Search

Background The purpose of this study was to assess the accuracy and safety of procedures using ultrasound equipment for acupuncture treatment. Methods A pilot, prospective randomized, single blinded, crossover clinical study on the accuracy and safety of ultrasound-guided Gyeontonghyeol; (BP-LE6) acupuncture treatment was conducted. Patients (n; = 13) with shoulder pain were randomly divided into 2 groups. During Visit 1, ultrasound-guided BP-LE6 acupuncture was administered to the experimental group. In the control group, patients received BP-LE6 acupuncture (without checking ultrasound images) by manipulating the ultrasound probe as if administering ultrasound-guided acupuncture. Visit 2 was arranged within 7-14 days and the remaining procedures, other than those administered in Visit 1, were performed. In both the experimental group and control group, the number of needle insertions, and time required for the treatment to result in the patients feeling de-qi; was recorded. The numeric rating scale (NRS) score for shoulder pain was recorded before and after the acupuncture treatment. Results The number of needle insertions was 5.31 ± 3.50 times in the experimental group, and 6.62 ± 3.38 times in the control group, however, there was no statistically significant difference between the groups (p; > 0.05). The mean time required to perform the procedure was 151.54 ± 48.59 seconds in the experimental group and 86.69 ± 37.17 seconds in the control group, which was statistically significantly different (p; < 0.05). The changes observed in numerical rating scale scores between groups were not statistically significantly different. Conclusions Although there was no statistically significant difference, administering acupuncture using ultrasound guidance may lead to accurate needling with a reduced number of needle insertion attempts. A large-scale clinical study of better design should be conducted in the future.

This study was performed to evaluate research studies utilizing ultrasound diagnostic units, the practitioners who performed the ultrasound assessments, and how they had been used primarily in tandem with the Korean Medicine Advanced Searching Integrated System. This study identified 46 studies following a literature search, and discovered that a Korean medicine doctor led the ultrasonography in 13 studies, a medical technician was responsible in 6 studies, a roentgenologist carried it out in 5, and 19 of the studies did not specify who had conducted it. Ultrasonography had been actively used in the course of the clinical practice of Korean medicine, and it may serve as a useful and reliable diagnostic tool for evaluating the effectiveness of Korean medicine. The results of this study will help to promote more ultrasound studies in the future.

Introduction Gender differences are important intrinsic factors in wrist arterial pulse assessment in traditional Chinese and Korean medicine. The current study aimed to examine gender differences in wrist pulse waves at the Cun, Guan, and Chi positions of the wrist and to identify associations between physical indices and anatomical properties at all three positions. Methods One hundred thirty-nine middle-aged Korean men and women participated in this cross-sectional study. A blood analysis was performed, and blood pressure and medical history were recorded. Artery diameter and depth, blood flow velocity, and pulse wave were measured. Results The pulse power index (PPI), pulse depth index (PDI), and power spectrum density at the third harmonic frequency/first harmonic frequency (PSD_w3_w1) showed highly significant differences according to gender. Men exhibited larger PPI values than women at all three positions. The PDI and PSD_w3_w1 in men were higher at the Cun position than those in women, whereas the PDI at the Chi position was higher in women than in men. Gender differences in the spectral harmonic energy ratio were greater at the Guan and Chi positions than those at the Cun position. The subendocardial viability ratio differed significantly between genders. In women, the PDI was highly positively correlated with radial artery depth at all positions; however, in men, the PDI was only marginally correlated with artery depth at the Guan and Chi positions. Conclusion We suggest that gender differences should be considered in wrist artery pulse diagnosis, including those related to pulse diagnostic positions and anatomical properties.

