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Jun MH, Ku B, Kim K, Lee KH, Kim JU. A screening method for mild cognitive impairment in elderly individuals combining bioimpedance and MMSE. Front Aging Neurosci 2024; 16:1307204. [PMID: 38327500 PMCID: PMC10847325 DOI: 10.3389/fnagi.2024.1307204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 01/08/2024] [Indexed: 02/09/2024] Open
Abstract
We investigated a screening method for mild cognitive impairment (MCI) that combined bioimpedance features and the Korean Mini-Mental State Examination (K-MMSE) score. Data were collected from 539 subjects aged 60 years or older at the Gwangju Alzheimer's & Related Dementias (GARD) Cohort Research Center, A total of 470 participants were used for the analysis, including 318 normal controls and 152 MCI participants. We measured bioimpedance, K-MMSE, and the Seoul Neuropsychological Screening Battery (SNSB-II). We developed a multiple linear regression model to predict MCI by combining bioimpedance variables and K-MMSE total score and compared the model's accuracy with SNSB-II domain scores by the area under the receiver operating characteristic curve (AUROC). We additionally compared the model performance with several machine learning models such as extreme gradient boosting, random forest, support vector machine, and elastic net. To test the model performances, the dataset was divided into a training set (70%) and a test set (30%). The AUROC values of SNSB-II scores were 0.803 in both sexes, 0.840 for males, and 0.770 for females. In the combined model, the AUROC values were 0.790 (0.773) for males (and females), which were significantly higher than those from the model including MMSE scores alone (0.723 for males and 0.622 for females) or bioimpedance variables alone (0.640 for males and 0.615 for females). Furthermore, the accuracies of the combined model were comparable to those of machine learning models. The bioimpedance-MMSE combined model effectively distinguished the MCI participants and suggests a technique for rapid and improved screening of the elderly population at risk of cognitive impairment.
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Affiliation(s)
- Min-Ho Jun
- Digital Health Research Division, Korea Institute of Oriental Medicine (KIOM), Daejeon, Republic of Korea
| | - Boncho Ku
- Digital Health Research Division, Korea Institute of Oriental Medicine (KIOM), Daejeon, Republic of Korea
- School of Korean Convergence Medical Science, University of Science and Technology, Daejeon, Republic of Korea
| | - Kahye Kim
- Digital Health Research Division, Korea Institute of Oriental Medicine (KIOM), Daejeon, Republic of Korea
| | - Kun Ho Lee
- Gwangju Alzheimer’s Disease and Related Dementias (GARD) Cohort Research Center, Chosun University, Gwangju, Republic of Korea
- Department of Biomedical Science, Chosun University, Gwangju, Republic of Korea
- Dementia Research Group, Korea Brain Research Institute, Daegu, Republic of Korea
| | - Jaeuk U. Kim
- Digital Health Research Division, Korea Institute of Oriental Medicine (KIOM), Daejeon, Republic of Korea
- School of Korean Convergence Medical Science, University of Science and Technology, Daejeon, Republic of Korea
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Doan DNT, Kim K, Ku B, Lee KH, Kim JU. Reduced body cell mass and functions in lower extremities are associated with mild cognitive impairment and Alzheimer's dementia. Sci Rep 2023; 13:13389. [PMID: 37591966 PMCID: PMC10435546 DOI: 10.1038/s41598-023-39110-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 07/20/2023] [Indexed: 08/19/2023] Open
Abstract
This study examined the alterations of segmental body composition in individuals with Alzheimer's pathology (AD), including mild cognitive impairment (MCI) and dementia. A multifrequency bioimpedance analysis (BIA) was used to provide segmental water and impedance variables from 365 cognitively normal (CN), 123 MCI due to AD, and 30 AD dementia participants. We compared the BIA variables between the three groups, examined their correlations with neuropsychological screening test scores, and illustrate their 95% confidence RXc graphs. AD dementia participants were older, more depressive, and had worse cognitive abilities than MCI due to AD and CN participants. Although the BIA variables showed weak partial correlations with the cognitive test scores, we found patterns of an increasing water content in lean mass, increasing extra to intracellular water ratio, and decreasing reactance and phase angle in the lower extremities with effect sizes ranging from 0.26 to 0.51 in the groups of MCI and dementia due to AD compared with CN individuals. The RXc graphs upheld the findings with a significant displacement downward and toward the right, dominantly in the lower extremities. Individuals with AD pathology exhibit a reduced body cell mass or cell strength, an abnormal cellular water distribution, and an overhydration status in lean mass, especially in the lower extremities.
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Affiliation(s)
- Dieu Ni Thi Doan
- Digital Health Research Division, Korea Institute of Oriental Medicine, Daejeon, South Korea
- School of Korean Convergence Medical Science, University of Science and Technology, Daejeon, South Korea
| | - Kahye Kim
- Digital Health Research Division, Korea Institute of Oriental Medicine, Daejeon, South Korea
| | - Boncho Ku
- Digital Health Research Division, Korea Institute of Oriental Medicine, Daejeon, South Korea
| | - Kun Ho Lee
- Gwangju Alzheimer's Disease and Related Dementias (GARD) Cohort Research Center, Chosun University, Gwangju, South Korea
- Department of Biomedical Science, Chosun University, Gwangju, South Korea
- Dementia Research Group, Korea Brain Research Institute, Daegu, South Korea
| | - Jaeuk U Kim
- Digital Health Research Division, Korea Institute of Oriental Medicine, Daejeon, South Korea.
- School of Korean Convergence Medical Science, University of Science and Technology, Daejeon, South Korea.
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Opwonya J, Ku B, Kim K, Lee KH, Il Kim J, Kim JU. Saccadic eye movement variables as biomarkers for cognitive decline in elderly individuals. Annu Int Conf IEEE Eng Med Biol Soc 2023; 2023:1-4. [PMID: 38083172 DOI: 10.1109/embc40787.2023.10340128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
Alzheimer's disease (AD) is the leading cause of Dementia, and mild cognitive impairment (MCI) is often considered a precursor to the development of AD dementia and other types of Dementia. Biomarkers such as amyloid beta are specific and sensitive in identifying AD and can identify individuals who have biological evidence of the disease but have no symptoms, but clinicians and researchers may not easily use them on a large scale. Ocular biomarkers, such as those obtained through eye tracking (ET) technology, have the potential as a diagnostic tool due to their accuracy, affordability, and ease of use. In this study, we show that eye movement (EM) metrics from an interleaved Pro/Anti-saccade (PS/AS) ET task can differentiate between cognitively normal (CN) and MCI subjects and that the presence of Aβ brain deposits, a biomarker of AD, significantly affects performance on these tasks. Individuals with Aβ deposits (Aβ+) performed worse than those without (Aβ-). Our findings suggest that eye-tracking measurements may be a valuable tool for detecting amyloid brain pathology and monitoring changes in cognitive function in CN and MCI individuals over time.Clinical Relevance- The PS/AS paradigm, which measures saccadic eye movements, can accurately detect subtle cognitive impairments and changes in the brain associated with Alzheimer's disease in CN and MCI individuals. This makes it a valuable tool for identifying individuals at risk for cognitive decline and tracking changes in cognitive function over time.
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Opwonya J, Ku B, Lee KH, Kim JI, Kim JU. Eye movement changes as an indicator of mild cognitive impairment. Front Neurosci 2023; 17:1171417. [PMID: 37397453 PMCID: PMC10307957 DOI: 10.3389/fnins.2023.1171417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 05/23/2023] [Indexed: 07/04/2023] Open
Abstract
Background Early identification of patients at risk of dementia, alongside timely medical intervention, can prevent disease progression. Despite their potential clinical utility, the application of diagnostic tools, such as neuropsychological assessments and neuroimaging biomarkers, is hindered by their high cost and time-consuming administration, rendering them impractical for widespread implementation in the general population. We aimed to develop non-invasive and cost-effective classification models for predicting mild cognitive impairment (MCI) using eye movement (EM) data. Methods We collected eye-tracking (ET) data from 594 subjects, 428 cognitively normal controls, and 166 patients with MCI while they performed prosaccade/antisaccade and go/no-go tasks. Logistic regression (LR) was used to calculate the EM metrics' odds ratios (ORs). We then used machine learning models to construct classification models using EM metrics, demographic characteristics, and brief cognitive screening test scores. Model performance was evaluated based on the area under the receiver operating characteristic curve (AUROC). Results LR models revealed that several EM metrics are significantly associated with increased odds of MCI, with odds ratios ranging from 1.213 to 1.621. The AUROC scores for models utilizing demographic information and either EM metrics or MMSE were 0.752 and 0.767, respectively. Combining all features, including demographic, MMSE, and EM, notably resulted in the best-performing model, which achieved an AUROC of 0.840. Conclusion Changes in EM metrics linked with MCI are associated with attentional and executive function deficits. EM metrics combined with demographics and cognitive test scores enhance MCI prediction, making it a non-invasive, cost-effective method to identify early stages of cognitive decline.
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Affiliation(s)
- Julius Opwonya
- Digital Health Research Division, Korea Institute of Oriental Medicine, Daejeon, South Korea
- KM Convergence Science, University of Science and Technology, Daejeon, South Korea
| | - Boncho Ku
- Digital Health Research Division, Korea Institute of Oriental Medicine, Daejeon, South Korea
| | - Kun Ho Lee
- Gwangju Alzheimer’s Disease and Related Dementias (GARD) Cohort Research Center, Chosun University, Gwangju, South Korea
- Department of Biomedical Science, Chosun University, Gwangju, South Korea
- Dementia Research Group, Korea Brain Research Institute, Daegu, South Korea
| | - Joong Il Kim
- Digital Health Research Division, Korea Institute of Oriental Medicine, Daejeon, South Korea
| | - Jaeuk U. Kim
- Digital Health Research Division, Korea Institute of Oriental Medicine, Daejeon, South Korea
- KM Convergence Science, University of Science and Technology, Daejeon, South Korea
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Kim S, Yang M, Ku B, Cha E, Seo W, Son I, Kang H, Kim D, Song B, Yang CS, Kim S. Efficacy of mecasin for treatment of amyotrophic lateral sclerosis: A phase IIa multicenter randomized double-blinded placebo-controlled trial. J Ethnopharmacol 2023:116670. [PMID: 37257710 DOI: 10.1016/j.jep.2023.116670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Revised: 02/02/2023] [Accepted: 05/20/2023] [Indexed: 06/02/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Amyotrophic lateral sclerosis (ALS) is a lethal neurodegenerative disorder characterized by progressive paralysis of voluntary muscles. Mecasin, the extract of modified jakyakgamchobuja-tang-a herbal preparation comprising of Radix Paeoniae Alba, Radix Glycyrrhizae, Radix Aconiti Lateralis Preparata, Radix Salviae Miltiorrhizae, Rhizoma Gastrodiae, Radix Polygalae, Curcuma Root, Fructus Chaenomelis, and Rhizoma Atractylodis Japonicae-shows neuroprotective and anti-neuroinflammatory effects and alleviates the symptoms in patients with ALS. AIM OF THE STUDY This trial aimed to evaluate the efficacy and safety of mecasin in these patients. MATERIAL AND METHODS Patients were randomized to receive mecasin 1.6 g daily, mecasin 2.4 g daily, or placebo for 12 weeks. The primary endpoint was the Korean version of ALS Functional Rating Scale-Revised (K-ALSFRS-R) score. The secondary endpoints were muscular atrophy measurements, pulmonary function test results, creatine kinase levels, body weight, safety, and scores of the Medical Research Council (MRC) scale for muscle strength; Visual Analog Scale for pain (VAS pain); Hamilton Rating Scale for Depression; and Fatigue Severity Scale. RESULTS Among the 30 patients randomized, 24 completed the follow-up. Significant between-group differences were detected in the primary endpoint using the omnibus F-test. The changes in the K-ALSFRS-R score between 12 weeks and baseline were -0·25, -1·32, and -2·78 in the mecasin 1.6 g, mecasin 2.4 g, and placebo groups, respectively. The difference in the K-ALSFRS-R score between the mecasin 1.6 g and placebo groups was 2·53 points (95% confidence interval [CI]: 0·61-4·45), and that between the 2.4 g and placebo groups was 1·46 points (95% CI: 0·48-3·40). However, no significant differences were detected in the secondary endpoints (MRC: dyspnea, p = 0·139; VAS pain, p = 0·916; forced vital capacity, p = 0·373). The incidence of adverse events was similar and low in all groups. CONCLUSIONS Mecasin may retard symptomatic progression without major adverse effects. A phase IIb study to evaluate its long-term effects in ALS is ongoing.
