Counting Method and Application of Pulse-taking on both Carotid and Wrist Pulses in Suwen·LiuJieCangXiangLun (『소문(素問)·육절장상론(六節藏象論)』의 인영(人迎)·촌구(寸口) 맥진(脈診)의 셈법과 활용에 대한 연구)
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- Journal of Korean Medical classics
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- v.30 no.3
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- pp.77-93
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- 2017
Objectives : Clear and detailed analysis on Pulse-taking on both Carotid and Wrist Pulses is an absolute prerequisite if it is to be applied in real practice or its practical value proven. Methods : The original notes found in Suwen and Lingshu, their translations, and conventional studies regarding Suwen LiuJieCangXiangLun's Pulse-taking are compared and analyzed to find cases within medical texts where this method was used and to get an idea of the direction taken by the conventional study. Results : The ilsung, esung, samsung, and sasung of Carotid (or wrist pulses) refers that the pulse is one-, two-, three-, four-fold in differences. Refrainment should be practiced while comparing carotid and wrist pulses. Rather, they need to be compared with their normal states. Used by Luo Tianyi in Ming Dunasty, this method of pulse-taking was used for (radial artery) when diagnosing and treating the degree of seriousness of food injury. The measurement of maximum blood flow velocity using TCD done recently proved the validity of this pulse-taking, and it's been used for alleviating hypertension or tinnitus through acupuncture, or abating intractable diseases (around carotid). Conclusions : The obscurity of the measuring method of this pulse-taking can be resolved, and the problem which occurs while comparing carotid and wrist pulses can be solved. Even though there are differences in opinion regarding the positions when comparing the two pulses, their practical values are acknowledged since their usages in diagnosis, treatments, experiments, and researches have yielded positive results to a degree. They may not be used that often, but they are nonetheless under utilization.
In this work, we report the diagnostic relations among some primary pulse conditions such as the floating/sunken, deficient/forceful, large/fine, and the long/short pulses. For this purpose, we carried out a clinical test, in which 11 Oriental medical doctors had participated to diagnose the pulses for 1566 healthy subjects. The subjects were divided into 11 subgroups and each subgroup was allocated to an individual doctor. It resulted in that, for 847 subjects (54%), two or more than two pulse conditions were felt simultaneously, for which we counted the frequency of the pairs of the pulse conditions. For the statistical analysis, we used a Chi-square test. As a result, at high frequency, the forceful, large, and the long pulses were diagnosed in pairs or in their triplet, and a similar close relation was found between the deficient, fine, and the short pulses. The pairwise diagnoses of the pulse conditions between the forceful, large, and the long pulses, and between the deficient, fine, and the short pulses imply their close relatedness in clinics. This result is supported by the theory of deficiency/excess syndromes. Moreover, we show that the close relatedness among the pulse conditions can be understood in terms of the geometric features of the radial artery near the prominent bone. This is the first work which reports the relatedness between the primary pulses by an objective clinical test.
