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The Usefulness of 4D Echocardiographic Modality for Assessing RV Affection in Uncontrolled Hypertensive Patients

  • Rehab M. Hamdy;Shaimaa A Habib;Layla A Mohamed;Ola H. Abd Elaziz
    • Journal of Cardiovascular Imaging
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    • v.30 no.4
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    • pp.279-289
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    • 2022
  • BACKGROUND: In many cardiovascular disorders, the contractile performance of the right ventricle (RV) is the primary determinant of prognosis. For evaluating RV volumes and function, 4 dimensional (4D)-echocardiography has become common. This research used 2D and 4D modalities to assess RV contractile performance in hypertensive patients. METHODS: A total of 150 patients with essential hypertension were enrolled in this study, along with 75 age and sex-matched volunteers. Clinical evaluation and echocardiographic examination (including M-mode, tissue Doppler imaging, and 2D speckle tracking) were conducted on all participants. RV volumes, 4D-ejection fraction (EF), 4D-fractional area change (FAC), 4D-tricuspid annular plane systolic excursion (TAPSE), 4D-septal and free wall (FW) strain were all measured using 4D-echocardiography. RESULTS: Hypertensive patients showed 2D-RV systolic and diastolic dysfunction (including TAPSE, 2D-right ventricular global longitudinal strain, RV-myocardial performance index and average E/EaRV) and 4D-RV impairment (including right ventricular EF, FAC, RV strain and TAPSE, right ventricular end-diastolic volume and right ventricular end-systolic volume) compared to the control group. We verified the prevalence of RV systolic dysfunction in hypertension patients using the following parameters: 1) 15% of them had 2D-TAPSE < 17 mm vs. 40% by 4D-TAPSE; 2) 25% of them had 2D-GLS < 19% vs. 42% by 4D-septal strain and 35% by 4D FW strain; 3) 35% of hypertensive patients had 4D-EF < 45%; and finally; 4) 25% of hypertensive patients had 2D-FAC < 35% compared to 45% by 4D-FAC. CONCLUSIONS: The incidence of RV involvement was greater in 4D than in 2D-modality trans-thoracic echocardiography. We speculated that 4D-echocardiography with 4D-strain imaging would be more beneficial for examining RV morphology and function in hypertensive patients than 2D-echocardiography, since 4D-echocardiography could estimate RV volumes and function without making geometric assumptions.

The effect of Exercise on inhibition Blood pressure by Auricular-plaster Vaccaria seeds (이혈첨압왕불유행자(耳穴貼壓王不留行籽)가 운동시 혈압 억제에 미치는 영향)

  • Park, Ji-Soo;Yoon, Young-Sik;Kim, Dong-Jin;Ko, Hee-Jeong;Yum, Dae-Yul;Song, Yung-Sun
    • Journal of Pharmacopuncture
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    • v.13 no.4
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    • pp.63-74
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    • 2010
  • Objectives : The purpose of this study was to investigate effect of Exercise on inhibition Blood pressure by Auricular-plaster Vaccaria seeds Methods : This study picked 40 peoples from 20 May 2009 to 30 June 2009 and experiment them. Attached Vaccaria seeds to auricular acupuncture of the experiment group. Did not attach them to the control group. Them to exercise using a Bike-Ergometer exercise. I measured their blood pressure before the exercise, 15 minutes after the exercise and 30 minutes after the exercise. I compared the difference between the systolic blood pressure and diastolic blood pressure. The method to choose the subjects was Random allocation. Results : 1. Comparing the systolic blood pressure of the experiment group and the control group, the average systolic blood pressure of the experiment group, who did the Bike-Ergometer exercise putting on Auricular-plaster Vaccaria seeds, was 125.45 mmHg before the exercise, 121.20 mmHg 15 minutes after the exercise and 120.30 mmHg 30 minutes after the exercise. Terefore, the group's systolic blood pressure after the exercise was more controlled than the systolic blood pressure before the exercise. The control group's systolic blood pressure increased compared to the beginning. To measure the change before and after the exercise, I carried out paird-t test. The result was statistically significant. 2. Comparing the diastolic blood pressure of the experiment group and the control group, the average diastolic blood pressure of the experiment group, who did the Bike-Ergometer exercise putting on Auricular-plaster Vaccaria seeds, was 81.45 mmHg before the exercise, 79.65 mmHg 15 minutes after the exercise and 79.05 mmHg 30 minutes after the exercise. As a result of carrying out paird-t test to measure the change of the diastolic blood pressure, the change of the dilating blood pressure was statistically significant. However, the difference of the dilating blood pressure between 15 minutes after the exercise and 30 minutes after the exercise was not statistically significant. Comparing the systolic blood pressure and the diastolic blood pressure of the experiment group and the control group, the blood pressure of the experiment group, who did the Bike-Ergometer exercise putting on Auricular-plaster Vaccaria seeds, decreased compared to the beginning and the blood pressure of the control group, who did not put on Auricular-plaster Vaccaria seeds, increased compared to the beginning. Conclusions : The hypothesis was supported that the increase of the systolic and diastolic blood pressure of the experiment group, putting on Auricular-plaster Vaccaria seeds, was more controlled than that of the control group. In future, it can be medically used by verifying the various effects through repeated studies.

