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Biomedical subjects

T S Kuo

Publications and source records attributed to T S Kuo.

At least 37 records · Page 2Linked to original sources

Exponentially tapered T-tube model in the characterization of arterial non-uniformity.

There is no question that geometric and elastic tapering is the rule of the nature of the mammalian arterial system. In this investigation, we determine the role of an exponentially tapered T-tube model to characterize the non-uniform nature and physical properties of the vasculature. The tapering feature could be inferred to show a connection between characteristic impedance at the distal of the tube and that at the entrance of the tube. Pulsatile pressure and flow signals of the ascending aorta were measured in 12 closed-chest, anesthetized dogs. This non-uniform T-tube model fits the measured aortic pressure waveform well. The mathematical and experimental model impedance spectra are similar. In the basal state, the distal characteristic impedance is 9.5% higher than the input characteristic impedance. The input characteristic impedance estimated in the model is compatible with that calculated by averaging high-frequency moduli of impedance data points obtained from the ratio of the corresponding harmonics of pressure and flow. Furthermore, the exponentially tapered T-tube model has a close estimate in wave transit time when compared with that computed by the impulse response of the filtered aortic input impedance. These data suggest that inclusion of tube tapering improves the mathematical model so that it is capable of characterizing the non-uniform nature of the arterial system. We conclude that the non-uniform properties of wave-transmission paths play an important role in governing the behavior of an asymmetric T-tube for the representation of the arterial system.

Animals↗

A comparative analysis of various EMG pattern recognition methods.

Identification of motions of the neck and shoulders using the electromyographic (EMG) signal was investigated in this study. Three discrimination methods, the Euclidean distance measure (EDM), the weighted distance measure (WDM) and the modified maximum likelihood method (MMLM), were used to compare the conventional autoregressive (AR) and cepstral coefficients with closely positioned (C-type) and separately located (S-type) electrode arrangements. Surface electrodes were bilaterally located on and between the sternocleidomastoid and the upper trapezius muscles. The EMG signals obtained during 20 repetitions of 10 motions were analyzed for each subject. Results from nine subjects showed that the mean recognition rate of the cepstral coefficients was at least 5% better than that of the AR coefficients for the S-type signals, while the improvement was less obvious for the C-type signals. The MMLM obtained the best discrimination results of the three discrimination methods. The S-type signals achieved higher recognition rates than the C-type signals in most cases. Among the various combinations of feature sets, classifiers and electrode arrangements proposed in this study, the combination of the cepstral coefficients and the MMLM with the S-type arrangement achieved the best discrimination efficiency. The proper choice of five of 10 motions raised the recognition rate to more than 97%.

Adult↗

Real-time implementation of electromyogram pattern recognition as a control command of man-machine interface.

The purpose of this study was to develop a real-time electromyogram (EMG) discrimination system to provide control commands for man-machine interface applications. A host computer with a plug-in data acquisition and processing board containing a TMS320 C31 floating-point digital signal processor was used to attain real-time EMG classification. Two-channel EMG signals were collected by two pairs of surface electrodes located bilaterally between the sternocleidomastoid and the upper trapezius. Five motions of the neck and shoulders were discriminated for each subject. The zero-crossing rate was employed to detect the onset of muscle contraction. The cepstral coefficients, derived from autoregressive coefficients and estimated by a recursive least square algorithm, were used as the recognition features. These features were then discriminated using a modified maximum likelihood distance classifier. The total response time of this EMG discrimination system was achieved about within 0.17 s. Four able bodied and two C5/6 quadriplegic subjects took part in the experiment, and achieved 95% mean recognition rate in discrimination between the five specific motions. The response time and the reliability of recognition indicate that this system has the potential to discriminate body motions for man-machine interface applications.

Case-Control Studies↗

Impedance and wave reflection in arterial system: simulation with geometrically tapered T-tubes.