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Affiliation(s)
- Sungha Kim
- Clinical Research Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Muhack Yang
- Center of ALS/MND, Wonkwang University Gwangju Medical Hospital, Gwangju, Republic of Korea
| | - Boncho Ku
- Clinical Research Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Eunhye Cha
- Center of ALS/MND, Wonkwang University Gwangju Medical Hospital, Gwangju, Republic of Korea
| | - Wookcheol Seo
- Center of ALS/MND, Wonkwang University Gwangju Medical Hospital, Gwangju, Republic of Korea
| | - Ilhong Son
- Department of Neurology, Wonkwang University Sanbon Hospital, Gyunggi-do, Republic of Korea
| | - Hyungwon Kang
- Department of Korean Neuropsychiatry Medicine, Wonkwang University, Jeollabuk-do, Republic of Korea
| | - Dongwoung Kim
- Clinical Research Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Bongkeun Song
- Department of Internal Medicine, Wonkwang University Gwangju Medical Hospital, Gwangju, 61729, Republic of Korea
| | - Chang-Sop Yang
- Clinical Research Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Sungchul Kim
- Center of ALS/MND, Wonkwang University Gwangju Medical Hospital, Gwangju, Republic of Korea.
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Jang JS, Kim JI, Ku B, Lee JH. Reliability Analysis of Vertebral Landmark Labelling on Lumbar Spine X-ray Images. Diagnostics (Basel) 2023; 13:diagnostics13081411. [PMID: 37189512 DOI: 10.3390/diagnostics13081411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 03/28/2023] [Accepted: 04/12/2023] [Indexed: 05/17/2023] Open
Abstract
Vertebral landmark labelling on X-ray images is important for objective and quantitative diagnosis. Most studies related to the reliability of labelling focus on the Cobb angle, and it is difficult to find studies describing landmark point locations. Since points are the most fundamental geometric feature that can generate lines and angles, the assessment of landmark point locations is essential. The aim of this study is to provide a reliability analysis of landmark points and vertebral endplate lines with a large number of lumbar spine X-ray images. A total of 1000 pairs of anteroposterior and lateral view lumbar spine images were prepared, and 12 manual medicine experts participated in the labelling process as raters. A standard operating procedure (SOP) was proposed by consensus of the raters based on manual medicine and provided guidelines for reducing sources of error in landmark labelling. High intraclass correlation coefficients ranging from 0.934 to 0.991 verified the reliability of the labelling process using the proposed SOP. We also presented means and standard deviations of measurement errors, which could be a valuable reference for evaluating both automated landmark detection algorithms and manual labelling by experts.
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Affiliation(s)
- Jun-Su Jang
- Digital Health Research Division, Korea Institute of Oriental Medicine, 1672 Yuseong-daero, Yuseong-gu, Daejeon 34054, Republic of Korea
| | - Joong Il Kim
- Digital Health Research Division, Korea Institute of Oriental Medicine, 1672 Yuseong-daero, Yuseong-gu, Daejeon 34054, Republic of Korea
| | - Boncho Ku
- Digital Health Research Division, Korea Institute of Oriental Medicine, 1672 Yuseong-daero, Yuseong-gu, Daejeon 34054, Republic of Korea
| | - Jin-Hyun Lee
- Institute for Integrative Medicine, Catholic Kwandong University International St. Mary's Hospital, 25 Simgok-ro 100 beon-gil, Seo-gu, Incheon 22711, Republic of Korea
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Choi J, Ku B, Doan DNT, Park J, Cha W, Kim JU, Lee KH. Prefrontal EEG slowing, synchronization, and ERP peak latency in association with predementia stages of Alzheimer's disease. Front Aging Neurosci 2023; 15:1131857. [PMID: 37032818 PMCID: PMC10076640 DOI: 10.3389/fnagi.2023.1131857] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Accepted: 03/06/2023] [Indexed: 04/11/2023] Open
Abstract
Background Early screening of elderly individuals who are at risk of dementia allows timely medical interventions to prevent disease progression. The portable and low-cost electroencephalography (EEG) technique has the potential to serve it. Objective We examined prefrontal EEG and event-related potential (ERP) variables in association with the predementia stages of Alzheimer's disease (AD). Methods One hundred elderly individuals were recruited from the GARD cohort. The participants were classified into four groups according to their amyloid beta deposition (A+ or A-) and neurodegeneration status (N+ or N-): cognitively normal (CN; A-N-, n = 27), asymptomatic AD (aAD; A + N-, n = 15), mild cognitive impairment (MCI) with AD pathology (pAD; A+N+, n = 16), and MCI with non-AD pathology (MCI(-); A-N+, n = 42). Prefrontal resting-state eyes-closed EEG measurements were recorded for five minutes and auditory ERP measurements were recorded for 8 min. Three variables of median frequency (MDF), spectrum triangular index (STI), and positive-peak latency (PPL) were employed to reflect EEG slowing, temporal synchrony, and ERP latency, respectively. Results Decreasing prefrontal MDF and increasing PPL were observed in the MCI with AD pathology. Interestingly, after controlling for age, sex, and education, we found a significant negative association between MDF and the aAD and pAD stages with an odds ratio (OR) of 0.58. Similarly, PPL exhibited a significant positive association with these AD stages with an OR of 2.36. Additionally, compared with the MCI(-) group, significant negative associations were demonstrated by the aAD group with STI and those in the pAD group with MDF with ORs of 0.30 and 0.42, respectively. Conclusion Slow intrinsic EEG oscillation is associated with MCI due to AD, and a delayed ERP peak latency is likely associated with general cognitive impairment. MCI individuals without AD pathology exhibited better cortical temporal synchronization and faster EEG oscillations than those with aAD or pAD. Significance The EEG/ERP variables obtained from prefrontal EEG techniques are associated with early cognitive impairment due to AD and non-AD pathology. This result suggests that prefrontal EEG/ERP metrics may serve as useful indicators to screen elderly individuals' early stages on the AD continuum as well as overall cognitive impairment.
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Affiliation(s)
- Jungmi Choi
- Human Anti-Aging Standards Research Institute, Uiryeong-gun, Republic of Korea
| | - Boncho Ku
- Digital Health Research Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Dieu Ni Thi Doan
- Digital Health Research Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
- School of Korean Convergence Medical Science, University of Science and Technology, Daejeon, Republic of Korea
| | - Junwoo Park
- Gwangju Alzheimer’s Disease and Related Dementias Cohort Research Center, Chosun University, Gwangju, Republic of Korea
| | - Wonseok Cha
- Human Anti-Aging Standards Research Institute, Uiryeong-gun, Republic of Korea
| | - Jaeuk U. Kim
- Digital Health Research Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
- School of Korean Convergence Medical Science, University of Science and Technology, Daejeon, Republic of Korea
- *Correspondence: Jaeuk U. Kim,
| | - Kun Ho Lee
- Gwangju Alzheimer’s Disease and Related Dementias Cohort Research Center, Chosun University, Gwangju, Republic of Korea
- Department of Biomedical Science, Chosun University, Gwangju, Republic of Korea
- Dementia Research Group, Korea Brain Research Institute, Daegu, Republic of Korea
- Kun Ho Lee,
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Doan DNT, Ku B, Kim K, Jun M, Choi KY, Lee KH, Kim JU. Corrigendum: Segmental bioimpedance variables in association with mild cognitive impairment. Front Nutr 2022; 9:1006423. [PMID: 36185643 PMCID: PMC9518655 DOI: 10.3389/fnut.2022.1006423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 08/31/2022] [Indexed: 11/13/2022] Open
Affiliation(s)
- Dieu Ni Thi Doan
- Department of Digital Health Research, Korea Institute of Oriental Medicine, Daejeon, South Korea
- Korean Convergence Medicine, University of Science and Technology, Daejeon, South Korea
| | - Boncho Ku
- Department of Digital Health Research, Korea Institute of Oriental Medicine, Daejeon, South Korea
| | - Kahye Kim
- Department of Digital Health Research, Korea Institute of Oriental Medicine, Daejeon, South Korea
| | - Minho Jun
- Department of Digital Health Research, Korea Institute of Oriental Medicine, Daejeon, South Korea
| | - Kyu Yeong Choi
- Gwangju Alzheimer's Disease and Related Dementias (GARD) Cohort Research Center, Chosun University, Gwangju, South Korea
| | - Kun Ho Lee
- Gwangju Alzheimer's Disease and Related Dementias (GARD) Cohort Research Center, Chosun University, Gwangju, South Korea
- Department of Biomedical Science, Chosun University, Gwangju, South Korea
- Dementia Research Group, Korea Brain Research Institute, Daegu, South Korea
| | - Jaeuk U. Kim
- Department of Digital Health Research, Korea Institute of Oriental Medicine, Daejeon, South Korea
- Korean Convergence Medicine, University of Science and Technology, Daejeon, South Korea
- *Correspondence: Jaeuk U. Kim
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Doan DNT, Ku B, Kim K, Jun M, Choi KY, Lee KH, Kim JU. Segmental Bioimpedance Variables in Association With Mild Cognitive Impairment. Front Nutr 2022; 9:873623. [PMID: 35719147 PMCID: PMC9201435 DOI: 10.3389/fnut.2022.873623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 05/04/2022] [Indexed: 11/23/2022] Open
Abstract
Objective To examine the changes in body composition, water compartment, and bioimpedance in mild cognitive impairment (MCI) individuals. Methods We obtained seven whole-body composition variables and seven pairs of segmental body composition, water compartment, and impedance variables for the upper and lower extremities from the segmental multi-frequency bioelectrical impedance analysis (BIA) of 939 elderly participants, including 673 cognitively normal (CN) people and 266 individuals with MCI. Participants’ characteristics, anthropometric information, and the selected BIA variables were described and statistically compared between the CN participants and those with MCI. The correlations between the selected BIA variables and neuropsychological tests such as the Korean version of the Mini-Mental State Examination and Seoul Neuropsychological Screening Battery – Second Edition were also examined before and after controlling for age and sex. Univariate and multivariate logistic regression analyses with estimated odds ratios (ORs) were conducted to investigate the associations between these BIA variables and MCI prevalence for different sexes. Results Participants with MCI were slightly older, more depressive, and had significantly poorer cognitive abilities when compared with the CN individuals. The partial correlations between the selected BIA variables and neuropsychological tests upon controlling for age and sex were not greatly significant. However, after accounting for age, sex, and the significant comorbidities, segmental lean mass, water volume, resistance, and reactance in the lower extremities were positively associated with MCI, with ORs [95% confidence interval (CI)] of 1.33 (1.02–1.71), 1.33 (1.03–1.72), 0.76 (0.62–0.92), and 0.79 (0.67–0.93), respectively; with presumably a shift of water from the intracellular area to extracellular space. After stratifying by sex, resistance and reactance in lower extremities remained significant only in the women group. Conclusion An increase in segmental water along with segmental lean mass and a decrease in body cell strength due to an abnormal cellular water distribution demonstrated by reductions in resistance and reactance are associated with MCI prevalence, which are more pronounced in the lower extremities and in women. These characteristic changes in BIA variables may be considered as an early sign of cognitive impairment in the elderly population.