Clinical Evaluation of the Accuracy of Electronic Home Blood Pressure Measuring Devices (가정용 전자식 혈압계의 정확도에 대한 임상적 평가)

  • Choo Ji-Na
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.9 no.1
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    • pp.101-112
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    • 2002
  • Purpose: This study evaluated the accuracy of electronic devices compared with mercury sphygmomanometer. Of 132 outpatients with electronic devices. 77 who possessed oscillometric cuff devices participated in this study. Method: When the blood pressure was measured, all electronic devices were connected by means of a Y-connector to a mercury sphygmomanometer. Using the simultaneous same arm approach, each comparison was carried out three times at 2-minute intervals. Results: Compared with the mercury sphygmomanometer, the electronic devices underestimated systolic and diastolic blood pressure, respectively by $4.0{\pm}5.8mmHg$ and $2.5{\pm}67mmHg$, which satisfies the standard error range of the American Association for the Advancement of Medical Instrumentation. According to the British Hypertension Society criteria, these differences achieved C grade for both systolic and diastolic pressure. For the graphical analysis, the differences had a tendency to fulfill the permitted error limits in both diastolic and systolic blood pressure. Moreover, the purchase duration was not correlated with the accuracy of electronic devices. Conclusion: These results indicate that difference in blood pressure between electronic devices and mercury sphygmomanometer is within the standard error. Therefore, electronic blood pressure measuring devices may be useful for therapeutic self-management of hypertension.

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Estimation of Systolic Blood Pressure using PTTL (PTTL을 이용한 수축기 혈압추정)

  • Kil, Se-Kee;Kwan, Jang-Woo;Yoon, Kwang-Sub;Lee, Sang-Min
    • The Transactions of The Korean Institute of Electrical Engineers
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    • v.57 no.6
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    • pp.1095-1101
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    • 2008
  • The desirable method to diagnose abnormal blood pressure is to measure and manage blood pressure continuously and regularly. However, the sphygmomanometers that are based on a cuff have faults in that they can not measure the blood pressure continuously and they cause an unpleasant feeling. Therefore, it is essential to develop a new measuring method that causes no pain and that can obtain blood pressure continuously without any unpleasant feeling. Thus, we propose here a regression method to estimate the systolic blood pressure by using the PTTL(pulse transit time on leg) with some body parameters which are chosen from the relational analysis with systolic blood pressure. The data we use to make the regression model were obtained in triplicate from each of 50 males who were from 18 to 35 years. And we made estimation experiments of blood pressure on 10 males who did not take part in the making the regression model. According to the results, the proposed method showed a mean error of 4.00 mmHg and the standard variance was 2.45 mmHg. When we comparing the results of the proposed method with the rule of American National Standards Institute of the Association of the Advancement of Medical Instruments(ANSI/AAMI), the results satisfied the rule of a mean error less than 5 mmHg and a standard variance less than 8 mmHg. Therefore we were able to validate the usefulness of the proposed method.

