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Background: The Sasang typology is a traditional Korean personalized medicine and its Cold-Heat subgroup identification is essential for effective use of medical herbs and acupuncture. The purpose of this study was to discover differences between Cold-Heat subgroups with objective clinical measures and to examine its clinical usefulness. Methods: The pathophysiological symptoms of the digestive system, temperament and body shape of 241 patients were measured using the Sasang Digestive Function Inventory (SDFI), Sasang Personality Questionnaire (SPQ) and Body Mass Index (BMI). The differences between Cold and Heat subgroups of each Sasang types were tested by Analysis of Covariance considering age and sex, while the associations of SDFI, SPQ and BMI with Cold-Heat subgroup were examined by logistic regression analysis. Results: There were significant differences between Cold and Heat subgroups in SDFI, SPQ and BMI for the So-Yang, SDFI and BMI for the Tae-Eum type and SDFI-Digestion subscale for the So-Eum type. Moreover, the SDFI-Digestion was a substantial predictor for Cold-Heat subgroup identification in three Sasang types. The logistic regression model with SDFI, SPQ and BMI correctly predicted 81.9%, 77% and 75.5% of the Cold-Heat subgroups in So-Yang, Tae-Eum and So-Eum types, respectively. Conclusion: The results of the present study showed that the objective and validated clinical measures of SDFI, SPQ and BMI would be useful for differentiating Cold-Heat subgroups of Sasang typology. Further clinical studies on pathophysiological mechanisms in Cold-Heat subgroup are required to generalize these results. Keywords: Sasang typology, Cold-Heat subgroup, Sasang Digestive Function Inventory (SDFI), Sasang Personality Questionnaire (SPQ), Body Mass Index (BMI)

The purpose of this study was to review the pharmacognostic characteristics of Sasang type-specific medical herbs and suggest biological mechanisms that might be related to the personalized treatment of the East. Major compounds and their pharmacological activities of medical herbs for each Sasang types were systematically reviewed. The pharmacognostic characteristics of its main compounds were systematically analyzed with previous studies and three web-based databases. Sasang type-specific medical herbs were selected, and biological effects of their phytochemicals were reviewed from the pathophysiological features of each Sasang types. Phenolics were dominant in Tae-Yang type-specific herbs, iridoids and triterpenes with antipyretic and diuretic effects were in So-Yang type-specific, saponins (triterpene saponins and steroidal saponins) with antitussive effects were in Tae-Eum type-specific, and monoterpene and sesquiterpenes with stomachic effect were in So-Eum type-specific herbs. Pharmacognostic understandings on Sasang type-specific medical herbs with consideration of type-specific pathophysiological features were provided for the first time. This study would contribute to in-depth understandings on the pathophysiology of Sasang typology and integration of East-Asian and Western personalized medicine.

Background: Traditional Korean Sasang constitutional (SC) medicine categorizes individuals into four constitutional types [Tae-eum (TE), So-eum (SE), Tae-yang (TY), or So-yang (SY)] based on biological and physiological characteristics. As these characteristics are closely related to the bioenergetics of the human body, we assessed the correlation between SC type and energy metabolism features. Methods: Forty healthy, young (22.3 ± 1.4 years) males volunteered to participate in this study. Participants answered an SC questionnaire, and their face shape, voice tone, and body shape were assessed using an SC analysis tool. Thirty-one participants (10 TE, 10 SE, 3 TY, and 8 SY) were selected for further analysis. Collected blood samples were subjected to blood composition analysis, mitochondrial function analysis, and whole-exome sequencing. Results: The SY type showed significantly lower total cholesterol and high-density lipoprotein cholesterol levels than the SE type. Cellular and mitochondrial Adenosine triphosphate (ATP) levels were similar across types. All types showed similar basal mitochondrial oxygen consumption rates, whereas the TE type showed a significantly lower ATP-linked oxygen consumption rate than the other types. Whole-exome sequencing identified several genes variants that were exclusively detected in particular SC types, including 19 for SE, seven for SY, 11 for TE, and six for TY. Conclusion: SC type-specific differences in mitochondrial function and gene mutations were detected in a small group of healthy, young Korean males. These results are expected to greatly improve the accurate screening and utilization of SC medicine. Keywords: energy metabolism, mitochondria, Sasang constitutional medicine, whole-exome sequencing