Background: The purpose of this study was to analyze domestic and foreign clinical research into ultrasound-guided Oriental medicine acupuncture. Methods: Ultrasound-guided Oriental medicine acupuncture studies were retrieved from PubMed, CNKI, KISS, NDSL, and OASIS. Results: Of 6,260 articles, 17 articles were selected. There was 1 article in 2004, 1 in 2008, 2 in 2011, 1 in 2012, 4 in 2013, 3 in 2016, 2 in 2017, and 3 in 2018. Of the 17 selected articles 6 articles were studies of omalgia, 4 of knee pain and 2 of peroneal nerve palsy. In addition, there was 1 article of occipital headache, 1 of neck pain, 1 of tarsal tunnel syndrome, 1 of angioma and 1 of hiccup. In these 17 studies the ultrasound frequency range where mentioned, was 5-14 MHz. Conclusion: This study provided basic data as reference for the design of more diversified and systematic clinical research in the domestic Oriental medicine community in the future.

Introduction Obesity is a chronic disease risk factor. The objective of this study was to assess the association of obesity with anatomical and physical indices at the Cun, Guan, and Chi positions related to the radial artery. Methods A total of 109 healthy subjects aged 30–50 years participated in this study. Binary logistic regression was performed to examine differences in physical and anatomical indices between normal and obese subject groups. Results The arterial diameter was associated with obesity at the Guan (adjusted p = 0.0441, adjusted OR = 1.65 [1.013–2.687]) and Chi positions (adjusted p = 0.0028, OR = 2.277 [1.327–3.908]) but not the Cun position. No association between the arterial blood flow velocity and obesity were observed at the three positions. The pulse depth index (PDI) was related to obesity at the Cun (adjusted p = 0.0038, OR = 2.119 [1.274–3.526]) and Guan positions (adjusted p = 0.0422, OR = 1.595 [1.017–2.503]). The high-frequency spectral energy proportion of the total pulse energy (HSEP) was significantly different only at the Chi position (adjusted p = 0.0418, OR = 0.571 [0.333–0.979]), and the spectral energy ratio (SER) was related to obesity only at the Guan position (adjusted p = 0.0468, OR = 1.76 [1.008–3.073]). Conclusion Our study demonstrated that the arterial diameter, PDI, HSEP, and SER were associated with obesity at one or more positions. Our findings suggest that obesity may be considered in arterial pulse diagnosis and anatomical characteristics.

Pulse diagnosis is one of the representative diagnostic methods in Oriental medicine. In this study, a pulse pressure sensor array coated with silicone, which includes 6 piezo-resistive sensors and 1 thermistor, is fabricated for pulse measurement. It is necessary to coat the pulse sensor array with silicone to avoid the fracture or damage of pressure sensors when the sensor is in contact with the skin and a constant pressure is applied. However, the silicone coating on the pulse sensor array can cause signal interference among the sensors in the pulse sensor array. The interference number (IN), a calculation for expressing the degree of interference among channels, is changed according to the silicone thickness on the pulse sensor array. The IN is increased by a thick silicone coating, but the fabrication error, an important index for the mass production of the sensor array, is reduced by the thickness of the silicone coating. We propose that the thickness of the silicone on the pulse sensor array is an important consideration for the performance of the fabricated sensor and manufacturing repeatability.

Background Piezo-resistive pressure sensors are widely used for measuring pulse waves of the radial artery. Pulse sensors are generally fabricated with a cover layer because pressure sensors without a cover layer are fragile when they come into direct contact with the skin near the radial artery. However, no study has evaluated the dynamic pulse wave response of pulse sensors depending on the thickness and hardness of the cover layer. This study analyzed the dynamic pulse wave response according to the thickness and hardness of the cover layer and suggests an appropriate thickness and hardness for the design of pulse sensors with semiconductor device-based pressure sensors. Methods Pulse sensors with 6 different cover layers with various thicknesses (0.8 mm, 1 mm, 2 mm) and hardnesses (Shore type A; 30, 43, 49, 71) were fabricated. Experiments for evaluating the dynamic pulse responses of the fabricated sensors were performed using a pulse simulator to transmit the same pulse wave to each of the sensors. To evaluate the dynamic responses of the fabricated pulse sensors, experiments with the pulse sensors were conducted using a simulator that artificially generated a constant pulse wave. The pulse wave simulator consisted of a motorized cam device that generated the artificial radial pulse waveform by adjusting the stroke of the cylindrical air pump and an air tube that conveyed the pulse to the artificial wrist. Results The amplitude of the measured pulse pressure decreased with increasing thickness and hardness of the cover layer. Normalized waveform analysis showed that the thickness rather than the hardness of the cover layer contributed more to waveform distortion. Analysis of the channel distribution of the pulse sensor with respect to the applied constant dynamic pressure showed that the material of the cover layer had a large effect. Conclusions In this study, in-line array pulse sensors with various cover layers were fabricated, the dynamic pulse wave responses according to the thickness and the hardness of the cover layer were analyzed, and an appropriate thickness and hardness for the cover layer were suggested. The dynamic pulse wave responses of pulse sensors revealed in this study will contribute to the fabrication of improved pulse sensors and pulse wave analyses.