Performance Analysis of Extended QRD-RLS Equalizer (Extended QRD-RLS 등화기의 성능 분석)

  • Jang, Jin-Kyu;Jang, Young-Beom
    • Journal of the Institute of Electronics Engineers of Korea TC
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    • v.48 no.8
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    • pp.27-35
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    • 2011
  • In this paper, performances of the extended QRD-RLS equalizer is analyzed. Since the extended QRD-RLS equalizer is efficiently implemented by systolic array architecture, we analyze performances of this structure with signals of different lengths. By multiplying the frequency responses of the unknown channel and proposed equalizer, we observed the flatness of the overall system function. Through the simulation, it is shown that the performance of the extended QRD-RLS equalizer is remarkably increased with input signals of length 16.

Type II Optimal Normal Basis Multipliers in GF(2n) (타입 II 최적 정규기저를 갖는 GF(2n)의 곱셈기)

  • Kim, Chang Han;Chang, Nam Su
    • Journal of the Korea Institute of Information Security & Cryptology
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    • v.25 no.5
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    • pp.979-984
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    • 2015
  • In this paper, we proposed a Semi-Systolic multiplier of $GF(2^n)$ with Type II optimal Normal Basis. Comparing the complexity of the proposed multiplier with Chiou's multiplier proposed in 2012, it is saved $2n^2+44n+26$ in total transistor numbers and decrease 4 clocks in time delay. This means that, for $GF(2^{333})$ of the field recommended by NIST for ECDSA, the space complexity is 6.4% less and the time complexity of the 2% decrease. In addition, this structure has an advantage as applied to Chiou's method of concurrent error detection and correction in multiplication of $GF(2^n)$.

Optimized and Portable FPGA-Based Systolic Cell Architecture for Smith-Waterman-Based DNA Sequence Alignment

  • Shah, Hurmat Ali;Hasan, Laiq;Koo, Insoo
    • Journal of information and communication convergence engineering
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    • v.14 no.1
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    • pp.26-34
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    • 2016
  • The alignment of DNA sequences is one of the important processes in the field of bioinformatics. The Smith-Waterman algorithm (SWA) performs optimally for aligning sequences but is computationally expensive. Field programmable gate array (FPGA) performs the best on parameters such as cost, speed-up, and ease of re-configurability to implement SWA. The performance of FPGA-based SWA is dependent on efficient cell-basic implementation-unit design. In this paper, we present an optimized systolic cell design while avoiding oversimplification, very large-scale integration (VLSI)-level design, and direct mapping of iterative equations such as previous cell designs. The proposed design makes efficient use of hardware resources and provides portability as the proposed design is not based on gate-level details. Our cell design implementing a linear gap penalty resulted in a performance improvement of 32× over a GPP platform and surpassed the hardware utilization of another implementation by a factor of 4.23.

Relationship between the Changes of Catecholamines and Blood Pressure Induced by Exposure to Low- and High-levels of Lead in Rats

  • Yoon, Suh-Young;Yoo, Kyeong-Seok;Cheong, Jae-Hoon
    • Biomolecules & Therapeutics
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    • v.7 no.4
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    • pp.322-328
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    • 1999
  • In this study, it was tested whether the changes of catecholamines and its metabolites are related with the changes of blood pressure(BP) induced by different levels of lead exposure. Adult male SD rats were exposed to lead by giving drinking water containing 50(low doses), 200 and 1,000 ppm(high doses) of lead(as lead acetate) or sodium acetate(for control groups, supplying an identical amount of acetate) for 7 or 16 weeks. The systolic BP was measured in the unanesthetized state by the tail-cuff technique. Levels of catecholamines and its metabolites in urine were measured by HPLC-ECD. Rats receiving 200 and 1,000 ppm developed an elevation of systolic BP at 3 and 7 weeks compared with week 0, but blood pressure levels at 16 weeks returned to normal. For the 50 ppm lead treated group, systolic BP increased significantly at 7 weeks and 16 weeks. The concentrations of norepinephrine and VMA in the urine of lead exposed rats changed similarly to the changes of blood pressure, but blood viscosity levels in all lead treated rats increased continuously during all lead treatment periods. This result suggests that the changes of catecholamines and its metabolites in urine by lead intoxication may influence the changes of blood pressure.