Background: The Sasang Personality Questionnaire (SPQ) is an objective measure of Yin–Yang temperament of Sasang typology with proven clinical and structural validity; however, it has not been validated in people younger than 20 years. The purpose of this study was to examine the biopsychological structure of the SPQ in high school students. Methods: A total of 670 Korean high school students (365 boys and 305 girls) completed the SPQ, Junior version of Temperament and Character Inventory (JTCI), and weight and height measures. The correlation between the SPQ and JTCI subscales was investigated, and the differences of these subscales, body mass index, and Pondera Index between the high (30%), middle (40%), and low (30%) SPQ total score groups were examined with analysis of variance. The profile analysis was also performed to compare JTCI subscale profiles of the three SPQ total score groups. Results: The SPQ total score significantly correlated positively with JTCI novelty seeking (r = 0.548 and r = 0.540) and negatively with JTCI harm avoidance (r = –0.393 and r = –0.395) in boys and girls, respectively. The JTCI novelty-seeking score is significantly higher in the high SPQ total score group (24.12 ± 5.27 and 24.15 ± 5.17 for boys and girls, respectively) than in the low SPQ total score group (16.49 ± 5.08 and 17.24 ± 4.83, respectively), and the JTCI harm-avoidance score is significantly higher in the low SPQ total score group (25.34 ± 6.08 and 26.64 ± 5.77 for boys and girls, respectively) than in the high SPQ total score group (19.27 ± 6.62 and 19.23 ± 6.00, respectively). The JTCI subscale profiles for the three SPQ total score groups were significantly different for boys (degrees of freedom = 3.416, F = 292.16, p

Previous studies on the Sasang typology have focused on the differential diagnosis of each Sasang type with type-specific pathophysiological symptoms (TSPS). The purpose of this study was to elucidate the latent physiological mechanism related to these clinical indicators. We searched six electronic databases for articles published from 1990 to 2015 using the Sasang typology-related keywords, and found and analyzed 35 such articles. The results were summarized into six TSPS categories: perspiration, temperature preference, sleep, defecation, urination, and susceptibility to stress. The Tae-Eum and So-Eum types showed contrasting features with TSPS, and the So-Yang type was in the middle. The Tae-Eum type has good digestive function, regular bowel movement and defecation, high sleep quality, and low susceptibility to stress and cold. The Tae-Eum type has relatively large volumes of sweat and feels fresh after sweating; however, the urine is highly concentrated. These clinical features might be related to the biopsychological traits of the Tae-Eum type, including a low trait anxiety level and high ponderal and body mass indices. This study used the autonomic reactivity hypothesis for explaining the pathophysiological predispositions in the Sasang typology. The Tae-Eum and So-Eum Sasang types have a low threshold in parasympathetic and sympathetic activation, respectively. This study provides a foundation for integrating traditional Korean personalized medicine and Western biomedicine.

Global warming induces a dramatic elevation of heat-related morbidity and mortality worldwide. Individual variation of heat stress vulnerability depends on various factors such as age, gender, living area and conditions, health status, and individual innate characteristics. Sasang typology is a unique form of Korean traditional medicine, which is based on the hypothesis that constitution-specific traits of an individual determine the particular distinctive tendency in various aspects, including responses to the external environment. Recent scientific evidence shows that Sasang types differ in body composition, metabolic profile, susceptibility to certain disease patterns, and perspiration. This review aims to interpret these findings under the context of heat balance consisting of heat production (Hprod), heat loss (Hloss), and heat load (Hload). Based on the published data, at a given body mass, the TaeEum type tended to have a lower Hprod at rest and at the exhaustion state, which may indicate the lower metabolic efficiency of this type. Meanwhile, the surface-to-mass ratio and heat capacity of the TaeEum type appear to be lower, implying a lower heat dissipation capacity and heat storage tolerance. Thus, because of these characteristics, the TaeEum type seems to be more vulnerable to heat stress than the other constitutions. Differences in temperature regulation across constitutional types should be taken into account in daily physical activity, health management, and medical research.

Background: Sasang typology is a widely used personalized traditional medicine in clinical diagnosis and treatment in Korea. The aim of this study was to examine the personality construct of the Sasang Personality Questionnaire (SPQ) to replicate the previous findings in the adolescent sample. Methods: A total of 543 high school students completed the SPQ and the Korean version of the Junior Temperament and Character Inventory (JTCI). The relationships between the subscales of JTCI and SPQ were examined using Pearson's correlation. The profile analysis and analysis of variance were used to investigate the difference among high, middle, and low SPQ total score groups. Results: The SPQ and its subscales were significantly correlated with the JTCI subscales. SPQ total score was positively correlated with Novelty Seeking (r = 0.424) and negatively correlated with Harm Avoidance (r = –0.291). The high, middle, and low SPQ total score groups showed significantly different JTCI profile (flatness with Greenhouse–Geisser correction, df = 3.424, F = 443.812, p