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Affiliation(s)
- Dieu Ni Thi Doan
- Department of Digital Health Research, Korea Institute of Oriental Medicine, Daejeon, South Korea
- Korean Convergence Medicine, University of Science and Technology, Daejeon, South Korea
| | - Boncho Ku
- Department of Digital Health Research, Korea Institute of Oriental Medicine, Daejeon, South Korea
| | - Kahye Kim
- Department of Digital Health Research, Korea Institute of Oriental Medicine, Daejeon, South Korea
| | - Minho Jun
- Department of Digital Health Research, Korea Institute of Oriental Medicine, Daejeon, South Korea
| | - Kyu Yeong Choi
- Gwangju Alzheimer’s Disease and Related Dementias (GARD) Cohort Research Center, Chosun University, Gwangju, South Korea
| | - Kun Ho Lee
- Gwangju Alzheimer’s Disease and Related Dementias (GARD) Cohort Research Center, Chosun University, Gwangju, South Korea
- Department of Biomedical Science, Chosun University, Gwangju, South Korea
- Dementia Research Group, Korea Brain Research Institute, Daegu, South Korea
| | - Jaeuk U. Kim
- Department of Digital Health Research, Korea Institute of Oriental Medicine, Daejeon, South Korea
- Korean Convergence Medicine, University of Science and Technology, Daejeon, South Korea
- *Correspondence: Jaeuk U. Kim,
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Ku B, Addington J, Bearden C, Cadenhead K, Cannon T, Compton M, Cornblatt B, Druss B, Keshavan M, Mathalon D, Mcglashan T, Perkins D, Seidman L, Stone W, Tsuang M, Woods S, Walker E. The association between area-level residential instability and gray matter volume changes. Eur Psychiatry 2022. [PMCID: PMC9567589 DOI: 10.1192/j.eurpsy.2022.2033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction Area-level residential instability (ARI), an index of social fragmentation, has been shown to explain the association between urbanicity and psychosis. Urban upbringing has been shown to be associated with decreased gray matter volumes (GMV)s of brain regions corresponding to the right caudal middle frontal gyrus (CMFG) and rostral anterior cingulate cortex (rACC). Objectives We hypothesize that greater ARI will be associated with reduced right posterior CMFG and rACC GMVs. Methods Data were collected at baseline as part of the North American Prodrome Longitudinal Study. Counties where participants resided during childhood were geographically coded using the US Censuses to area-level factors. ARI was defined as the percentage of residents living in a different house five years ago. Generalized linear mixed models tested associations between ARI and GMVs. Results This study included 29 HC and 64 CHR-P individuals who were aged 12 to 24 years, had remained in their baseline residential area, and had magnetic resonance imaging scans. ARI was associated with reduced right CMFG (adjusted β = -0.258; 95% CI = -0.502 – -0.015) and right rACC volumes (adjusted β = -0.318; 95% CI = -0.612 – -0.023). The interaction terms (ARI X diagnostic group) in the prediction of both brain regions were not significant, indicating that the relationships between ARI and regional brain volumes held for both CHR-P and HCs. Conclusions Like urban upbringing, ARI may be an important social environmental characteristic that adversely impacts brain regions related to schizophrenia. Disclosure No significant relationships.
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Opwonya J, Doan DNT, Kim SG, Kim JI, Ku B, Kim S, Park S, Kim JU. Saccadic Eye Movement in Mild Cognitive Impairment and Alzheimer's Disease: A Systematic Review and Meta-Analysis. Neuropsychol Rev 2021; 32:193-227. [PMID: 33959887 PMCID: PMC9090874 DOI: 10.1007/s11065-021-09495-3] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Accepted: 03/01/2021] [Indexed: 11/30/2022]
Abstract
Alzheimer’s disease (AD) is the leading cause of dementia, and mild cognitive impairment (MCI) is considered the transitional state to AD dementia (ADD) and other types of dementia, whose symptoms are accompanied by altered eye movement. In this work, we reviewed the existing literature and conducted a meta-analysis to extract relevant eye movement parameters that are significantly altered owing to ADD and MCI. We conducted a systematic review of 35 eligible original publications in saccade paradigms and a meta-analysis of 27 articles with specified task conditions, which used mainly gap and overlap conditions in both prosaccade and antisaccade paradigms. The meta-analysis revealed that prosaccade and antisaccade latencies and frequency of antisaccade errors showed significant alterations for both MCI and ADD. First, both prosaccade and antisaccade paradigms differentiated patients with ADD and MCI from controls, however, antisaccade paradigms was more effective than prosaccade paradigms in distinguishing patients from controls. Second, during prosaccade in the gap and overlap conditions, patients with ADD had significantly longer latencies than patients with MCI, and the trend was similar during antisaccade in the gap condition as patients with ADD had significantly more errors than patients with MCI. The anti-effect magnitude was similar between controls and patients, and the magnitude of the latency of the gap effect varied among healthy controls and MCI and ADD subjects, but the effect size of the latency remained large in both patients. These findings suggest that, using gap effect, anti-effect, and specific choices of saccade paradigms and conditions, distinctions could be made between MCI and ADD patients as well as between patients and controls.
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Affiliation(s)
- Julius Opwonya
- Future Medicine Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
- Korean Convergence Medicine, University of Science and Technology, Daejeon, Republic of Korea
| | - Dieu Ni Thi Doan
- Future Medicine Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
- Korean Convergence Medicine, University of Science and Technology, Daejeon, Republic of Korea
| | - Seul Gee Kim
- Future Medicine Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Joong Il Kim
- Future Medicine Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Boncho Ku
- Future Medicine Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Soochan Kim
- Department of Electrical and Electronic Engineering, Hankyong National University, Anseong, Republic of Korea
| | - Sunju Park
- Department of Preventive Medicine, College of Korean Medicine, Daejeon University, Daejeon, Republic of Korea.
| | - Jaeuk U Kim
- Future Medicine Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea.
- Korean Convergence Medicine, University of Science and Technology, Daejeon, Republic of Korea.
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12
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Jun M, Ku B, Kim J, Kim KH, Kim JU. Mediation effect of the duration of diabetes mellitus on the decrease in bioimpedance phase angles in ethnically Korean people: A multicenter clinical study. J Diabetes Investig 2021; 12:790-802. [PMID: 32902171 PMCID: PMC8089017 DOI: 10.1111/jdi.13399] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 08/05/2020] [Accepted: 09/01/2020] [Indexed: 12/14/2022] Open
Abstract
AIMS/INTRODUCTION We carried out a multicenter clinical study to investigate whether the decrease in segmental phase angles (PhA values) observed using bioelectrical impedance is useful in screening for diabetes mellitus and monitoring disease progression. MATERIALS AND METHODS The segmental PhA values of the four limbs were acquired using multifrequency bioimpedance at 5, 50 and 250 kHz in three clinics. Differences in PhA values between the diabetes and control groups were analyzed using the two-sample t-test and analysis of variance (anova). Changes in PhA values with increasing durations of diabetes were analyzed using a moderated mediation model and multivariate linear regression analysis. We recruited 217 participants aged ≥40 years (diabetes 158, controls 59, men 106, women 111, A-clinic 71, B-clinic 70 and C-clinic 76). RESULTS PhA values at 50 kHz were significantly decreased in people with diabetes (PhA of the right arm in men: t-value -4.0, P < 0.001; PhA of the right leg in women: t-value -4.6 P < 0.001), and the difference was partially attributable to the duration of diabetes, as well as aging. Specifically, the mediation effect of the duration of diabetes on the decrease in PhA values was 29.8% in the left arm of men, 53.3% in the right arm of women, and 36.3% in the left arm of both sexes. CONCLUSIONS Phase angle values at 50 kHz decreased in people with diabetes, and the changes were exacerbated as the disease duration increased. Thus, bioimpedance PhA values represent a non-invasive tool for monitoring the progression of diabetes mellitus.
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Affiliation(s)
- Min‐Ho Jun
- Korea Institute of Oriental Medicine (KIOM)DeajeonKorea
| | - Boncho Ku
- Korea Institute of Oriental Medicine (KIOM)DeajeonKorea
| | - Jihye Kim
- Korea Institute of Oriental Medicine (KIOM)DeajeonKorea
| | - Keun Ho Kim
- Korea Institute of Oriental Medicine (KIOM)DeajeonKorea
- Korean Convergence MedicineUniversity of Science and TechnologyDeajeonKorea
| | - Jaeuk U Kim
- Korea Institute of Oriental Medicine (KIOM)DeajeonKorea
- Korean Convergence MedicineUniversity of Science and TechnologyDeajeonKorea
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13
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Doan DNT, Ku B, Choi J, Oh M, Kim K, Cha W, Kim JU. Predicting Dementia With Prefrontal Electroencephalography and Event-Related Potential. Front Aging Neurosci 2021; 13:659817. [PMID: 33927610 PMCID: PMC8077968 DOI: 10.3389/fnagi.2021.659817] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 03/19/2021] [Indexed: 11/13/2022] Open
Abstract
Objective: To examine whether prefrontal electroencephalography (EEG) can be used for screening dementia. Methods: We estimated the global cognitive decline using the results of Mini-Mental Status Examination (MMSE), measurements of brain activity from resting-state EEG, responses elicited by auditory stimulation [sensory event-related potential (ERP)], and selective attention tasks (selective-attention ERP) from 122 elderly participants (dementia, 35; control, 87). We investigated that the association between MMSE and each EEG/ERP variable by using Pearson’s correlation coefficient and performing univariate linear regression analysis. Kernel density estimation was used to examine the distribution of each EEG/ERP variable in the dementia and non-dementia groups. Both Univariate and multiple logistic regression analyses with the estimated odds ratios were conducted to assess the associations between the EEG/ERP variables and dementia prevalence. To develop the predictive models, five-fold cross-validation was applied to multiple classification algorithms. Results: Most prefrontal EEG/ERP variables, previously known to be associated with cognitive decline, show correlations with the MMSE score (strongest correlation has |r| = 0.68). Although variables such as the frontal asymmetry of the resting-state EEG are not well correlated with the MMSE score, they indicate risk factors for dementia. The selective-attention ERP and resting-state EEG variables outperform the MMSE scores in dementia prediction (areas under the receiver operating characteristic curve of 0.891, 0.824, and 0.803, respectively). In addition, combining EEG/ERP variables and MMSE scores improves the model predictive performance, whereas adding demographic risk factors do not improve the prediction accuracy. Conclusion: Prefrontal EEG markers outperform MMSE scores in predicting dementia, and additional prediction accuracy is expected when combining them with MMSE scores. Significance: Prefrontal EEG is effective for screening dementia when used independently or in combination with MMSE.
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Affiliation(s)
- Dieu Ni Thi Doan
- Korea Institute of Oriental Medicine, Daejeon, South Korea.,Korean Convergence Medicine, University of Science and Technology, Daejeon, South Korea
| | - Boncho Ku
- Korea Institute of Oriental Medicine, Daejeon, South Korea
| | - Jungmi Choi
- Human Anti-Aging Standards Research Institute, Uiryeong-gun, South Korea
| | - Miae Oh
- Korea Institute for Health and Social Affairs, Sejong, South Korea
| | - Kahye Kim
- Korea Institute of Oriental Medicine, Daejeon, South Korea
| | - Wonseok Cha
- Human Anti-Aging Standards Research Institute, Uiryeong-gun, South Korea
| | - Jaeuk U Kim
- Korea Institute of Oriental Medicine, Daejeon, South Korea.,Korean Convergence Medicine, University of Science and Technology, Daejeon, South Korea
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14
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Seo JW, Kim SG, Kim JI, Ku B, Kim K, Lee S, Kim JU. Principal Characteristics of Affected and Unaffected Side Trunk Movement and Gait Event Parameters during Hemiplegic Stroke Gait with IMU Sensor. Sensors (Basel) 2020; 20:s20247338. [PMID: 33371295 PMCID: PMC7765925 DOI: 10.3390/s20247338] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 12/16/2020] [Accepted: 12/19/2020] [Indexed: 11/16/2022]
Abstract
This study describe the characteristics of hemiplegic stroke gait with principal component analysis (PCA) of trunk movement (TM) and gait event (GE) parameters by the inertial measurement unit (IMU) sensors: (1) Background: This process can determine dominant variables through multivariate examination to identify the affected, unaffected, and healthy lower-limb sides; (2) Methods: The study monitored forty patients with stroke and twenty-eight healthy individuals comprising the control group for comparison. The IMU sensors were attached to each subject while performing a 6 m walking test. Sixteen variables extracted from the measured data were divided into 7 GE and 9 TM variables explaining pelvis tilt, oblique, and rotation. (3) Results: The tilt range variables of the trunk movement on the affected and unaffected sides were lower than those of the healthy side; this showed between-group differences in various GE variables. For the healthy and affected sides, 80% of variances were explained with 2 or 3 PCs involving only a few dominant variables; and (4) Conclusions: The difference between each side leg should be considered during the development of a diagnosis method. This research can be utilized to develop functional assessment tools for personalized treatment and to design appropriate training protocols.