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The Relationship of Renin Activity, Hormonal Na, Ca and Habitual Na, Ca Intake in Hypertension (정상생활을 하는 고혈압 환자에서 Renin활성도의 차이와 Na, Ca 조절호르몬 및 Na, Ca 섭취습관과의 관련성)

  • 박정아
    • Journal of Nutrition and Health
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    • v.32 no.6
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    • pp.671-680
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    • 1999
  • In order to investigate the relationship between plasma renin activity and metabolism of Ca and Na in blood pressure, the habitual dietary intakes of Na and Ca urinary excretion of Ca, Na and K, and plasma level of renin activity, aldosterone, and indices of Ca metabolism were measured in 27 untreated hypertensive women and 30 age-matched normal women on a free diet. Hypertensive subjects were classified into high renin hypertensive (HH), medium renin hypertensive(HM) and low renin showed no significant difference among normotensive, LH, MH and HM groups. It appeared that 25-(OH) Vit D3 level of HH group was significantly higher than LH group(p<0.05). There was significant difference in habitual intake of Ca between normotensive and LH groups. However, habitual intake of Na showed no significant difference among normotensive, LH, MH and HH group. Positive correlation of systolic and diastolic blood pressure with PTH(r=0.324, r=0.375) and urinary Ca(r=0.496, r=0.278) and a negative correlation of systolic blood pressure with habitual Ca intake(r=-0.371) existed(p<0.05). A relative magnitude of factors affecting hypertension was analyzed by multiple regression analysis. Overall results about relative influence of independent variables to dependent variable (systolic blood pressure) indicated that urinary Ca was the higher correlation in all subjects(p<0.0001), followed by age and aldosterone. PTH showed a significant correlation for relative influence on diastolic blood pressure in all subjects. The above results indicated that renin-aldosterone system and Ca regulating hormone had a mutual relationship in hypertension.

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Prediction of Pumping Efficacy of Left Ventricular Assist Device according to the Severity of Heart Failure: Simulation Study (심실의 부하감소 측면에서 좌심실 보조장치의 최적 치료시기 예측을 위한 시뮬레이션 연구)

  • Kim, Eun-Hye;Lim, Ki Moo
    • Journal of the Korean Society of Manufacturing Process Engineers
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    • v.12 no.4
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    • pp.22-28
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    • 2013
  • It is important to begin left ventricular assist device (LVAD) treatment at appropriate time for heart failure patients who expect cardiac recovery after the therapy. In order to predict the optimal timing of LVAD implantation, we predicted pumping efficacy of LVAD according to the severity of heart failure theoretically. We used LVAD-implanted cardiovascular system model which consist of 8 Windkessel compartments for the simulation study. The time-varying compliance theory was used to simulate ventricular pumping function in the model. The ventricular systolic dysfunction was implemented by increasing the end-systolic ventricular compliance. Using the mathematical model, we predicted cardiac responses such as left ventricular peak pressure, cardiac output, ejection fraction, and stroke work according to the severity of ventricular systolic dysfunction under the treatments of continuous and pulsatile LVAD. Left ventricular peak pressure, which indicates the ventricular loading condition, decreased maximally at the 1st level heart-failure under pulsatile LVAD therapy and 2nd level heart-failure under continuous LVAD therapy. We conclude that optimal timing for pulsatile LVAD treatment is 1st level heart-failure and for continuous LVAD treatment is 2nd level heart-failure when considering LVAD treatment as "bridge to recovery".