Objective Sasang constitutional medicine is a component of Traditional Korean Medicine that stresses the hereditary makeup of disease incidences or therapeutic responses. This study investigated the relationship between the incidence of cancer and Sasang constitution classification. Methods Five hundred and one cancer patients were classified as having one of the four types of Sasang constitutions (Taeumin, Soumin, Soyangin, Taeyangin) using Questionnaire for Sasang Constitution Classification II, then compared with data from 1423 healthy subjects. Results The Sasang constitutional distribution for the cancer patients was significantly different from that for healthy subjects: 22.8% vs 46.9% for Taeumin, 35.5% vs 24.0% for Soumin, and 41.7% vs 29.1% for Soyangin. Our results assumed that the lowest cancer incidence would be in Taeumin (around 2-fold in both sex) while the highest cancer incidence in Soumin males (2.8-fold) and Soyangin females (2.1-fold). Conclusion This study identified a trend involving the frequency of cancer and the Sasang constitutional classification. We hope that this finding will provide new ideas for the study of cancer incidence and its preventive management.

Background Sasang typology is a personalized traditional medicine widely used in clinical diagnosis and treatment in Korea. The aim of this study was to examine the biopsychological personality profiles of traditional Korean Sasang typology in a clinical sample of Korean children. Methods A total of 150 children were classified as one of three traditional Korean Sasang types (19 So-Yang, 118 Tae-Eum, and 13 So-Eum) by two clinical experts in Sasang typology. The childrens' mothers completed the Korean version of the Junior Temperament and Character Inventory (JTCI). The four temperament dimensions of JTCI were compared between the different Sasang types using analysis of variance (ANOVA) and profile analysis. Results There were no significant differences in age, gender, and parents' education levels across the Sasang types. The JTCI temperament profile for each of the child Sasang types was significantly different (profile analysis, df=5.315, F =2.508, p =0.027). There were significant differences in novelty-seeking ( F =3.850, p =0.023) and novelty-seeking subscales, but not with other temperament dimensions. Conclusion These results demonstrated distinct temperament traits associated with traditional Korean Sasang types in children using an objective biopsychological personality inventory. With further investigation into the biopsychological profiles of the children, the longitudinal stability of the Sasang typology can be examined.

Background Facial features are regarded as representative and reliable characteristics for diagnosing a person's Sasang Constitution (SC). However, the description of these features tends to depend on the interpretation and the opinion of the doctor that follows the SC approach. In this paper, we performed a facial feature analysis of SC types in an objective and quantitative manner. Here, site-to-site variability can be an obstacle to properly analyzing facial features when images are taken from various sites, which may have different experimental environments. A compensation technique to reduce the site-to-site variability was proposed before performing the feature analysis. Methods The frontal and profile images of 1464 patients recruited from various oriental medical clinics (19 sites) were used. Candidate feature variables were created, which were inspired by the facial characteristics of the SC types described in the Sasang constitutional medicine literature. To resolve the problems involved in processing data collected from various sites with heterogeneous experimental environments, a compensation technique was proposed. Statistical analysis techniques were employed to observe the differences among the SC types and to demonstrate how effectively the site-to-site variability was reduced. Results The facial features that were significant for diagnosing the SC types were identified by a statistical analysis, and it was verified that the compensation technique reduced the site-to-site variability produced by the differences in photographic distance. Conclusion It is noted that the significant facial features represent common characteristics of each SC type in the sense that we collected extensive opinions from many Sasang constitutional medicine doctors with various points of view. Additionally, a compensation method for the photographic distance is needed to find the significant facial features. We expect these findings and the related compensation technique to contribute to establishing a scientific basis for the precise diagnosis of SC types in clinical practice.

The effects of white ginseng and red ginseng ethanol extracts on the proliferation, nitric oxide (NO) production and tumor necrosis factor-α (TNF-α) in human B and T lymphocytes isolated from blood cell of sasang constitution were examined in vitro. White ginseng extract known as medicine suitable for soeumin constitution showed the highest immune activities such as proliferation, NO production and TNF-α in soeumin constitution, and followed by taeeumin and soyangin, respectively (P＜0.05). However, there were immunologically insignificant differences among sasang constitution lymphocytes treated by red ginseng ethanol extract. Both white and red ginseng ethanol extracts showed significantly higher immunological activities than LPS-induced sasang constitution lymphocytes on NO production and TNF-α release (P＜0.05). The different immunological activities of white and red ginseng extracts in sasang constitution lymphocytes might be due to the component changes during the processing of ginseng. Thus, the findings of components suitable for all constitutions from red ginseng extract could be applied as a new constitution marker.