Introduction: In traditional East Asian medicine, the color and shape features of a tongue reflect the health of the body. The repeatability of computerized tongue diagnosis is highly dependent on the image acquisition process. In this study, a method for providing frontal and profile feedback gridlines for the tongue image acquisition process was proposed and the resulting color and shape repeatability was assessed. Methods: Eight subjects were recruited and 120 images were acquired. For each subject, 15 tongue images were acquired with three different gridline types, including no gridline (Group I), frontal gridlines (Group II), and frontal and profile gridlines (Group III) in a pseudo-randomized order. To evaluate repeatability, intra-class correlation coefficients (ICCs) were calculated from the mean values and histogram fitting parameters for Commission Internationale de l’Eclairage L*a*b*, profile angles, and tongue area ratios (TARs) of four edge regions, respectively. Results: The ICCs for all the color features in Group I were lower as compared with those in Group II and additionally, the ICCs for all the color features in Group III were larger compared with those in Group II. The ICCs of the shape features were lower than those of the color features. The ICCs of TARs in Group I were lower than those in Groups II and III. From the tip to the root of the tongue region, the ICCs of mean luminance tended to decrease in all the groups, but the intensity of the decline in Group III was lower than those in Group I and Group II. Conclusions: The proposed tongue image acquisition process with frontal and profile gridlines improved the repeatability of color and shape features and potentially improve diagnostic accuracy of computerized tongue diagnosis. © 2014 Elsevier GmbH. All rights reserved.

Tongue diagnosis is an essential process to noninvasively assess the condition of a patient's internal organs in traditional medicine. To obtain quantitative and objective diagnostic results, image acquisition and analysis devices called tongue diagnosis systems (TDSs) are required. These systems consist of hardware including cameras, light sources, and a ColorChecker, and software for color correction, segmentation of tongue region, and tongue classification. To improve the performance of TDSs, various types TDSs have been developed. Hyperspectral imaging TDSs have been suggested to acquire more information than a two-dimensional (2D) image with visible light waves, as it allows collection of data from multiple bands. Three-dimensional (3D) imaging TDSs have been suggested to provide 3D geometry. In the near future, mobile devices like the smart phone will offer applications for assessment of health condition using tongue images. Various technologies for the TDS have respective unique advantages and specificities according to the application and diagnostic environment, but this variation may cause inconsistent diagnoses in practical clinical applications. In this manuscript, we reviewed the current trends in TDSs for the standardization of systems. In conclusion, the standardization of TDSs can supply the general public and oriental medical doctors with convenient, prompt, and accurate information with diagnostic results for assessing the health condition.

The purpose of this dissertation is finding the meaning and form of Euthanasia, Considering by Criminal law that the core of the debate over the `pros and cons` of euthanasia, And seeking measures about needs of currently Euthanasia legislation and institutional establishment. Through the remarkable progress, today`s medical science makes to cure the Incurable patients, and artificially prolong human life by life-support system. These changes of Healthcare Environments extending a permissible range of Euthanasia over the series of criminal discussions about Euthanasia. And medical treatment has been discussed from negative side to positive side. So, In the current legal system, seeking for realistic measure is demands of the times behind the penally and ethical problems. Therefore, I will study the needs of legal system and reestablish values about Respect for Human Life.