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Affiliation(s)
- Jeong-Woo Seo
- Future medicine division, Korea Institute of Oriental Medicine, Daejeon 34504, Korea; (J.-W.S.); (S.-G.K.); (J.I.K.); (B.K.); (K.K.)
| | - Seul-Gee Kim
- Future medicine division, Korea Institute of Oriental Medicine, Daejeon 34504, Korea; (J.-W.S.); (S.-G.K.); (J.I.K.); (B.K.); (K.K.)
| | - Joong Il Kim
- Future medicine division, Korea Institute of Oriental Medicine, Daejeon 34504, Korea; (J.-W.S.); (S.-G.K.); (J.I.K.); (B.K.); (K.K.)
| | - Boncho Ku
- Future medicine division, Korea Institute of Oriental Medicine, Daejeon 34504, Korea; (J.-W.S.); (S.-G.K.); (J.I.K.); (B.K.); (K.K.)
| | - Kahye Kim
- Future medicine division, Korea Institute of Oriental Medicine, Daejeon 34504, Korea; (J.-W.S.); (S.-G.K.); (J.I.K.); (B.K.); (K.K.)
| | - Sangkwan Lee
- Department of Internal Medicine and Neuroscience, College of Korean Medicine, Wonkwang University, Iksan 54538, Korea;
| | - Jaeuk U. Kim
- Future medicine division, Korea Institute of Oriental Medicine, Daejeon 34504, Korea; (J.-W.S.); (S.-G.K.); (J.I.K.); (B.K.); (K.K.)
- Korean Convergence Medicine, University of Science and Technology, Daejeon 34054, Korea
- Correspondence: ; Tel.: +82-42-868-9558
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15
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Abstract
Abstract
Introduction
Obstructive sleep apnea (OSA) is a condition characterized by repeated episodes of partial or complete obstruction of the respiratory passages during the sleep. Traditional polysomnography (PSG) for OSA estimation is bulky and time-consuming for daily use. Therefore, this study aims to develop a novel photoplethysmography (PPG) and accelerometer based smart watch for OSA detection, in which a high-performance and low-complexity automated OSA detection was embedded for long-term in-home measurement.
Methods
The developed watch measured PPG signals from wrist radial artery and body motion from accelerometer as well. 121 patients (92 males, 29 females) were recruited from the normal community and Center of Sleep, National Taiwan University Hospital, Taiwan in this study. All OSA scoring were analyzed by three registered PSG technologists. The AHI of the cohort was 10.1±18.3 (0 to 82.7). An automated OSA detection algorithm was designed based on machine-learning (ML) technique, in which was iteratively updated according to each 30-second epoch of the collected data. Subsequently, obstructive and hypopnea events were detected according to the OSA detection algorithm.
Results
To better valid the effectiveness, this study focused on the estimation performance of the subjects with AHI>15. Based on hold-out validation, the average sensitivity and precision in the AHI>15 cohort were 77.2% and 58.6%, respectively, with a Cohen’s kappa of 0.46. The interclass correlation between the watch and technologists was 0.81 (95%CI: 0.61-0.91). The result showed that the proposed automated OSA detection could achieve consistent result with technologist during standard sleep testing.
Conclusion
This study developed a wrist-based watch based on ML technique to assess OSA severity. We compared the performance with clinical technologists for the OSA detection. Further, the sensitivity and precision were generally acceptable while subjects were with AHI>15. The proposed wrist-based watch could provide reliable performance for OSA estimation, and may be of a light for future in-home sleep studies.
Support
This study was supported by Mediatek Inc.
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Affiliation(s)
- H Chiu
- Mediatek Inc., Hsinchu city, TAIWAN
| | - P Lee
- Centre of Sleep Disorder, National Taiwan University Hospital, Taipei City, TAIWAN
| | - B Ku
- Mediatek Inc., Hsinchu city, TAIWAN
| | - Y Liu
- Mediatek Inc., Hsinchu city, TAIWAN
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16
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Yi J, Ku B, Kim SG, Khil T, Lim Y, Shin M, Jeon S, Kim J, Kang B, Shin J, Kim K, Jeong AY, Park JH, Choi J, Cha W, Shin C, Shin W, Kim JU. Traditional Korean Medicine-Based Forest Therapy Programs Providing Electrophysiological Benefits for Elderly Individuals. Int J Environ Res Public Health 2019; 16:E4325. [PMID: 31698811 PMCID: PMC6888007 DOI: 10.3390/ijerph16224325] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Revised: 10/25/2019] [Accepted: 10/29/2019] [Indexed: 02/01/2023]
Abstract
We aimed to develop forest therapy programs (FTPs) to prevent dementia and related health problems in the elderly population, with the assumption that health benefits are FTP-type specific and depend on the participant's psychophysiological traits. For this purpose, we developed two distinct FTPs, namely, a guided-breathing meditation program (BP) and a walking program (WP); we adopted the approach of Sasang constitutional (SC) medicine, which categorizes individuals into one of three SC types (SC1, SC2, or SC3) for medical care. The FTPs ran 11 sessions over 11 weeks. We recruited 29/31/28 participants who were 65 years of age or older for the BP/WP/control groups, respectively; obtained electrophysiological measurements via electroencephalogram (EEG), heart rate variability (HRV), and bioimpedance; and analyzed the intervention effects with analysis of covariance. Compared with the control, the BP and WP resulted in benefits for neural activity and parasympathetic nervous activity (PNA), respectively, and both FTPs yielded distinct beneficial effects on bioimpedance. Constitution-specific effects were also present. The SC1- and SC2-type participants gained positive effects in neural activity from the BP and WP, respectively. The SC3-type participants showed improvements in PNA from the WP. In conclusion, for older individuals, both programs conferred health benefits that would help prevent dementia, and the benefits were program-specific and constitution-specific.
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Affiliation(s)
- Jiyune Yi
- Department of Forest Therapy, Graduate School of Chungbuk National University, Chungju, Chungbuk 28644, Korea; (J.Y.); (B.K.)
| | - Boncho Ku
- Korea Institute of Oriental Medicine, Daejeon 34054, Korea
| | - Seul Gee Kim
- Korea Institute of Oriental Medicine, Daejeon 34054, Korea
| | - Taegyu Khil
- Department of Forest Therapy, Graduate School of Chungbuk National University, Chungju, Chungbuk 28644, Korea; (J.Y.); (B.K.)
| | - Youngsuwn Lim
- Department of Forest Therapy, Graduate School of Chungbuk National University, Chungju, Chungbuk 28644, Korea; (J.Y.); (B.K.)
| | - Minja Shin
- Department of Forest Therapy, Graduate School of Chungbuk National University, Chungju, Chungbuk 28644, Korea; (J.Y.); (B.K.)
| | - Sookja Jeon
- Department of Forest Therapy, Graduate School of Chungbuk National University, Chungju, Chungbuk 28644, Korea; (J.Y.); (B.K.)
| | - Jingun Kim
- Department of Forest Therapy, Graduate School of Chungbuk National University, Chungju, Chungbuk 28644, Korea; (J.Y.); (B.K.)
| | - Byunghoon Kang
- Department of Forest Therapy, Graduate School of Chungbuk National University, Chungju, Chungbuk 28644, Korea; (J.Y.); (B.K.)
| | - Jongyeon Shin
- Department of Forest Therapy, Graduate School of Chungbuk National University, Chungju, Chungbuk 28644, Korea; (J.Y.); (B.K.)
| | - Kahye Kim
- Korea Institute of Oriental Medicine, Daejeon 34054, Korea
| | - Ah Young Jeong
- Department of Forest Therapy, Graduate School of Chungbuk National University, Chungju, Chungbuk 28644, Korea; (J.Y.); (B.K.)
| | | | - Jungmi Choi
- Human Anti-Aging Standards Research Institute, Uiryeong, Gyungnam 52151, Korea
| | - Wonseok Cha
- Human Anti-Aging Standards Research Institute, Uiryeong, Gyungnam 52151, Korea
| | - Changseob Shin
- Department of Forest Therapy, Graduate School of Chungbuk National University, Chungju, Chungbuk 28644, Korea; (J.Y.); (B.K.)
| | - Wonsop Shin
- Department of Forest Therapy, Graduate School of Chungbuk National University, Chungju, Chungbuk 28644, Korea; (J.Y.); (B.K.)
| | - Jaeuk U. Kim
- Korea Institute of Oriental Medicine, Daejeon 34054, Korea
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17
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Choi J, Ku B, You YG, Jo M, Kwon M, Choi Y, Jung S, Ryu S, Park E, Go H, Kim G, Cha W, Kim JU. Resting-state prefrontal EEG biomarkers in correlation with MMSE scores in elderly individuals. Sci Rep 2019; 9:10468. [PMID: 31320666 PMCID: PMC6639387 DOI: 10.1038/s41598-019-46789-2] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Accepted: 06/28/2019] [Indexed: 11/09/2022] Open
Abstract
We investigated whether cognitive decline could be explained by resting-state electroencephalography (EEG) biomarkers measured in prefrontal regions that reflect the slowing of intrinsic EEG oscillations. In an aged population dwelling in a rural community (total = 496, males = 165, females = 331), we estimated the global cognitive decline using the Mini-Mental State Examination (MMSE) and measured resting-state EEG parameters at the prefrontal regions of Fp1 and Fp2 in an eyes-closed state. Using a tertile split method, the subjects were classified as T3 (MMSE 28-30, N = 162), T2 (MMSE 25-27, N = 179), or T1 (MMSE ≤ 24, N = 155). The EEG slowing biomarkers of the median frequency, peak frequency and alpha-to-theta ratio decreased as the MMSE scores decreased from T2 to T1 for both sexes (-5.19 ≤ t-value ≤ -3.41 for males and -7.24 ≤ t-value ≤ -4.43 for females) after adjusting for age and education level. Using a double cross-validation procedure, we developed a prediction model for the MMSE scores using the EEG slowing biomarkers and demographic covariates of sex, age and education level. The maximum intraclass correlation coefficient between the MMSE scores and model-predicted values was 0.757 with RMSE = 2.685. The resting-state EEG biomarkers showed significant changes in people with early cognitive decline and correlated well with the MMSE scores. Resting-state EEG slowing measured in the prefrontal regions may be useful for the screening and follow-up of global cognitive decline in elderly individuals.