The aortic input impedance is simulated by an asymmetric T-tube model loaded with complex loads. A geometric tapering is incorporated to represent the vasculature, assuming a triangular distribution of the wave transmission paths. Parametric analyses using physiological data demonstrate that the predicted impedance and reflection coefficient spectrum (RCS) closely mimic the experimental data. The simulation also reveals several significant features. As diameter tapering can minimise the presence and influence of wave reflections, the impedance modulus stays relatively constant with two distinct minima. The frequency of first minimum of impedance modulus is evidence of the tube elasticity and load compliance in the lower extremity, and the frequency of second minimum is evidence of those in the upper extremity. The high-frequency portion of the impedance modulus is affected by the tube elasticity, but not by the load compliance. The impedance spectrum at higher frequencies shows no notable fluctuations corresponding to a decrease in blood or wall viscosity. Furthermore, the low-frequency range in RCS is dominated by the longer lower body tube, and the high-frequency range by the shorter upper body tube. This geometrically tapered T-tube is considered a more natural model for the description of the systemic arterial system.

Arteries↗

Microcomputer-based pulse stimulator.

A low-cost PC-based 2-channel stimulator was designed. This device can generate regular current pulses for many neuroscience experiments. It can also generate irregular pulses for nerve stimulation, thus could possibly avoid the problem of sensitization or habituation in the central nervous system. The stimulation frequency (can be < 0.0005 Hz) and pulse duration (5 microseconds to 65 ms) of this device can be programmed by an interactive user interface. Furthermore, the output current (0-10 mA) can be continuously varied and was optically isolated to minimize stimulus artifact. Moreover, features such as low-power consumption (0.2 mA of a 9 V battery) and high-compliance output (> 120 V) could accommodate the stimulator for widespread applications. A trial of nerve stimulation was illustrated besides the electrical specifications of the stimulator.

Electric Stimulation↗

Source localization of averaged and single EEG spikes using the electric dipole model.

A scheme for localizing the epileptic focus is proposed. The scheme is on the basis of a model with an electric dipole inside a four-layer inhomogeneous spherical model of head and utilizes a nonlinear programming algorithm applying the gradient projection method. Various initial estimates are used to prove the stability of the implemented dipole model. Fourteen single spike data and the averaged spike data are used to localize the epileptic focus. The results of the usage of the averaged spike data show that the dipole position is compatible with visual inspection of experienced clinical physicians. The results of the usage of the single spike show that 11 of the 14 single spikes have dipole locations near the result of the averaged spike but the estimated dipole moments differ markedly from one another. The localization results of the other three single spikes show that the dipole position is strongly affected by the background EEG. This kind of interference generally causes the eccentricity of the dipole to deviate from its anatomically meaningful value. According to our results, the electric dipole model is concluded to be valuable for the clinical application of localizing epileptic foci.

Algorithms↗

Evaluation of parametric methods in EEG signal analysis.

In this paper, a well designed database, considering statistical characteristics and including all types of Electroencephalogram (EEG) is built. 900 EEG segments, each with a short interval (1.024 sec) in this database are clustered into eight classes. Three tests of white noise for evaluating the efficiency of autoregressive (AR) and autoregressive-moving average (ARMA) models are proposed. The Akaike information criterion (AIC) is used for determining orders of AR and ARMA models. The AR model requires a higher model order (8.67 on the average) than the ARMA model (6.17 on the average). However, it is found that about 96% of the 900 segments can be efficiently represented by the AR model, and only about 78% of them can be efficiently represented by ARMA model. We therefore conclude that the AR model is preferred for estimating EEG signals.

Algorithms↗

The application of cepstral coefficients and maximum likelihood method in EMG pattern recognition.

A new technique for classifying patterns of movement via electromyographic (EMG) signals is presented. Two methods (conventional autoregressive (AR) coefficients and cepstral coefficients) for extracting features from EMG signals and three classification algorithms (Euclidean Distance Measure (EDM), Weighted Distance Measure (WDM), and Maximum Likelihood Method (MLM)) for discriminating signals representative of broad classes of movements are described and compared. These three classifiers are derived from Bayes classifier with some assumptions, the relationship among them is discussed. The conventional MLM is modified to avoid heavy matrix inversion. Six able-bodied subjects with two pairs of surface electrodes located on bilateral sternocleidomastoid and upper trapezius muscles were studied in the experiment. The EMG signals of 20 repetitions of 10 motions were analyzed for each subject. Experimental results showed that mean recognition rate of the cepstral coefficients was at least 5% superior to that of the AR coefficients. The improvement achieved by the cepstral method was statistically significant for all the three classifiers. Reasons for the superiority of cepstral features were investigated from the feature space and frequency domain, respectively. The cepstral coefficients owned better cluster separability in feature space and they emphasized the more informative part in the frequency domain. The discrimination rate of the MLM was the highest among three classifiers. Incorporation of the cepstral features with the MLM could reduce the misclassification rate by 10.6% when compared with the combination of AR coefficients and EDM. Proper choice of five of ten motions could further raise the recognition rate to more than 95%.

