• Proceedings of the KIEE Conference
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• 2009.07a
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• pp.1966_1967
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• 2009

As an attempt to characterize the pulse behaviors at the three pulse diagnosis positions in the oriental medicine which are called Chon, Gwan, and Cheok, we measure the pluse waveforms by SphygmoCor apparatus, that has been used widely for the evaluation of the arterial stiffness, and examine the Augmentation Index (AIx) at the aorta. For the study, twenty healthy men at the age of twenties have participated as the subject group. The pulse has been measured twice at the three palpation positions, and by two-way repeated measures ANOVA we tested the repeatability and the mean differences in the aortic AIx between Chon, Gwan, and Cheok. The AIx was found to be statistically different between the measurement positions. Duncan's test shows that the AIx is statistically different between Chon and the other two positions. Our study may be used as a reference for further scientific quantification of the pulse diagnosis.

• Biomedical Science Letters
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• v.15 no.1
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• pp.9-15
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• 2009

Early age at menarche, which is indicator of early biological maturity, has been shown to be associated with increased adult body mass index. Early menarche has also been associated with many cardiovascular disease risk factors and metabolic syndrome. To evaluate the impact of menarche to cardiovascular risk factor, we assessed by age at menarche, brachial-ankle pulse wave velocity (baPWV), which represents arterial stiffness, in women with or without metabolic syndrome. The subjects recruited for this study were three hundred one women. Relatively early menarche and relatively late menarche were classified according to less than $50^{th}$ percentile for relatively early menarche, and great than the $50^{th}$ percentile for relatively late menarche. Subject were divided four group, 1) women who had not adulthood metabolic syndrome and relatively early menarche, 2) women who had not adulthood metabolic syndrome and relatively late menarche, 3) women who had adulthood metabolic syndrome and relatively early menarche, 4) women who had adulthood metabolic syndrome and relatively late menarche. Women who had a relatively early menarche with adulthood metabolic syndrome had significantly high levels of blood pressure, triglyceride, fasting insulin and homeostatic model assessment of insulin resistance (HOMA-IR) levels than women with late menarche with adulthood metabolic syndrome, and had significantly lower HDL-cholesterol levels. And also, women who underwent a relatively early menarche with metabolic syndrome had highest level of baPWV in adult. In this study we found effect of age at menarche on adulthood metabolic risk factors for cardiovascular disease (e.g., baPWV, insulin resistance, hyperlipidemia) in Korean women.

• Clinical and Experimental Pediatrics
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• v.50 no.6
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• pp.549-555
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• 2007

Purpose : Pulse wave velocity (PWV) and ankle brachial index (ABI) are simple, non-invasive methods to assess arterial stiffness. These parameters are also known to be closely related to cardiovascular risk factors and diseases. The purposes of this study were to measure blood pressure, PWV, ABI in healthy Korean adolescents, set up their normal values and assess their correlations. Methods : Three hundred ninety two healthy adolescents (213 boys and 179 girls) underwent measurement of brachial ankle pulse wave velocity (baPWV), ABI, body mass index(BMI) and blood pressure from four extremities. Linear regression analysis was performed to reveal the correlations between PWV, ABI and independent variables. Results : Blood pressure and PWV were significantly higher in all extremities in males compared to females. Blood pressure of both brachial and ankle showed positive correlation with body weight, height, and BMI, whereas ABI showed no correlation with any of these indices. Conclusion : Blood pressure increases as body weight, height and BMI increases. PWV shows positive correlation with blood pressure. It will be helpful to predict the risks of cardiovascular diseases in adolescents.

• Clinical and Experimental Pediatrics
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• v.49 no.4
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• pp.368-374
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• 2006

Purpose : The prevalence of obesity in children is increasing rapidly. Epidemiologic studies suggest that obesity induced atherosclerosis may start in childhood. We investigated whether obese children show early abnormalities of the arterial wall and endothelial dysfunction. Methods : Thirty-eight obese children(14-16 years old of age, male, body mass index $29.40{\pm}3.18kg/m^2$) and forty-five age and sex-matched healthy control children(body mass index $18.43{\pm}1.01kg/m^2$) were enrolled. Their carotid artery intima-media thickness(IMT) and brachial artery flowmediated dilation(FMD) response were measured by high-quality ultrasound system, and compliance, distensibility, stiffness index, incremental elastic modulus and wall stress were calculated by equation. In addition, we looked at the relations between these arterial features and metabolic cardiovascular risk factors. Results : The obese children had significantly increased IMT($0.52{\pm}0.09mm$ vs $0.40{\pm}0.07mm$, P< 0.001) and markedly impaired FMD($7.35{\pm}7.78$ percent vs $20.34{\pm}16.81$ percent, P<0.001) than the healthy controls. But the compliance and distensibility were lower, and the stiffness index, incremental elastic modules and wall stress were higher in the obese group than the control group, but not statistically significantly. Body mass index was highly associated with increased IMT(r=0.612, P<0.001) and reduced FMD(r=-0.414, P<0.001). Conclusion : We showed the deleterious effect of child obesity on both early functional and structural atherosclerotic markers. The ultrasonic findings will be used for screening and follow up markers to identify high-risk patients among obese children.

