilatory responses to CO2 inhalation and exercise. It is postulated that ventilatory output (VE) is set by the respiratory center to minimize a net operating cost representing the conflicting challenges of arterial chemical imbalance and respiratory-mechanical discomfort (intolerance of effort), given, respectively, by a quadratic function of arterial PCO2 and a logarithmic function of VE. In addition, the system is assumed to be mechanically limited at maximum VE (Vmax). The predicted responses in VE during moderate hypercapnia, exercise, and ventilatory loading closely mimic those normally observed, even though no separate signal unique to exercise is assumed. As a quantitative validation, the model yielded good fits to ventilatory response data obtained in eight healthy subjects during eucapnic and hypercapnic exercise; the predicted Vmax averaged approximately 77% of the maximum voluntary ventilation in all subjects. The results demonstrate the plausibility of the proposed optimization mechanism and suggest an important role for respiratory-mechanical factors in the control of VE.

Carbon Dioxide↗