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Affiliation(s)
- Jungmi Choi
- Human Anti-Aging Standards Research Institute, Uiryeong-gun, Gyeongsangnam-do, Republic of Korea
| | - Boncho Ku
- Korea Institute of Oriental Medicine, Yusung-gu, Deajon, Republic of Korea
| | - Young Gooun You
- Uiryeong Community Health Center, Uiryeong-gun, Gyeongsangnam-do, Republic of Korea
| | - Miok Jo
- Uiryeong Community Health Center, Uiryeong-gun, Gyeongsangnam-do, Republic of Korea
| | - Minji Kwon
- Uiryeong Community Health Center, Uiryeong-gun, Gyeongsangnam-do, Republic of Korea
| | - Youyoung Choi
- Uiryeong Community Health Center, Uiryeong-gun, Gyeongsangnam-do, Republic of Korea
| | - Segyeong Jung
- Uiryeong Community Health Center, Uiryeong-gun, Gyeongsangnam-do, Republic of Korea
| | - Soyoung Ryu
- Uiryeong Community Health Center, Uiryeong-gun, Gyeongsangnam-do, Republic of Korea
| | - Eunjeong Park
- Uiryeong Community Health Center, Uiryeong-gun, Gyeongsangnam-do, Republic of Korea
| | - Hoyeon Go
- Semyung University, Jecheon-si, Chungcheongbuk-do, Republic of Korea
| | - Gahye Kim
- Korea Institute of Oriental Medicine, Yusung-gu, Deajon, Republic of Korea
| | - Wonseok Cha
- Human Anti-Aging Standards Research Institute, Uiryeong-gun, Gyeongsangnam-do, Republic of Korea
| | - Jaeuk U Kim
- Korea Institute of Oriental Medicine, Yusung-gu, Deajon, Republic of Korea.
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Kim JI, Ku B, Kim K, Choi J, Cha W, Oh M, Kim JU. Screening of dementia with resting-state brain activity by two-channel EEG. Advances in Integrative Medicine 2019. [DOI: 10.1016/j.aimed.2019.03.399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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19
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Kim SG, Ku B, Kim K, Bae JH, Lee S, Kim JU. Changes of Pulse Wave Characteristics with Improvement in Stroke Patients. Advances in Integrative Medicine 2019. [DOI: 10.1016/j.aimed.2019.03.223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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20
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Abstract
Human body undergoes the 24-hour daily rhythm in response primarily to light and darkness. The circadian rhythms of biomarkers reflect bodily conditions including the prognosis of some pathologies. As a sensitive index of sympathetic nervous response (SNR), electrodermal activity (EDA) is a recent research topic in healthcare industry as a noninvasive and easy-access biosignal. The EDA response at Ryodoraku points (RPs) is of potential clinical usage in relation to SNR and meridian theory, but still remains in its primitive development stage.In this study, the 24-hour variations of EDA for 14 hospitalized participants were monitored over 3 days using a Ryodoraku device, and a circadian model of EDA was constructed using a cosinor analysis based on the linear mixed effect model.As a result, EDA at every RP showed a circadian cycle with its value the lowest in the morning and increased gradually until the late afternoon, and monotonically decreased again until the next morning. Circadian variations were observed in EDAs of all 12 RPs. However, Ryodoraku-specific features were not detected. Midline estimating statistic of rhythm (MESOR) values in men and young group were higher than in women and old group, and cosinor analysis showed significant circadian rhythms, especially for men and young groups. Especially, circadian variation in EDA in the young group went above 35% of the MESOR value.It implies that the circadian rhythm should be considered for the Ryodoraku analysis to examine bodily conditions or the prognosis of some pathologies.
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21
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Lee BJ, Ku B. A comparison of trunk circumference and width indices for hypertension and type 2 diabetes in a large-scale screening: a retrospective cross-sectional study. Sci Rep 2018; 8:13284. [PMID: 30185890 PMCID: PMC6125465 DOI: 10.1038/s41598-018-31624-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Accepted: 08/21/2018] [Indexed: 12/14/2022] Open
Abstract
Anthropometric indices determine important risk factors for many chronic diseases. However, to date, no study has simultaneously analyzed the capabilities of trunk circumference and width indices to identify hypertension and type 2 diabetes in a large-scale screening study. The objectives of this study were to examine the associations of hypertension and - diabetes with circumference and width indices measured at the five identical positions (axillary, chest, rib, waist, and pelvic) and to compare the capabilities of circumference and width indices to identify the two diseases. Data were obtained from the Korean Health and Genome Epidemiology Study database. The associations and abilities of the circumference indices to identify diabetes were greater than those for hypertension. Overall, trunk circumference indices displayed stronger associations with and greater abilities to identify hypertension and diabetes than did trunk width indices at the five positions. In the comparative analysis between index pairs of circumference and width in patients with diabetes, significant differences were shown at all five positions and in the adjusted analysis of axillary, chest, rib, and pelvic positions. Therefore, width indices should not be used as an alternative indicator of type 2 diabetes in either men or women, except when measured at the waist.
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Affiliation(s)
- Bum Ju Lee
- Korea Institute of Oriental Medicine, Future Medicine Division, Deajeon, 305-811, Republic of Korea.
| | - Boncho Ku
- Korea Institute of Oriental Medicine, Future Medicine Division, Deajeon, 305-811, Republic of Korea
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22
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Abstract
Probing the electrical response of the human body is minimally invasive and a promising area of investigation for future health care. The electrical responses of individuals may vary depending on daily physiological rhythms or environmental changes, which may hamper their prediction for pathological status. In this study, we observed circadian expressions via both alternating current (AC) and direct current (DC) electrical responses of the human body using bioelectrical impedance analysis (BIA) and electrodermal activity (EDA). In total, 14 healthy adults (9 males and 5 females) participated and were hospitalized for 2 nights with controlled caloric intake, sleep hours and residential conditions. The EDA data showed a significant circadian rhythm, but the BIA data did not show significant modulations during the measurement period. No difference was found between circadian changes in male and female participants. The acrophase of the EDA voltage response showed similar behavior with variations in the heart rate variability, with a resistance minimum occurring at approximately 4 pm, implying that the behavior of the EDA is probably affected by the sympathetic nerve response. Moreover, the resistance of the EDA varied by up to 15% from its mean value, which suggests that circadian variations cannot be neglected for the correct diagnosis of pathological conditions. In contrast, the BIA method did not show this circadian variation but showed independent results over the measurement period. This difference in performance implies that the DC and AC responses of the human body contain different electrophysiological information.
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Affiliation(s)
- Jungyoon Kim
- a KM Fundamental Research Division , Korea Institute of Oriental Medicine , Daejeon , Republic of Korea
| | - Boncho Ku
- a KM Fundamental Research Division , Korea Institute of Oriental Medicine , Daejeon , Republic of Korea
| | - Jang-Han Bae
- a KM Fundamental Research Division , Korea Institute of Oriental Medicine , Daejeon , Republic of Korea
| | - Gyu-Cheol Han
- b Department of Otolaryngology-Head and Neck Surgery , Gachon University of Medicine and Science, Graduate School of Medicine , Incheon , Republic of Korea
| | - Jaeuk U Kim
- a KM Fundamental Research Division , Korea Institute of Oriental Medicine , Daejeon , Republic of Korea
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Son MJ, Im HJ, Ku B, Lee JH, Jung SY, Kim YE, Lee SB, Kim JY, Son CG. An Herbal Drug, Gongjin-dan, Ameliorates Acute Fatigue Caused by Short-Term Sleep-Deprivation: A Randomized, Double-Blinded, Placebo-Controlled, Crossover Clinical Trial. Front Pharmacol 2018; 9:479. [PMID: 29867485 PMCID: PMC5958722 DOI: 10.3389/fphar.2018.00479] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Accepted: 04/23/2018] [Indexed: 01/17/2023] Open
Abstract
Introduction:Gongjin-dan (GJD) is an herbal drug commonly used in Korea and China to combat fatigue, but there are only few clinical studies on its effectiveness and experimental studies on its mechanism of action, and no randomized controlled trial of GJD on the efficacy and mechanism of action has been reported. Here, we performed an exploratory study to evaluate both questions regarding GJD use in humans. Methods: A randomized, double-blinded, placebo-controlled, crossover clinical trial was conducted in the Republic of Korea. Healthy male participants were recruited and randomly allocated to groups receiving GJD-placebo or placebo-GJD in sequence. Fatigue was artificially induced by sleep deprivation for 2 nights. The primary outcome was a change in serum cortisol level; levels of biomarkers for stress hormones as well as oxidative stress and immunologic factors were also assessed, and questionnaires on fatigue and sleep quality were conducted. Results: Twelve and 11 participants were assigned to the GJD-placebo and placebo-GJD groups, respectively. Of all 23 participants, depending on crossover design, we analyzed a total of 20 participants for GJD, and 21 for placebo. An increase in serum cortisol appeared to be attenuated by GJD administration (p = 0.25), but the effect was not statistically significant; a similar pattern was observed in salivary cortisol levels (p = 0.14). Overall, GJD showed a tendency to reduce fatigue according to the Brief Fatigue Inventory (BFI, p = 0.07) and the Fatigue Severity Scale (FSS, p = 0.13) questionnaires. BFI and FSS scores in the first stage (before the crossover), however, were significantly improved (BFI, p = 0.02; FSS, p = 0.05) after GJD treatment (relative to placebo). GJD also seemed to improve sleep quality as assessed by the Leeds Sleep Evaluation Questionnaire (p = 0.06), with a significant improvement specifically in the condition "Getting To Sleep" (p = 0.02). Five participants experienced minor adverse events, but no adverse events were specific to the GJD administration period. Conclusions: This trial produced the first clinical evidence that GJD might have anti-fatigue properties, especially under sleep deprivation; however, the investigation of cortisol-mediated mechanisms requires further larger-scale studies in the future. TRIAL REGISTRATION World Health Organization International Clinical Trials Registry Platform KCT0001681 (http://apps.who.int/trialsearch/Trial2.aspx?TrialID=KCT0001681).
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Affiliation(s)
- Mi Ju Son
- Clinical Research Division, Korea Institute of Oriental Medicine, Daejeon, South Korea
| | - Hwi-Jin Im
- Liver and Immunology Research Center, Daejeon Korean Medicine Hospital of Daejeon University, Daejeon, South Korea
| | - Boncho Ku
- KM Fundamental Research Division, Korea Institute of Oriental Medicine, Daejeon, South Korea
| | - Jun-Hwan Lee
- Clinical Research Division, Korea Institute of Oriental Medicine, Daejeon, South Korea.,Korean Medicine Life Science, University of Science & Technology, Daejeon, South Korea
| | - So Young Jung
- Clinical Research Division, Korea Institute of Oriental Medicine, Daejeon, South Korea
| | - Young-Eun Kim
- Mibyeong Research Center, Korea Institute of Oriental Medicine, Daejeon, South Korea
| | - Sung Bae Lee
- Liver and Immunology Research Center, Daejeon Korean Medicine Hospital of Daejeon University, Daejeon, South Korea
| | - Jun Young Kim
- Liver and Immunology Research Center, Daejeon Korean Medicine Hospital of Daejeon University, Daejeon, South Korea
| | - Chang-Gue Son
- Liver and Immunology Research Center, Daejeon Korean Medicine Hospital of Daejeon University, Daejeon, South Korea
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Liu Y, Lee P, Ku B, Lin Y, Chen T. 0308 High-performance Single-channel EEG Sleep Staging Using Artificial Intelligence. Sleep 2018. [DOI: 10.1093/sleep/zsy061.307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Y Liu
- Mediatek Inc., Hsinchu city, TAIWAN
| | - P Lee
- Centre of Sleep Disorder, National Taiwan University Hospital, Taipei City, TAIWAN
| | - B Ku
- Mediatek Inc., Hsinchu city, TAIWAN
| | - Y Lin
- Mediatek Inc., Hsinchu city, TAIWAN
| | - T Chen
- Mediatek Inc., Hsinchu city, TAIWAN
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Abstract
INTRODUCTION About 55% to 75% of stroke survivors have motor disorders and problems that affect their quality of life. The prevention of secondary neurological damages through relapse prevention and the rehabilitation of stroke patients suffering from morbidities are crucial to improve the prognosis of patients with stroke. Pulse examinations can be used to determine the stroke progression. This study will investigate the differences and changes in radial artery pressure-pulse waves during the treatment of hemiplegia caused by stroke. METHODS/DESIGN This study protocol is for a prospective matched case-control study. A total of 84 participants will be recruited, 56 patients with hemiplia caused by stroke, and 28 control patients matched by age, gender, and body mass index. The primary outcome of this study will be the differences and changes in the radial augmentation index. DISCUSSION The results of the study will help to determine the differences and changes in radial artery pressure-pulse waves during the treatment of hemiplegia caused by stroke. The findings will provide information about the physiological and hemodynamic mechanisms. CONCLUSION This will be the first study to analyze the pulse wave of the radial artery (PWRA) on the affected side and on the normal side in stroke patients with hemiplegia. This study will clarify whether the radial artery pressure pulse wave can be used to evaluate the result of stroke treatment objectively. The results of the study will be available in February 2019. The version of the protocol is v1.6 written in March 7, 2016. ETHICS AND DISSEMINATION Written informed consent will be obtained from all participants. This study has been approved by the Institutional Review Board (IRB) of Wonkwang University Gwangju Hospital, Gwangju, Republic of Korea (WKIRB-2016/8). The study findings will be published in peer-reviewed journals and presented at national and international conferences. TRIAL REGISTRATION NUMBER This trial was registered with the Clinical Research Information Service (CRIS) of the Korea National Institute of Health (NIH), Republic of Korea (KCT0002147).