• Clinical and Experimental Pediatrics
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• v.49 no.10
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• pp.1093-1099
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• 2006

Purpose : Homocysteine is a strong and independent risk factor for cardiovascular disease. The deleterious effects of homocysteine included endothelial dysfunction, arterial intimal-medial thickening, wall stiffness and procoagulant activity. However, the precise mechanism responsible for homocysteine release in children with coronary artery disease is still unknown. The purpose of this study was to investigate serum homocysteine and tumor necrosis $factor(TNF)-{\alpha}$ levels and identify whether these levels had any association with the development of coronary artery lesions in Kawasaki disease(KD). Methods : Serum homocysteine and $TNF-{\alpha}$ levels were measured in 24 KD patients(group 1, eight patients with normal coronary artery; group 2, 16 patients with coronary artery lesions) and 21 controls(group 3, 10 afebrile controls; group 4, 11 febrile controls). Blood samples were drawn from each study group before and after intravenous immunoglobulin(IVIG) therapy and in the convalescent stage. Results : The homocysteine levels before IVIG therapy were significantly higher in group 1 than in group 3, and in group 2 than in group 3 and 4. The $TNF-{\alpha}$ levels before IVIG therapy were significantly higher in group 2 than group 3 and 4. Serum homocysteine and $TNF-{\alpha}$ levels were highest in group 2 before IVIG therapy. In the acute KD patients, serum homocysteine levels correlated significantly with $TNF-{\alpha}$ levels. Conclusion : The increased serum homocysteine levels in the acute stage increase the susceptibility to coronary arterial lesions in KD. $TNF-{\alpha}$ may also play an important role in the formation of coronary arterial lesions in KD.

• International Journal of Vascular Biomedical Engineering
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• v.4 no.2
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• pp.19-24
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• 2006

Background: Pulse wave velocity (PWV), which is inversely related to the distensibility of an arterial wall, offers a simple and potentially useful approach for an evaluation of cardiovascular diseases. In spite of the clinical importance and widespread use of PWV, there exist no standard either for pulse sensors or for system requirements for accurate pulse wave measurement. Objective of this study was to assess the reproducibility of PWV values using a newly developed PWV measurement system in healthy subjects prior to a large-scale clinical study. Methods: System used for the study was the PP-1000 (Hanbyul Meditech Co., Korea), which provides regional PWV values based on the measurements of electrocardiography (ECG), phonocardiography (PCG), and pulse waves from four different sites of arteries (carotid, femoral, radial, and dorsalis pedis) simultaneously. Seventeen healthy male subjects with a mean age of 33 years (ranges 22 to 52 years) without any cardiovascular disease were participated for the experiment. Two observers (observer A and B) performed two consecutive measurements from the same subject in a random order. For an evaluation of system reproducibility, two analyses (within-observer and between-observer) were performed, and expressed in terms of mean difference ${\pm}2SD$, as described by Bland and Altman plots. Results: Mean and SD of PWVs for aorta, arm, and leg were $7.07{\pm}1.48m/sec,\;8.43{\pm}1.14m/sec,\;and\;8.09{\pm}0.98m/sec$ measured from observer A and $6.76{\pm}1.00m/sec,\;7.97{\pm}0.80m/sec,\;and\;\7.97{\pm}0.72m/sec$ from observer B, respectively. Between-observer differences ($mean{\pm}2SD$) for aorta, arm, and leg were $0.14{\pm\}0.62m/sec,\;0.18{\pm\}0.84m/sec,\;and\;0.07{\pm}0.86m/sec$, and the correlation coefficients were high especially 0.93 for aortic PWV. Within-observer differences ($mean{\pm}2SD$) for aorta, arm, and leg were $0.01{\pm}0.26m/sec,\;0.02{\pm}0.26m/sec,\;and\;0.08{\pm}0.32m/sec$ from observer A and $0.01{\pm}0.24m/sec,\;0.04{\pm}0.28m/sec,\;and\;0.01{\pm}0.20m/sec$ from observer B, respectively. All the measurements showed significantly high correlation coefficients ranges from 0.94 to 0.99. Conclusion: PWV measurement system used for the study offers comfortable and simple operation and provides accurate analysis results with high reproducibility. Since the reproducibility of the measurement is critical for the diagnosis in clinical use, it is necessary to provide an accurate algorithm for the detection of additional features such as flow wave, reflection wave, and dicrotic notch from a pulse waveform. This study will be extended for the comparison of PWV values from patients with various vascular risks for clinical application. Data acquired from the study could be used for the determination of the appropriate sample size for further studies relating various types of arteriosclerosis-related vascular disease.