Objectives : In the study on the waveform analysis of radial artery pulse diagnosis, we need to establish fundamentals of contemporary pulse diagnosis research. To achieve certain experimental basis on traditional pulse diagnosis, we have to research the differences of pulse waveform according to pressure (in 5 level) and position (Chon, Gwan, Cheok in radial artery). As a first step, in present thesis, we tried to find the differences of pulse waveform according to pressure. Methods and Results : In this research, we analyzed seven parameters of the waveform at five levels of pressure. The parameters are E(so called 'energy', a representative of pulse strength), h1(height of percussion wave) and h2(height of subincisura). The results were as follows. 1. When we analyzed the change of the waveform according to pressure in the left Gwan, E, hl, h2 and A differed between 1st and 2nd grade, between 1st and 3rd grade, between 1st and 4th grade, between 1st and 5th grade, between 2nd and 3rd grade, between 2nd and 5th grade, between 3rd and 5th grade and between 4th and 5th grade in 95% confidence interval. 2. And t2, t4 differed between 1st and 2nd grade, between 1st and 5th grade, between 2nd and 4th grade, between 2nd and 4th grade, between 2nd and 5th grade, between 3rd and 4th grade, between 3rd and 5th grade and between 4th and 5th grade in 95% confidence interval. 3. W differed between 1st and 3rd grade, between 1st and 4th grade, between 2nd and 3rd grade, between 2nd and 4th grade, between 2nd and 5th grade, between 3rd and 4th grade, between 3rd and 5th grade, and between 4th and 5th grade in 95% confidence interval. 4. And h2/h1 differed between 1st and 4th grade, between 1st and 5th grade, between 2nd and 4th grade, between 2nd and 5th grade, between 3rd and 4th grade & between 3rd and 5th grade in 95% confidence interval. 5. There were differences between 1st and 2nd grade & between 2nd and 5th grade in the case of t4/t2 in 95% confidence interval. And there were differences between 1st and 5th grade, between 3rd and 4th grade, between 3rd and 5th grade & between 4th and 5th grade in the case of W/A in 95% confidence interval. And were differences between 1st and 2nd grade, between 2nd and 3rd grade, between 2nd and 4th grade, between 3rd and 4th grade, between 3rd and 5th grade & between 4th and 5th grade in the case of A/E in 95% confidence interval. Conclusions : As mentioned above, we conclude that the waveform analysis according to five grade pressure in the left Gwan shows the difference of waveform in each grade pressure.
The wall shear stress in the vicinity of end-to end anastomoses under steady flow conditions was measured using a flush-mounted hot-film anemometer(FMHFA) probe. The experimental measurements were in good agreement with numerical results except in flow with low Reynolds numbers. The wall shear stress increased proximal to the anastomosis in flow from the Penrose tubing (simulating an artery) to the PTFE: graft. In flow from the PTFE graft to the Penrose tubing, low wall shear stress was observed distal to the anastomosis. Abnormal distributions of wall shear stress in the vicinity of the anastomosis, resulting from the compliance mismatch between the graft and the host artery, might be an important factor of ANFH formation and the graft failure. The present study suggests a correlation between regions of the low wall shear stress and the development of anastomotic neointimal fibrous hyperplasia(ANPH) in end-to-end anastomoses. 30523 T00401030523 ^x Air pressure decay(APD) rate and ultrafiltration rate(UFR) tests were performed on new and saline rinsed dialyzers as well as those roused in patients several times. C-DAK 4000 (Cordis Dow) and CF IS-11 (Baxter Travenol) reused dialyzers obtained from the dialysis clinic were used in the present study. The new dialyzers exhibited a relatively flat APD, whereas saline rinsed and reused dialyzers showed considerable amount of decay. C-DAH dialyzers had a larger APD(11.70
The wall shear stress in the vicinity of end-to end anastomoses under steady flow conditions was measured using a flush-mounted hot-film anemometer(FMHFA) probe. The experimental measurements were in good agreement with numerical results except in flow with low Reynolds numbers. The wall shear stress increased proximal to the anastomosis in flow from the Penrose tubing (simulating an artery) to the PTFE: graft. In flow from the PTFE graft to the Penrose tubing, low wall shear stress was observed distal to the anastomosis. Abnormal distributions of wall shear stress in the vicinity of the anastomosis, resulting from the compliance mismatch between the graft and the host artery, might be an important factor of ANFH formation and the graft failure. The present study suggests a correlation between regions of the low wall shear stress and the development of anastomotic neointimal fibrous hyperplasia(ANPH) in end-to-end anastomoses. 30523 T00401030523 ^x Air pressure decay(APD) rate and ultrafiltration rate(UFR) tests were performed on new and saline rinsed dialyzers as well as those roused in patients several times. C-DAK 4000 (Cordis Dow) and CF IS-11 (Baxter Travenol) reused dialyzers obtained from the dialysis clinic were used in the present study. The new dialyzers exhibited a relatively flat APD, whereas saline rinsed and reused dialyzers showed considerable amount of decay. C-DAH dialyzers had a larger APD(11.70