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Affiliation(s)
- Jaeuk U. Kim
- KM Fundamental Research Division, Korea Institute of Oriental Medicine, Daejeon
| | - Jae Kyoun Kim
- Clinical Trial Center, Wonkwang University Gwangju Hospital, Gwangju
- Department of Global Public Health and Korean Medicine Management, Graduate School, Kyung Hee University, Seoul
| | - Jae-Young Shin
- Clinical Research Division, Korea Institute of Oriental Medicine, Daejeon
| | - Boncho Ku
- KM Fundamental Research Division, Korea Institute of Oriental Medicine, Daejeon
| | - Jang-Han Bae
- KM Fundamental Research Division, Korea Institute of Oriental Medicine, Daejeon
| | - Seungryong Yeom
- Clinical Trial Center, Wonkwang University Gwangju Hospital, Gwangju
- College of Korean Medicine, Wonkwang University, Iksan, Jeonbuk, Republic of Korea
| | - Sangkwan Lee
- Clinical Trial Center, Wonkwang University Gwangju Hospital, Gwangju
- College of Korean Medicine, Wonkwang University, Iksan, Jeonbuk, Republic of Korea
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Jun MH, Kim S, Ku B, Cho J, Kim K, Yoo HR, Kim JU. Glucose-independent segmental phase angles from multi-frequency bioimpedance analysis to discriminate diabetes mellitus. Sci Rep 2018; 8:648. [PMID: 29330426 PMCID: PMC5766497 DOI: 10.1038/s41598-017-18913-7] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Accepted: 12/19/2017] [Indexed: 01/13/2023] Open
Abstract
We investigated segmental phase angles (PAs) in the four limbs using a multi-frequency bioimpedance analysis (MF-BIA) technique for noninvasively diagnosing diabetes mellitus. We conducted a meal tolerance test (MTT) for 45 diabetic and 45 control subjects stratified by age, sex and body mass index (BMI). HbA1c and the waist-to-hip-circumference ratio (WHR) were measured before meal intake, and we measured the glucose levels and MF-BIA PAs 5 times for 2 hours after meal intake. We employed a t-test to examine the statistical significance and the area under the curve (AUC) of the receiver operating characteristics (ROC) to test the classification accuracy using segmental PAs at 5, 50, and 250 kHz. Segmental PAs were independent of the HbA1c or glucose levels, or their changes caused by the MTT. However, the segmental PAs were good indicators for noninvasively screening diabetes In particular, leg PAs in females and arm PAs in males showed best classification accuracy (AUC = 0.827 for males, AUC = 0.845 for females). Lastly, we introduced the PA at maximum reactance (PAmax), which is independent of measurement frequencies and can be obtained from any MF-BIA device using a Cole-Cole model, thus showing potential as a useful biomarker for diabetes.
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Affiliation(s)
- Min-Ho Jun
- KM Fundamental Research Division, Korea Institute of Oriental Medicine (KIOM), 1672 Yuseongdaero, Yuseong-gu, Daejeon, Republic of Korea
| | - Soochan Kim
- Department of Electrical and Electronic Engineering & Institute for IT Convergence, Hankyong National University, 327 Jungang-no, Anseong-si, Gyeonggi-do, Republic of Korea
| | - Boncho Ku
- KM Fundamental Research Division, Korea Institute of Oriental Medicine (KIOM), 1672 Yuseongdaero, Yuseong-gu, Daejeon, Republic of Korea
| | - JungHee Cho
- KM Fundamental Research Division, Korea Institute of Oriental Medicine (KIOM), 1672 Yuseongdaero, Yuseong-gu, Daejeon, Republic of Korea
| | - Kahye Kim
- KM Fundamental Research Division, Korea Institute of Oriental Medicine (KIOM), 1672 Yuseongdaero, Yuseong-gu, Daejeon, Republic of Korea
| | - Ho-Ryong Yoo
- Internal Medicine of Cardiovascular, Daejeon Oriental Hospital of Oriental Medical College of Daejeon University, 22-5 Daehung-dong, Jung-gu, Daejeon, 301-724, Republic of Korea
| | - Jaeuk U Kim
- KM Fundamental Research Division, Korea Institute of Oriental Medicine (KIOM), 1672 Yuseongdaero, Yuseong-gu, Daejeon, Republic of Korea.
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Bae JH, Ku B, Jeon YJ, Kim H, Kim J, Lee H, Kim JY, Kim JU. Radial Pulse and Electrocardiography Modulation by Mild Thermal Stresses Applied to Feet: An Exploratory Study with Randomized, Crossover Design. Chin J Integr Med 2017; 26:299-306. [PMID: 29150789 DOI: 10.1007/s11655-017-2972-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Accepted: 06/25/2017] [Indexed: 12/28/2022]
Abstract
OBJECTIVE To investigate the changes in radial pulse induced by thermal stresses (TSs). METHODS Sixty subjects were enrolled. Using an open-label, 2×2 crossover randomization design, both feet of each subject were immersed in 15 °C water for cold stress (CS) and in 40 °C water for heat stress (HS) for 5 min each. Radial pulse, respiration and electrocardiogram (ECG) signals were recorded before, during and immediately after the TSs. RESULTS The analysis of heart rate variability revealed that CS increased the low-frequency (LF) and high-frequency (HF) components (P <0.05) and that HS reduced the LF and HF components (P <0.01). Both TSs reduced the normalized LF, increased the normalized HF, and reduced the LF/HF ratio. The differences in the ECG signals were more dominant during the TS sessions, but those in the radial pulse signals became more dominant immediately after the TS sessions. CS decreased the pulse depth (P <0.01) and increased the radial augmentation index (P <0.1), and HS increased the pulse pressure (P <0.1) and subendocardial viability ratio (P <0.01). There were no significant differences in pulse rate during the three time sequences of each TS. The respiration rate was increased (P <0.1), and the pulse rate per respiration (P/R ratio) was significantly decreased (P <0.05) with CS. The HF region (10-30 Hz) of the pulse spectral density was suppressed during both TSs. CONCLUSIONS CS induced vasoconstriction and sympathetic reactions, and HS induced vasodilation and parasympathetic reactions. Based on definitions used in pulse diagnosis, we made the novel discoveries that the pulse became slower (decreased P/R ratio), more floating and tenser under CS and that the HF region of the spectral power decreased significantly under both TSs.
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Affiliation(s)
- Jang-Han Bae
- Korean Medicine Fundamental Research Division, Korea Institute of Oriental Medicine, Daejeon, 34054, Republic of Korea
| | - Boncho Ku
- Korean Medicine Fundamental Research Division, Korea Institute of Oriental Medicine, Daejeon, 34054, Republic of Korea
| | - Young Ju Jeon
- Korean Medicine Fundamental Research Division, Korea Institute of Oriental Medicine, Daejeon, 34054, Republic of Korea
| | - Hyunho Kim
- Department of Biofunctional Medicine and Diagnostics, College of Korean Medicine, Kyung Hee University, Seoul, 02453, Republic of Korea
| | - Jihye Kim
- Korean Medicine Fundamental Research Division, Korea Institute of Oriental Medicine, Daejeon, 34054, Republic of Korea
| | - Haebeom Lee
- Department of Human Informatics of Korean Medicine, Interdisciplinary Programs, Kyung Hee University, Seoul, 02453, Republic of Korea
| | - Jong Yeol Kim
- Korean Medicine Fundamental Research Division, Korea Institute of Oriental Medicine, Daejeon, 34054, Republic of Korea
| | - Jaeuk U Kim
- Korean Medicine Fundamental Research Division, Korea Institute of Oriental Medicine, Daejeon, 34054, Republic of Korea.
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Kim TH, Ku B, Bae JH, Shin JY, Jun MH, Kang JW, Kim J, Lee JH, Kim JU. Hemodynamic changes caused by acupuncture in healthy volunteers: a prospective, single-arm exploratory clinical study. Altern Ther Health Med 2017; 17:274. [PMID: 28532415 PMCID: PMC5440909 DOI: 10.1186/s12906-017-1787-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2016] [Accepted: 05/11/2017] [Indexed: 11/10/2022]
Abstract
BACKGROUND Radial pressure pulse wave (RPPW) examination has been a key diagnostic component of traditional Chinese medicine. The objective of this study was to investigate the changes in RPPW along with various hemodynamic variables after acupuncture stimulation and to examine the validity of pulse diagnosis as a modern diagnostic tool. METHODS We conducted acupuncture stimulation at both ST36 acupuncture points in 25 healthy volunteers. We simultaneously assessed the RPPW by pulse tonometry; heart rate variability (HRV) by electrocardiogram; photoplethysmogram (PPG) signals, respiration rate, peripheral blood flow velocity and arterial depth by ultrasonography; and cardiac output by impedance cardiography, before, during and after a session of acupuncture stimulation. RESULTS We observed consistent patterns of increased spectral energy at low frequency (<10 Hz) and pulse power using RPPW examination and in the amplitude and systolic area of the PPG signal during the entire acupuncture session. The low- and high-frequency domains of HRV increased and decreased, respectively, during the acupuncture session. The peripheral blood velocity rose shortly after needle insertion, reached a maximum in the middle of the session and decreased afterwards. The augmentation index (AIX) and pulse transit time (PTT) obtained from RPPW did not change significantly. CONCLUSION Acupuncture stimulation at ST36 in healthy subjects increased the peripheral pulse amplitudes (pressure pulse wave (PPW) and PPG), blood flow velocity (ultrasonography) and sympathetic nerve activity (HRV). The lack of changes in the AIX and PTT suggests that the increased pulse amplitudes and blood flow velocity may result from increased cardiac output. TRIAL REGISTRATION Clinical Research Information Service ( KCT0001663 ).