• Korean Journal of Clinical Laboratory Science
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• v.52 no.2
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• pp.119-127
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• 2020

According to previous studies, an impaired pulmonary function is associated with arterial stiffness (AS). The pulse pressure (PP) is an important predictor of AS, but the association of an impaired pulmonary function with the PP is unclear. Therefore, this study assessed the associations between the PP and the predicted forced vital capacity (predicted FVC) and predicted forced expiratory volume in one second (predicted FEV₁) in Korean non-smoking adults. The data obtained from 6,857 adults during the 2013~2015 Korean National Health and Nutrition Examination Survey were analyzed. After adjusting for the related variables, the ORs of restrictive pulmonary disease (RPD, the predicted FVC<80.0% with FEV₁/FVC≥70.0%) using the normal PP group (PP≤60 mmHg) as a reference group was significant for the high PP group (PP>60 mmHg; 1.337 [95% confidence interval (CI), 1.049~1.703]). In addition, the ORs of obstructive pulmonary disease (OPD, FEV₁/FVC<70.0%) using the normal PP group as a reference group were significant for the high PP group (1.339 [95% CI, 1.093~1.642]). In conclusion, a high PP is positively associated with both RPD and OPD in Korean non-smoking adults.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.20 no.11
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• pp.56-65
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• 2019

This study examined effects of 12 weeks of body weight based combined exercise training (resistance training for 30 min, aerobic training for 30min) on body composition (% body fat, lean body mass, fat mass and BMI (body mass index)) and cardiovascular factors (ankle-brachial index (ABI) and brachial-ankle pulse wave velocity (baPWV)) in elderly women. A total of 32 subjects participated in this study, and were randomly divided into either exercise group (n = 16, EG) or control group (n = 16, CG). All variables at pre-test were analyzed by independent t-test for baseline test, and all data post the study period were analyzed by two-way repeated measures ANOVA with contrast testing (α = 0.05). Our results indicate that body composition (% body fat, lean body mass, fat mass and BMI) in both EG and CG do not differ significantly. However, the right and left sides of baPWV in EG was significantly reduced, as compared to CG. Taken together, these results indicate that combined exercise training for 12 weeks positively influences the cardiovascular factors, and may prevent cardiovascular diseases in elderly females (over 65 years), thereby resulting in increased quality of life for the elderly.

• The Journal of Internal Korean Medicine
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• v.33 no.3
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• pp.257-271
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• 2012

Objectives : The purpose of this study was to confirm that the pulse analyzer is useful for analyzing characteristics of variables of pulse waves in age categories, evaluating pulse waves of the metabolic syndrome group, compared with those of the non-metabolic syndrome group in Korean adults. Methods : The pulse wave variables were measured in Guan of all 1,056 subjects by the pulse analyzer, using a pen-type piezoresistive sensor. The physical measurement, blood test and survey were also performed by each subject. Results : In the age categories, height of pre-incisura (h2), height of tidal wave (h3), area of percussion wave (Aw), and width of percussion wave (w) increased in accordance with increase in age. While ratio of systolic period area (As) went up according to the increase of age, ratio of diastolic period area (Ad) went down. Radial augmentation index (R-AI), h2/h1, h3/h1, w/t and angle of percussion wave went up by aging, generally. Aw rate (Aw/At) also increased. Among the metabolic syndrome group, in the ages of 19 and 44, ratio of systolic period area (As) was higher and ratio of diastolic period area (Ad) was lower than in the non-metabolic group. w/t, Aw/At, and angle of percussion wave were higher than in the non-metabolic syndrome group. Among the metabolic syndrome group over the age of 60, height of pre-incisura (h2), height of tidal wave (h3), total area (At), area of percussion wave (Aw), radial augmentation index (R-AI), h2/h1 and h3/h1 were higher than in the non-metabolic syndrome group. Conclusions : The pulse analyzer is useful to analyze arterial stiffness in the age categories and in the metabolic syndrome group by some measures.

• Korean Journal of Oriental Medicine
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• v.14 no.2
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• pp.107-112
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• 2008

Although the pulse diagnosis position, Guan is apart from Cun or Chi by only $10{\sim}20$ mm at most, traditional medical doctors applies different indent pressures and even they states different pulse images are felt at Cun, Guan and Chi, To support their clinical behaviors, in this study, we tested statistically whether there are differences in pulse waveform measured at these three positions with SphygmoCor system used world widely, A 30 years old female subject without any evidence of cardiovascular diseases was involved in this experiment. Radial pulse waves were recorded at three different positions on left lower arm 10 times at three positions-Cun, Guan and Chi. With ANOVA, we tested whether, among three different positions. there are any differences in 12 parameters of radial pulse waveform and in estimated AIx(Augmentation Index) as an arterial stiffness index extracted from radial pulse waveform. As results, differences in optimal indent pressure h0 were observed at different measuring positions(P<0.001) but not significantly different. And pulse pressure his were found to be different(Chi$22.60{\pm}3.06%,\;18.60{\pm}3.37%\;and\;26.4{\pm}5.02%$ respectively. Consequently. AIx at Gwan seems to be lowest and that at Chi seems to be highest. So. we assert the AIx at Chi is likely to be overestimated. In further studies. we want to examine what make differences in these parameters between measuring positions. And it also seems to be worthy to investigate the relationship between the depth of radial artery and AIx. And, ultimately, we need to determine the best measuring process including measuring position, hold-down pressure, signal quality validation and so on. so to achieve the optimal waveform which represents subject's health condition for both western medicine and traditional medicine.