We propose a novel classification algorithm for the floating pulse and the sunken pulse using a newly defined coefficient (Cfs). To examine the validity of the proposed algorithm, we carried out a clinical test in which 12 oriental medical doctors made pairwise diagnoses on the pulses of volunteering subjects. 169 subjects were simultaneously diagnosed by paired doctors, and the diagnoses in 121 subjects were concordant, yielding an accuracy of 72% and a Matthews correlation coefficient of 0.42, which indicates reasonable agreement between doctors. Two sampleT-tests showed that subjects in the sunken pulse group had significantly higher BMI andCfs(P<.05) than those in the floating pulse group. The pulse classification by the algorithm converged with the diagnoses of paired doctors with an accuracy up to 69%. With these results, we confirm the validity of the novel classification algorithm for the floating and sunken pulses.

Background: The objectives of this pilot study were to examine the association between hypertension and physical factors of wrist pulse waves to avoid subjective diagnoses in Traditional Chinese Medicine (TCM) and Traditional Korean Medicine (TKM). An additional objective was to assess the predictive power of individual and combined physical factors in order to identify the degree of agreement between diagnosis accuracies using physical factors and using a sphygmomanometer in the prediction of hypertension. Methods: In total, 393 women aged 46 to 73 years participated in this study. Logistic regression (LR) and a naive Bayes algorithm (NB) were used to assess statistically significant differences and the predictive power of hypertension, and a wrapper-based machine learning method was used to evaluate the predictive power of combinations of physical factors. Results: In both wrists, L-PPI and R-PPI (maximum pulse amplitudes in the left Gwan and right Gwan) were the factors most strongly associated with hypertension after adjusting for age and body mass index (p = < 0.001, odds ratio (OR) = 2.006 on the left and p = < 0.001, OR = 2.504 on the right), and the best predictors (NB-AUC = 0.692, LR-AUC = 0.7 on the left and NB-AUC = 0.759, LR-AUC = 0.763 on the right). Analyses of both individual and combined physical factors revealed that the predictive power of the physical factors in the right wrist was higher than for the left wrist. The predictive powers of the combined physical factors were higher than those of the best single predictors in both the left and right wrists. Conclusion: We suggested new physical factors related to the sum of the area on the particular region of pulse waves in both wrists. L-PPI and R-PPI among all variables used in this study were good indicators of hypertension. Our findings support the quantification and objectification of pulse patterns and disease in TCM and TKM for complementary and alternative medicine.

Introduction. According to traditional East Asian medicine (TEAM) theory, the tongue represents conditions of qi and blood. In the present study, the relationship between the tongue and the qi and blood in conditions with no apparent disease was investigated.Methods. A total of 454 elderly people with no apparent disease were recruited. Two Korean oriental medicine doctors classified subjects into a normal group (n = 402) and a sleep disorder group (n = 52). Three to five weeks after the experiment, 153 subjects were rerecruited for a second experiment. Two-dimensional color histograms, whose seven variables represent the color distribution in Commission Internationale de l'Éclairage 1976 (L*,a*,b*) color space, were produced from tongue images.Results. The color of the tongue body in the sleep disorder group appeared paler than that in the normal group, and the tongue coating in the normal group was less widely distributed compared with that in the sleep disorder group. The differences in tongue color between the normal at first experiment and sleep disorder at second experiment conditions were similar to the differences between the normal and the sleep disorder groups.Conclusions. The tongue states in the sleep disorder group indicate a qi and blood deficiency according to TEAM theory.