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Shin JY, Lee JH, Ku B, Bae JH, Un MH, Kim JU, Kim TH. Effects of Acupuncture Stimulation on the Radial artery's Pressure Pulse Wave in Healthy Young Participants: Protocol for a prospective, single-Arm, Exploratory, Clinical Study. J Pharmacopuncture 2016; 19:197-206. [PMID: 27695628 PMCID: PMC5043083 DOI: 10.3831/kpi.2016.19.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Introduction: This study aims to investigate the effects of acupuncture stimulation on the radial artery’s pressure pulse wave, along with various hemodynamic parameters, and to explore the possible underlying mechanism of pulse diagnosis in healthy participants in their twenties. Methods and analysis: This study is a prospective, single-arm, exploratory clinical study. A total of 25 healthy participants, without regard to gender, in their twenties will be recruited by physicians. Written informed consent will be obtained from all participants. The participants will receive acupuncture once at ST36 on both sides. The radial arterial pulse waves will be measured on the left arm of the subjects by using an applicable pulse tonometric device (KIOM-PAS). On the right arm (appearing twice), electrocardiogram (ECG), photoplethysmogram (PPG), respiration and cardiac output (CO) signals, will be measured using a physiological data acquisition system (Biopac module), while the velocity of blood flow, and the diameter and the depth of the blood vessel will be measured using an ultrasonogram machine on the right arm (appearing twice). All measurements will be conducted before, during, and after acupuncture. The primary outcome will be the spectral energy at high frequencies above 10 Hz (SE10-30Hz) calculated from the KIOM-PAS device signal. Secondary outcomes will be various variables obtained from the KIOM-PAS device, ECG, PPG, impedance cardiography modules, and an ultrasonogram machine. Discussion: The results of this trial will provide information regarding the physiological and the hemodynamic mechanisms underlying acupuncture stimulation and clinical evidence for the influence of acupuncture on the pressure pulse wave in the radial artery. Ethics and dissemination: This study was approved by the Institutional Review Board (IRB) of Kyung Hee University’s Oriental Medical Center, Seoul, Korea (KOMCIRB-150818-HR-030). The study findings will be published in peer-reviewed journals and presented at national and international conferences. Trial registration number: This trial was registered with the Clinical Research Information Service (CRIS) at the Korea National Institute of Health (NIH), Republic of Korea (KCT0001663), which is a registry in the World Health Organization’s (WHO’s) Registry Network.
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Affiliation(s)
- Jae-Young Shin
- Clinical Research Division, Korea Institute of Oriental Medicine, Daejeon, Korea
| | - Jun-Hwan Lee
- Clinical Research Division, Korea Institute of Oriental Medicine, Daejeon, Korea; Korean Medicine Life Science, University of Science & Technology (UST), Campus of Korea Institute of Oriental Medicine, Daejeon, Korea
| | - Boncho Ku
- KM Fundamental Research Division, Korea Institute of Oriental Medicine, Daejeon, Korea
| | - Jang Han Bae
- KM Fundamental Research Division, Korea Institute of Oriental Medicine, Daejeon, Korea
| | - Min-Ho Un
- KM Fundamental Research Division, Korea Institute of Oriental Medicine, Daejeon, Korea
| | - Jaeuk U Kim
- KM Fundamental Research Division, Korea Institute of Oriental Medicine, Daejeon, Korea; Korean Medicine Life Science, University of Science & Technology (UST), Campus of Korea Institute of Oriental Medicine, Daejeon, Korea
| | - Tae-Hun Kim
- Korean Medicine Clinical Trial Center, Kyung Hee University Oriental Medical Center, Seoul, Korea
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Son MJ, Im HJ, Kim YE, Ku B, Lee JH, Son CG. Evaluation of the anti-fatigue effects of a traditional herbal drug, Gongjin-dan, under insufficient sleep conditions: study protocol for a randomised controlled trial. Trials 2016; 17:418. [PMID: 27550184 PMCID: PMC4994160 DOI: 10.1186/s13063-016-1542-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2015] [Accepted: 08/06/2016] [Indexed: 11/29/2022] Open
Abstract
Background Many herbal medicines are traditionally used as anti-fatigue agents in east Asian countries; however, there is a dearth of clinical evidence supporting the anti-fatigue effects of such medicines and their mechanisms. This study is a feasibility trial to assess the clinical efficacy of Gongjin-dan (GJD) and verify its mechanisms by exploring fatigue outcomes, including endocrine and immunological biomarkers in humans. Methods/Design To investigate the anti-fatigue effects of GJD and the mechanism underlying these effects, a randomised, double-blind, placebo-controlled crossover clinical trial was designed. Participants (24 healthy male volunteers) will be hospitalised for 4 days (3 nights), during which acute fatigue and stress conditions will be induced by sleep deprivation, and GJD or a placebo will be administered (twice daily). The primary outcome will be changes in serum cortisol levels, measured in the morning, as an objective biomarker of sleep deprivation-induced fatigue and stress. The secondary outcomes will include: the Fatigue Severity Scale; the Brief Fatigue Inventory, and the Leeds Sleep Evaluation Questionnaire scores; levels of salivary cortisol, epinephrine, norepinephrine, oxidative stress-related biomarkers, homocysteine, and immunological factors; and heart rate variability. After a washout period of more than 4 weeks, a second treatment phase will commence in which participants who were previously administered the placebo will receive the drug and vice versa, following the same treatment regime as in the first phase. Discussion This study protocol provides a unique opportunity to enhance our understanding of fatigue and the effects of GJD on fatigue in terms of endocrine and immunological mechanisms by validating the study design and determining feasibility. Findings from this trial will help researchers to design a pilot or definitive clinical trial of traditional herbal medicine for chronic fatigue. Trial registration Korean National Clinical Trial Registry CRIS; KCT0001681, registered on 29 October 2015.
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Affiliation(s)
- Mi Ju Son
- Clinical Research Division, Korea Institute of Oriental Medicine, 1672 Yuseongdae-ro, Yuseong-gu, Daejeon, 34054, Republic of Korea
| | - Hwi-Jin Im
- Liver and Immunology Research Center, Daejeon Korean Medicine Hospital of Daejeon University, 176-9, Daeheung-ro, Jung-gu, Daejeon, 34929, Republic of Korea
| | - Young-Eun Kim
- Mibyeong Research Center, Korea Institute of Oriental Medicine, 1672 Yuseongdae-ro, Yuseong-gu, Daejeon, 34054, Republic of Korea
| | - Boncho Ku
- KM Fundamental Research Division, Korea Institute of Oriental Medicine, 1672 Yuseongdae-ro, Yuseong-gu, Daejeon, 34054, Republic of Korea
| | - Jun-Hwan Lee
- Clinical Research Division, Korea Institute of Oriental Medicine, 1672 Yuseongdae-ro, Yuseong-gu, Daejeon, 34054, Republic of Korea. .,Korean Medicine Life Science, University of Science & Technology, Campus of Korea Institute of Oriental Medicine, 1672 Yuseongdae-ro, Yuseong-gu, Daejeon, Republic of Korea.
| | - Chang-Gue Son
- Liver and Immunology Research Center, Daejeon Korean Medicine Hospital of Daejeon University, 176-9, Daeheung-ro, Jung-gu, Daejeon, 34929, Republic of Korea.
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Abstract
Background Chronic fatigue (CF) reflects an imbalance of inter-organ functions or of the four essential physiological components qi, blood (xue), yin, and yang. CF can be subdivided into different patterns. However, there are no diagnostic methods for CF. This study aimed to clinically validate a pattern identification method by identifying correlations between CF and responses to the qi blood yin yang deficiency questionnaire (QBYY-Q). Methods Participants were recruited between May and June 2014 through the Kyung Hee University Korean Medicine hospital website and via posters and comprised 129 CF patients diagnosed with the United States Centers for Disease Control and Prevention (1994) criteria. Participants who had organic diseases that explained the CF were excluded. A total of 159 participants were asked to complete the QBYY-Q, the fatigue severity scale, and the Chalder fatigue scale. The latter two questionnaires were used to assess convergent validity with the QBYY-Q. Among the 129 CF participants, 70 and 59 had chronic fatigue syndrome and idiopathic chronic fatigue, respectively. Two Korean medical doctors independently assessed participants’ qi, blood, yin, and yang deficiency patterns using QBYY deficiency pattern identification guidelines. Based on the results of a preliminary study of the QBYY-Q, we selected 32 reliable items for symptoms corresponding to each deficiency pattern. The items were used to estimate internal consistency and construct validity. Multinomial logistic regression analysis was performed for scores on each deficiency pattern. Results The data were means and standard deviations or numbers of participants and proportions for continuous and categorical variables, respectively. A statistical significance level of P < 0.05 was assumed. The QBYY-Q showed satisfactory internal consistency. Explanatory factor analysis extracted two factors for each deficiency pattern. The percentages of explained variance for qi, blood, yin, and yang deficiency were 45.1, 58.0, 52.2, and 63.4 %, respectively. Each QBYY-Q deficiency score was positively associated with each corresponding deficiency pattern. Qi deficiency was used as a reference category. Odds ratios of blood, yin, and yang deficiency were 10.97, 10.69, and 14.64, respectively. Conclusion The QBYY-Q was suitable for estimating the influences of qi, blood, yin, and yang deficiencies in CF. Trial registration This trial was registered with the Korean Clinical Trial Register (KCT0001199) Electronic supplementary material The online version of this article (doi:10.1186/s13020-016-0092-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Jihye Kim
- KM Fundamental Research Division, Korea Institute of Oriental Medicine, 1672 Yuseongdae-ro, Yuseong-gu, Daejeon, 34054 Republic of Korea
| | - Boncho Ku
- KM Fundamental Research Division, Korea Institute of Oriental Medicine, 1672 Yuseongdae-ro, Yuseong-gu, Daejeon, 34054 Republic of Korea
| | - Keun Ho Kim
- KM Fundamental Research Division, Korea Institute of Oriental Medicine, 1672 Yuseongdae-ro, Yuseong-gu, Daejeon, 34054 Republic of Korea
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Lee BJ, Jeon YJ, Ku B, Kim JU, Bae JH, Kim JY. Association of hypertension with physical factors of wrist pulse waves using a computational approach: a pilot study. BMC Complement Altern Med 2015; 15:222. [PMID: 26162371 PMCID: PMC4499170 DOI: 10.1186/s12906-015-0756-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/02/2015] [Accepted: 06/30/2015] [Indexed: 02/02/2023]
Abstract
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 naïve 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.
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Affiliation(s)
- Bum Ju Lee
- KM Fundamental Research Division, Korea Institute of Oriental Medicine, 1672 Yuseongdae-ro, Yuseong-gu, Deajeon, 305-811, Republic of Korea
| | - Young Ju Jeon
- KM Fundamental Research Division, Korea Institute of Oriental Medicine, 1672 Yuseongdae-ro, Yuseong-gu, Deajeon, 305-811, Republic of Korea
| | - Boncho Ku
- KM Fundamental Research Division, Korea Institute of Oriental Medicine, 1672 Yuseongdae-ro, Yuseong-gu, Deajeon, 305-811, Republic of Korea
| | - Jaeuk U Kim
- KM Fundamental Research Division, Korea Institute of Oriental Medicine, 1672 Yuseongdae-ro, Yuseong-gu, Deajeon, 305-811, Republic of Korea
| | - Jang-Han Bae
- KM Fundamental Research Division, Korea Institute of Oriental Medicine, 1672 Yuseongdae-ro, Yuseong-gu, Deajeon, 305-811, Republic of Korea
| | - Jong Yeol Kim
- KM Fundamental Research Division, Korea Institute of Oriental Medicine, 1672 Yuseongdae-ro, Yuseong-gu, Deajeon, 305-811, Republic of Korea.
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Kim JS, Ku B, Woo TG, Oh AY, Jung YS, Soh YM, Yeom JH, Lee K, Park BJ, Oh BH, Ha NC. Conversion of cell-survival activity of Akt into apoptotic death of cancer cells by two mutations on the BIM BH3 domain. Cell Death Dis 2015; 6:e1804. [PMID: 26136077 PMCID: PMC4650712 DOI: 10.1038/cddis.2015.118] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2014] [Revised: 03/24/2015] [Accepted: 03/24/2015] [Indexed: 12/13/2022]
Abstract
Survival and proliferation of cancer cells are often associated with hyperactivity of the serine/threonine kinase, Akt. Herein, we show that prosurvival activity of Akt can be converted into prodeath activity by embedding an Akt recognition sequence in the apoptogenic BH3 domain of human BIM. The recognition sequence was created by introducing two mutations, I155R and E158S, into the core region of the BIM BH3 domain. Although a 21-mer BIM BH3 peptide containing these two mutations bound weakly to BCL-XL and BCL-2, this peptide with phosphorylation of Ser158 bound to these proteins with a dissociation constant of <10 nM. The crystal structure of the phosphorylated peptide bound to BCL-XL revealed that the phospho-Ser158 makes favorable interactions with two BCL-XL residues, which cannot be formed with unphosphorylated Ser158. Remarkably, the designed peptide showed a cytotoxic effect on PTEN-null PC3 tumor cells whose Akt activity is aberrantly high. The cell-killing activity disappeared when the cellular Akt activity was lowered by ectopic PTEN expression. Thus, these results lay a foundation for developing a peptide or protein agent that is dormant in normal cells but is transformed into a potent apoptogenic molecule upon phosphorylation by hyperactivity of Akt in cancer cells.