Engineers have developed new instruments that aid in diagnosis and therapy Ultrasonic imaging has provided a nondamaging method of imaging internal organs. A complex transducer emits ultrasonic waves at many angles and reconstructs a map of internal anatomy and also velocities of blood in vessels. Fast computed tomography permits reconstruction of the 3-dimensional anatomy and perfusion of the heart at 20-Hz rates. Positron emission tomography uses certain isotopes that produce positrons that react with electrons to simultaneously emit two gamma rays in opposite directions. It locates the region of origin by using a ring of discrete scintillation detectors, each in electronic coincidence with an opposing detector. In magnetic resonance imaging, the patient is placed in a very strong magnetic field. The precessing of the hydrogen atoms is perturbed by an interrogating field to yield two-dimensional images of soft tissue having exceptional clarity. As an alternative to radiology image processing, film archiving, and retrieval, picture archiving and communication systems (PACS) are being implemented. Images from computed radiography, magnetic resonance imaging (MRI), nuclear medicine, and ultrasound are digitized, transmitted, and stored in computers for retrieval at distributed work stations. In electrical impedance tomography, electrodes are placed around the thorax. 50-kHz current is injected between two electrodes and voltages are measured on all other electrodes. A computer processes the data to yield an image of the resistivity of a 2-dimensional slice of the thorax. During fetal monitoring, a corkscrew electrode is screwed into the fetal scalp to measure the fetal electrocardiogram. Correlations with uterine contractions yield information on the status of the fetus during delivery To measure cardiac output by thermodilution, cold saline is injected into the right atrium. A thermistor in the right pulmonary artery yields temperature measurements, from which we can calculate cardiac output. In impedance cardiography, we measure the changes in electrical impedance as the heart ejects blood into the arteries. Motion artifacts are large, so signal averaging is useful during monitoring. An intraarterial blood gas monitoring system permits monitoring in real time. Light is sent down optical fibers inserted into the radial artery, where it is absorbed by dyes, which reemit the light at a different wavelength. The emitted light travels up optical fibers where an external instrument determines O2, CO2, and pH. Therapeutic devices include the electrosurgical unit. A high-frequency electric arc is drawn between the knife and the tissue. The arc cuts and the heat coagulates, thus preventing blood loss. Hyperthermia has demonstrated antitumor effects in patients in whom all conventional modes of therapy have failed. Methods of raising tumor temperature include focused ultrasound, radio-frequency power through needles, or microwaves. When the heart stops pumping, we use the defibrillator to restore normal pumping. A brief, high-current pulse through the heart synchronizes all cardiac fibers to restore normal rhythm. When the cardiac rhythm is too slow, we implant the cardiac pacemaker. An electrode within the heart stimulates the cardiac muscle to contract at the normal rate. When the cardiac valves are narrowed or leak, we implant an artificial valve. Silicone rubber and Teflon are used for biocompatibility. Artificial hearts powered by pneumatic hoses have been implanted in humans. However, the quality of life gradually degrades, and death ensues. When kidney stones develop, lithotripsy is used. A spark creates a pressure wave, which is focused on the stone and fragments it. The pieces pass out normally. When kidneys fail, the blood is cleansed during hemodialysis. Urea passes through a porous membrane to a dialysate bath to lower its concentration in the blood. The blind are able to read by scanning the Optacon with their fingertips. A camera scans letters and converts them to an array of vibrating pins. The deaf are able to hear using a cochlear implant. A microphone detects sound and divides it into frequency bands. 22 electrodes within the cochlea stimulate the acoustic the acoustic nerve to provide sound patterns. For those who have lost muscle function in the limbs, researchers are implanting electrodes to stimulate the muscle. Sensors in the legs and arms feed back signals to a computer that coordinates the stimulators to provide limb motion. For those with high spinal cord injury, a puff and sip switch can control a computer and permit the disabled person operate the computer and communicate with the outside world.