Background Human skin properties have been used as an important diagnostic component in traditional medicine as they change with health conditions. Sasang constitutional medicine (SCM) puts emphasis on the recognition of the constitution-specific skin features prior to the diagnostic decision of health. In this work, in search of skin-characteristics effectively reflecting SCM features, we compared several skin properties such as perspiration, visco-elasticity, elasticity, and elasticity hysteresis, in several candidate body parts. Methods We conducted a clinical study in which a total of 111 healthy females aged 50 – 70 years participated with their Sasang constitution (SC) types determined objectively by the Sasang constitutional analytic tool. Perspiration on the skin surface was estimated by using a capacitance sensor to measure the amount of moisture on the palm, forehead, and philtrum before and after a heating stimulus. We acquired the visco-elasticity, elasticity, and elasticity hysteresis at the forearm by Dermalab’s elasticity sensing device. An analysis of covariance (ANCOVA) was conducted to evaluate the effect of SC on the nine skin features acquired. Results The visco-elasticity of the forearm of the Soeum-in (SE) group was significantly lower than that of the Taeeum-in (TE) group (F = 68.867, p

Sasang constitutional medicine (SCM) shares its philosophy with that of personalized medicine: it provides constitution-specific treatment and healthcare individualized for each patient. In this work, we propose the concept of the Sasang Health Index (SHI) as an attempt to assess the individualized health status in the framework of SCM. From the target population of females in their fifties and older, we recruited 298 subjects and collected their physiological data, including complexion, radial pulse, and voice, and their questionnaire responses. The health status of each subject was evaluated by two Korean medical doctors independently, and the SHI model was obtained by combining all the integrative features of the phenotype data using a regression technique. As a result, most subjects belonged to either the healthy, subhealthy, or slightly diseased group, and the intraclass correlation coefficient between the two doctors’ health scoring reached 0.95. We obtained an SHI model for each constitution type with adjustedR-squares of 0.50, 0.56, and 0.30, for the TE, SE, and SY constitution types, respectively. In the proposed SHI model, the significant characteristics used in the health assessment consisted of constitution-specific features in accordance with the classic literature and features common to all the constitution types.

An accurate assessment of the pulse depth in pulse diagnosis is vital to determine the floating and sunken pulse qualities (PQs), which are two of the four most basic PQs. In this work, we proposed a novel model of assessing the pulse depth based on sensor displacement (SD) normal to the skin surface and compared this model with two previous models which assessed the pulse depth using contact pressure (CP). In contrast to conventional stepwise CP variation tonometry, we applied a continuously evolving tonometric mechanism at a constant velocity and defined the pulse depth index as the optimal SD where the largest pulse amplitude was observed. By calculating the pulse depth index for 18 volunteers, we showed that the pulse was deepest atCheok(significance level:P<0.01), while no significant difference was found betweenChonandGwan. In contrast, the two CP-based models estimated that the pulse was shallowest atGwan(P<0.05). For the repeated measures, the new SD-based model showed a smaller coefficient of variation(CV≈7.6%)than the two CP-based models (CV≈13.5% and 12.3%, resp.). The SD-based pulse depth assessment is not sensitive to the complex geometry around the palpation locations and temperature variation of contact sensors, which allows cost-effective sensor technology.

In this work, we analyze the baseline, signal strength, aortic augmentation index (AIx), radial AIx, time to reflection and P_T2 at Chon, Gwan, and Cheok, which are the three pulse diagnosis positions in Oriental medicine. For the pulse measurement, we used the SphygmoCor apparatus, which has been widely used for the evaluation of the arterial stiffness at the aorta. By two-way repeated measures analysis of variance, we tested two independent measurements for repeatability and investigated their mean differences among Chon, Gwan and Cheok. To characterize further the parameters that were shown to be different between each palpation position, we carried out Duncan's test for the multiple comparisons. The baseline and signal strength were statistically different () among Chon, Gwan and Cheok, respectively, which supports the major hypothesis of Oriental medicine that all of the three palpation positions contain different clinical information. On the other hand, aortic AIx and time to reflection were found to be statistically different between Chon and the others, and radial AIx and P_T2 did not show any difference between pulse positions. In the clinical sense, however, the aortic AIx at each palpation position was found to fall within the 90% confidence interval of normal arterial compliance. The results of the multiple comparisons indicate that the parameters of arterial stiffness were independent of the palpation positions. This work is the first attempt to characterize quantitatively the pulse signals at Chon, Gwan and Cheok with some relevant parameters extracted from the SphygmoCor apparatus.