Adult↗

The correlation of cardiac mass with arterial haemodynamics of resistive and capacitive load in rats with normotension and established hypertension.

In hypertensive animals and humans, cardiac hypertrophy may occur as a consequence of an external load on the heart. Several studies have suggested that the non-pulsatile components of arterial haemodynamics, such as arterial pressure and vascular resistance, do not adequately represent the ventricular afterload and are not well correlated with the degree of cardiac hypertrophy (CH). The present study was undertaken to analyse the correlation between the degree of CH and various haemodynamic parameters in the spontaneously hypertensive rat (SHR) with established hypertension. A total of 36 SHRs (6-8 months) with a tail-cuff pressure above 190 mm Hg were used. Control data were obtained from 32 age-matched normotensive Wistar Kyoto rats (WKY). Animals were anaesthetized with pentobarbitone sodium (40 mg/kg i.p.) and artificially ventilated with a respirator. A Millar catheter with a high-fidelity pressure sensor was used to record the aortic pressure and an electromagnetic flow transducer to monitor the aortic flow. The pressure and flow signals were subjected to Fourier transformation for the analysis of the arterial impedance spectrum. The left ventricular weight-to-body weight ratio (LVW/BW) was taken as a measure of the degree of CH. The measured haemodynamic parameters in these anaesthetized, open-chest SHRs were systolic pressure (SP) (mean +/- SE) 172 +/- 4 mm Hg, diastolic pressure (DP), 120 +/- 3 mm Hg, pulse pressure (PP) 52 +/- 2 mm Hg, peripheral resistance (Rp) 344,032 +/- 8,012 dyne.s.cm-5, characteristic impedance (Zc) 6,442 +/- 313 dyne.s.cm-5, the impedance modulus at the first harmonic (Z1) 26,611 +/- 1,061 dyne.s.cm-5, mean arterial compliance (Cm) 0.87 +/- 0.04 microliter/mm Hg and LVW/BW 3.092 +/- 0.026 mg/g.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

Exponentially tapered t-tube model of systemic arterial system in dogs.

This study determines the role of an asymmetric T-tube model as a representation of arterial mechanical properties. The model consists of two non-uniform tubes connected in parallel. The non-uniform properties of each tube include geometric and elastic tapering and each tube terminates in a complex load. Pulsatile pressure and flow velocity of the ascending aorta were measured in 10 closed-chest, anaesthetized dogs. An exponentially tapered transmission line is used to describe the non-uniform properties of the vasculature. The phase constant is a function of position along the path length due to geometric and elastic tapers. This non-uniform T-tube model makes it possible to fit the measured pressure waveform in the ascending aorta. Model parameters could be estimated and used to interpret the physical properties of the arterial system. The mathematical and experimental model impedance spectra are similar. There is a close correspondence between the impedance parameters derived from the non-uniform T-tube model and values computed from measurements on dogs. The results suggest that inclusion of tube tapering improves the mathematical model so that it closely represents the experimentally derived arterial impedance in closed-chest dogs. We conclude that the non-uniform properties of wave-transmission paths may play an important role in governing the behaviour of an asymmetric T-tube for the description of the arterial system.

Animals↗

Impaired left ventricular relaxation and arterial stiffness in patients with essential hypertension.

1. This study was designed to determine how left ventricular relaxation function in patients with essential hypertension is impaired by arterial haemodynamic load that is increased in early ejection phase. These patients did not suffer from cardiac hypertrophy or disturbed coronary perfusion. We used a high-fidelity multisensor catheter to record pressure and flow signals in the ascending aorta. The timing and magnitude of wave reflection were obtained by decomposing the measured waves into their forward and backward components. Radionuclide angiography was employed to obtain the time-activity curve. The left ventricular relaxation function was assessed by analysing the time-activity curve, which was filtered using Fourier expansion with the number of harmonics for minimum error. 2. In comparison with age-matched normotensive subjects (seven subjects with mean blood pressure 97 mmHg), hypertensive subjects (seven subjects with mean blood pressure 138 mmHg) had a shorter backward wave arrival time (193 +/- 26 versus 258 +/- 35 ms) and a higher reflection factor (0.58 +/- 0.12 versus 0.42 +/- 0.07). Isovolumic relaxation period was prolonged in hypertensive subjects (118 +/- 19 versus 90 +/- 19 ms). There was an inverse correlation between isovolumic relaxation period and backward wave arrival time in all 14 subjects (r = -0.67, P < 0.05). In contrast, there were no significant differences in cardiac output and time to peak ejection rate between the two groups. 3. Our analyses revealed that early return of the enhanced wave reflection may profoundly impair left ventricular relaxation function in patients with hypertension.(ABSTRACT TRUNCATED AT 250 WORDS)

Arteries↗

Evaluation of left ventricular functional status using thermodynamic indices.

Conventional methods to assess cardiac contractility have been focused on the mechanical properties of the myocardium. Many of these have suffered from theoretical and practical drawbacks. In this study, we have attempted to evaluate the left ventricular contractile status using the thermodynamic principle and compared these indices with the conventional index (dP/dt). A total of 8 mongrel dogs were anesthetized and artificially ventilated. A Millar catheter with high-fidelity multiple sensors was inserted into the aorta to record the simultaneous changes in aortic flow and pressure waves. Cardiac inotropy was increased by graded doses (2-32 micrograms/kg/min) of dobutamine. Angiotensin injection (100-300 micrograms) to achieve a blood pressure elevation of 30 mmHg was employed for afterload augmentation. Preload was increased by rapid infusion of 6% dextran solution (20 ml/kg). Several thermodynamic parameters were calculated at steady state during the control period and after drug interventions. These included power-averaged rate of power density generation (ARPD), peak ejection rate of change of power (PREP), energy-averaged power density (APD) and frequency-normalized ARPD (FARPD). PREP and APD were unchanged by afterload increment while FARPD, ARPD and dP/dt decreased significantly with an increase in afterload, ARPD was highly sensitive to an increased preload (p < 0.001), and PREP was also changed significantly by an increase in preload. dP/dt was boarderlinely affected by Dextran infusion (p = 0.05), and APD was independent of preload (P > 0.05). Inotropic stimulation increased ARPD, PREP, APD, FARPD and dP/dt by 139.0 +/- 48.0%, 98.0 +/- 51.4%, 74.0 +/- 49.7%, 60.0 +/- 30.4% and 44.6 +/- 10.4%, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Angiotensin II↗

The filter properties of the arterial beds of organs in rats.

The frequency properties of arterial beds in organs were studied by temporarily ligating the renal, the gastric, the splenic or the superior mesenteric arteries of rats. Blood-pressure waves of the tail arteries were recorded before and during the ligations, and were analysed by Fourier's transformation. Their frequency spectra have been found to change profiles following specific patterns with the ligations of different arteries. The results were significant with regard to the frequency selectivities of the organic arterial beds. Such frequency properties can be clearly explained when the circulation system is viewed as an electrical circuit network in which the organic arterial beds work as filters.

Animals↗

Effects of nifedipine on systemic hydraulic vascular load in patients with hypertension.

STUDY OBJECTIVE: The aim of the study was (1) to determine the difference in aortic input impedance and derived parameters between hypertensives and normotensives; and (2) to assess the acute effects of nifedipine on the aortic impedance, compliance, and resistance in patients with hypertension. DESIGN: A high fidelity multisensor catheter (Millar) was used to obtain the aortic pressure and flow signals for impedance analysis. The acute effects of nifedipine on the impedance parameters were evaluated at steady state before and after (10-30 min) a sublingual dose of 10 mg. PATIENTS: The patients included seven normotensive (mean blood pressure, 97 mm Hg) and nine hypertensive (mean blood pressure, 135 mm Hg), age matched, ethnic Chinese. Patients with clinical evidence of heart failure and valvular or congenital heart diseases were excluded. MEASUREMENTS AND MAIN RESULTS: Pulsatile aortic flow and pressure were measured by Millar catheter inserted into the ascending aorta. Cross sectional area of aorta was estimated by echocardiograms. Cardiac output was determined by Fick principle with an oximeter. These data were subjected to Fourier analysis for impedance spectra. In comparison with normotensives, hypertensives had increased peripheral vascular resistance R, at 2751(705) v 1651(363) dyne.s.cm-5; increased characteristic impedance Zc, at 193(64) v 122(27) dyne.s.cm-5; and increased first zero crossing frequency of impedance phase angle fo, at 4.8(0.9) v 3.4(0.7) Hz. Arterial compliances corresponding to peak systolic pressure Cs were lower, at 0.32(0.19) v 0.90(0.32) ml.mm Hg-1, as was mean pressure Cm, at 0.55(0.25) v 1.24(0.38) ml.mm Hg-1, and end diastolic pressure Cd, at 0.83(0.29) v 1.65(0.44) ml.mm Hg-1. Although the values of external ventricular hydraulic power were higher in hypertensive subjects, the difference was not statistically significant. Nifedipine administration in 7/9 hypertensives significantly reduced R, from 2806(721) to 2433(664) dyne.s.cm-5; mean aortic pressure Pm, from 138(22) to 112(12) mm Hg; total external ventricular power Wt, from 1452(306) to 1121(135) mW; and steady external power Ws, from 1251(310) to 939(119) mW; but did not reduce Zc, fo, Cs, Cm, Cd, and oscillatory external power Wo. CONCLUSIONS: The results indicate that (1) the stiffness of proximal aorta and vascular tone of peripheral arterioles are higher in hypertensives than in normotensives; (2) in hypertensive subjects, sublingual administration of nifedipine reduces the arterial pressure and peripheral arteriolar tone, but not the stiffness of proximal aorta; (3) the decrease in total external ventricular power in hypertensives treated with nifedipine results from a reduction in the steady, but not the oscillatory, component of hydraulic external ventricular power.

Aorta↗

Severe rhabdomyolysis induced acute renal failure, caused by diabetic ketoacidosis.

A 23 year-old obese Chinese gentleman was admitted to our hospital with the main problem of conscious disturbance for one day. The physical examination and laboratory data confirmed that this is a case of diabetic ketoacidosis complicated with rhabdomyolysis resulting in acute renal failure three days after admission, and regained his renal function after intensive hemodialysis and other conservative treatment.

Acute Kidney Injury↗

Specific frequency properties of renal and superior mesenteric arterial beds in rats.

In order to investigate the effects of arterial beds on pressure waveforms in arteries, the pressure waves observed in the rat tail artery were resolved into their Fourier moduli before and during ligation of the left renal artery and the superior mesenteric artery. Consistently different patterns of waveform changes in the tail artery were seen on occlusion of these vessels. Ligation of the renal artery reduced, and of the superior mesenteric artery increased, the pressure harmonics over most of the spectra. These results imply that to study the changes in the pressure contours as the observation point is moved downstream, one may have to account separately for the contributions of individual arterial beds. This is relevant in considering the degree to which it is appropriate for data to be amalgamated in models of the systemic arterial bed.

Animals↗

The development of a closed-loop controlled functional electrical stimulation (FES) in gait training.

A closed-loop functional electrical stimulation (FES) system is developed to provide hemiplegic patients with a real-time stimulation to their muscles to prevent the drop-foot and the quadriceps weakness from happening during gait training. The FES is controlled by position sensors (ps) and triggered by footswitches (f) with real-time feedback. As the FES receives the signals from these sensors, it adjusts and outputs an optimum set of stimulation parameters automatically. One hemiplegic patient was recruited to conduct clinical evaluation and treated by using the new closed-loop FES system. It was revealed that the mean velocity, cadence, stride length, active ankle motion range, and functional ambulation category (FAC) improved significantly from 0.12 +/- 0.07 ms-1, 40.3 +/- 18.3 steps min-1, 0.35 +/- 0.10 m, 15 degrees, level 2 to 0.42 +/- 0.23 ms-1, 68.2 +/- 19.0 steps min-1, 0.70 +/- 0.22 m, 40 degrees, level 4 respectively for the patient. A paired t-test indicated that differences in the electromyography (EMG) of the tibialis anterior and the quadriceps muscles between the patient's disabled (affected side) foot and normal (unaffected side) foot are not significant (p > 0.05) after 12 weeks of training. It is concluded that this new closed-loop FES system is capable of providing this hemiplegic patient with restoration to regular walking after appropriate gait training. Future studies, including randomized-controlled study, should be implemented to document the efficacy of this system.

Electric Stimulation Therapy↗