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Affiliation(s)
- J-S Kim
- Department of Agricultural Biotechnology, Center for Food Safety and Toxicology, Research Institute for Agriculture and Life Sciences, Seoul National University, Seoul, Republic of Korea
| | - B Ku
- 1] Department of Biological Sciences, KAIST Institute for the Biocentury, Cancer Metastasis Control Center, Korea Advanced Institute of Science and Technology, Daejeon, Republic of Korea [2] Functional Genomics Research Center, Korea Research Institute of Bioscience and Biotechnology, Daejeon, Republic of Korea
| | - T-G Woo
- Department of Molecular Biology, Pusan National University, Busan, Republic of Korea
| | - A-Y Oh
- Department of Molecular Biology, Pusan National University, Busan, Republic of Korea
| | - Y-S Jung
- Department of Molecular Biology, Pusan National University, Busan, Republic of Korea
| | - Y-M Soh
- Department of Biological Sciences, KAIST Institute for the Biocentury, Cancer Metastasis Control Center, Korea Advanced Institute of Science and Technology, Daejeon, Republic of Korea
| | - J-H Yeom
- Department of Life Science, Chung-Ang University, Seoul, Republic of Korea
| | - K Lee
- Department of Life Science, Chung-Ang University, Seoul, Republic of Korea
| | - B-J Park
- Department of Molecular Biology, Pusan National University, Busan, Republic of Korea
| | - B-H Oh
- Department of Biological Sciences, KAIST Institute for the Biocentury, Cancer Metastasis Control Center, Korea Advanced Institute of Science and Technology, Daejeon, Republic of Korea
| | - N-C Ha
- Department of Agricultural Biotechnology, Center for Food Safety and Toxicology, Research Institute for Agriculture and Life Sciences, Seoul National University, Seoul, Republic of Korea
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Shin JY, Ku B, Kim JU, Lee YJ, Kang JH, Heo H, Choi HJ, Lee JH. Short term effect of laser acupuncture on low back pain: A randomized, placebo-controlled, double-blind trial. Integr Med Res 2015. [DOI: 10.1016/j.imr.2015.04.128] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Kim J, Kim KH, Ku B. A Study of the Diagnostic Methods for Chronic Fatigue in Korean Medicine (KM). Integr Med Res 2015. [DOI: 10.1016/j.imr.2015.04.357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Lee BJ, Ku B, Nam J, Pham DD, Kim JY. Prediction of fasting plasma glucose status using anthropometric measures for diagnosing type 2 diabetes. IEEE J Biomed Health Inform 2014; 18:555-61. [PMID: 24608055 DOI: 10.1109/jbhi.2013.2264509] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
It is well known that body fat distribution and obesity are important risk factors for type 2 diabetes. Prediction of type 2 diabetes using a combination of anthropometric measures remains a controversial issue. This study aims to predict the fasting plasma glucose (FPG) status that is used in the diagnosis of type 2 diabetes by a combination of various measures among Korean adults. A total of 4870 subjects (2955 females and 1915 males) participated in this study. Based on 37 anthropometric measures, we compared predictions of FPG status using individual versus combined measures using two machine-learning algorithms. The values of the area under the receiver operating characteristic curve in the predictions by logistic regression and naive Bayes classifier based on the combination of measures were 0.741 and 0.739 in females, respectively, and were 0.687 and 0.686 in males, respectively. Our results indicate that prediction of FPG status using a combination of anthropometric measures was superior to individual measures alone in both females and males. We show that using balanced data of normal and high FPG groups can improve the prediction and reduce the intrinsic bias of the model toward the majority class.
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Kim YM, Ku B, Jung CJ, Kim JU, Jeon YJ, Kim KH, Kim JY. Constitution-specific features of perspiration and skin visco-elasticity in SCM. Altern Ther Health Med 2014; 14:24. [PMID: 24422750 PMCID: PMC3897972 DOI: 10.1186/1472-6882-14-24] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2013] [Accepted: 01/10/2014] [Indexed: 11/10/2022]
Abstract
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 < 0.001), whereas the elasticity hysteresis of the SE group was higher than that of the TE group (F = 10.364, p < 0.01). The TE group had more perspiration on the forehead than the SE group (F = 9.050, p < 0.01). The SE group had a large perspiration difference between the philtrum and the forehead compared with the TE group (F = 7.892, p < 0.01). CONCLUSIONS We found four significant skin features that reflect the inherent constitutional attributes of the TE and SE groups in accordance with SCM literature; the visco-elasticity, elasticity hysteresis, perspiration on the forehead and philtrum. Our findings are based on a novel interpretation of the SCM literature and will contribute to developing the constitutional health status evaluation system in SCM.
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Jang JS, Ku B, Kim YS, Nam J, Kim KH, Kim JY. A practical approach to Sasang constitutional diagnosis using vocal features. Altern Ther Health Med 2013; 13:307. [PMID: 24200041 PMCID: PMC4226254 DOI: 10.1186/1472-6882-13-307] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2013] [Accepted: 10/30/2013] [Indexed: 11/10/2022]
Abstract
BACKGROUND Sasang constitutional medicine (SCM) is a type of tailored medicine that divides human beings into four Sasang constitutional (SC) types. Diagnosis of SC types is crucial to proper treatment in SCM. Voice characteristics have been used as an essential clue for diagnosing SC types. In the past, many studies tried to extract quantitative vocal features to make diagnosis models; however, these studies were flawed by limited data collected from one or a few sites, long recording time, and low accuracy. We propose a practical diagnosis model having only a few variables, which decreases model complexity. This in turn, makes our model appropriate for clinical applications. METHODS A total of 2,341 participants' voice recordings were used in making a SC classification model and to test the generalization ability of the model. Although the voice data consisted of five vowels and two repeated sentences per participant, we used only the sentence part for our study. A total of 21 features were extracted, and an advanced feature selection method-the least absolute shrinkage and selection operator (LASSO)-was applied to reduce the number of variables for classifier learning. A SC classification model was developed using multinomial logistic regression via LASSO. RESULTS We compared the proposed classification model to the previous study, which used both sentences and five vowels from the same patient's group. The classification accuracies for the test set were 47.9% and 40.4% for male and female, respectively. Our result showed that the proposed method was superior to the previous study in that it required shorter voice recordings, is more applicable to practical use, and had better generalization performance. CONCLUSIONS We proposed a practical SC classification method and showed that our model having fewer variables outperformed the model having many variables in the generalization test. We attempted to reduce the number of variables in two ways: 1) the initial number of candidate features was decreased by considering shorter voice recording, and 2) LASSO was introduced for reducing model complexity. The proposed method is suitable for an actual clinical environment. Moreover, we expect it to yield more stable results because of the model's simplicity.
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Kim JU, Ku B, Kim YM, Do JH, Jang JS, Jang E, Jeon YJ, Kim KH, Kim JY. The concept of sasang health index and constitution-based health assessment: an integrative model with computerized four diagnosis methods. Evid Based Complement Alternat Med 2013; 2013:879420. [PMID: 23843888 PMCID: PMC3694382 DOI: 10.1155/2013/879420] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/09/2013] [Revised: 05/10/2013] [Accepted: 05/12/2013] [Indexed: 11/17/2022]
Abstract
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 adjusted R-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.
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Affiliation(s)
- Jaeuk U. Kim
- Medical Research Division, Korea Institute of Oriental Medicine, Daejeon 305-811, Republic of Korea
| | - Boncho Ku
- Medical Research Division, Korea Institute of Oriental Medicine, Daejeon 305-811, Republic of Korea
| | - Young-Min Kim
- Medical Research Division, Korea Institute of Oriental Medicine, Daejeon 305-811, Republic of Korea
| | - Jun-Hyeong Do
- Medical Research Division, Korea Institute of Oriental Medicine, Daejeon 305-811, Republic of Korea
| | - Jun-Su Jang
- Medical Research Division, Korea Institute of Oriental Medicine, Daejeon 305-811, Republic of Korea
| | - Eunsu Jang
- Medical Research Division, Korea Institute of Oriental Medicine, Daejeon 305-811, Republic of Korea
| | - Young Ju Jeon
- Medical Research Division, Korea Institute of Oriental Medicine, Daejeon 305-811, Republic of Korea
| | - Keun Ho Kim
- Medical Research Division, Korea Institute of Oriental Medicine, Daejeon 305-811, Republic of Korea
| | - Jong Yeol Kim
- Medical Research Division, Korea Institute of Oriental Medicine, Daejeon 305-811, Republic of Korea
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Lee BJ, Kim KH, Ku B, Jang JS, Kim JY. Prediction of body mass index status from voice signals based on machine learning for automated medical applications. Artif Intell Med 2013; 58:51-61. [PMID: 23453267 DOI: 10.1016/j.artmed.2013.02.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2012] [Revised: 12/21/2012] [Accepted: 02/05/2013] [Indexed: 11/28/2022]
Abstract
OBJECTIVES The body mass index (BMI) provides essential medical information related to body weight for the treatment and prognosis prediction of diseases such as cardiovascular disease, diabetes, and stroke. We propose a method for the prediction of normal, overweight, and obese classes based only on the combination of voice features that are associated with BMI status, independently of weight and height measurements. MATERIALS AND METHODS A total of 1568 subjects were divided into 4 groups according to age and gender differences. We performed statistical analyses by analysis of variance (ANOVA) and Scheffe test to find significant features in each group. We predicted BMI status (normal, overweight, and obese) by a logistic regression algorithm and two ensemble classification algorithms (bagging and random forests) based on statistically significant features. RESULTS In the Female-2030 group (females aged 20-40 years), classification experiments using an imbalanced (original) data set gave area under the receiver operating characteristic curve (AUC) values of 0.569-0.731 by logistic regression, whereas experiments using a balanced data set gave AUC values of 0.893-0.994 by random forests. AUC values in Female-4050 (females aged 41-60 years), Male-2030 (males aged 20-40 years), and Male-4050 (males aged 41-60 years) groups by logistic regression in imbalanced data were 0.585-0.654, 0.581-0.614, and 0.557-0.653, respectively. AUC values in Female-4050, Male-2030, and Male-4050 groups in balanced data were 0.629-0.893 by bagging, 0.707-0.916 by random forests, and 0.695-0.854 by bagging, respectively. In each group, we found discriminatory features showing statistical differences among normal, overweight, and obese classes. The results showed that the classification models built by logistic regression in imbalanced data were better than those built by the other two algorithms, and significant features differed according to age and gender groups. CONCLUSION Our results could support the development of BMI diagnosis tools for real-time monitoring; such tools are considered helpful in improving automated BMI status diagnosis in remote healthcare or telemedicine and are expected to have applications in forensic and medical science.
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Affiliation(s)
- Bum Ju Lee
- Medical Research Division, Korea Institute of Oriental Medicine, 1672 Yuseongdae-ro, Yuseong-gu, Daejeon 305-811, Republic of Korea
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Lee BJ, Ku B, Park K, Kim KH, Kim JY. A new method of diagnosing constitutional types based on vocal and facial features for personalized medicine. J Biomed Biotechnol 2012; 2012:818607. [PMID: 22899890 PMCID: PMC3415144 DOI: 10.1155/2012/818607] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2012] [Accepted: 05/30/2012] [Indexed: 11/18/2022] Open
Abstract
The aim of the present study is to develop an accurate constitution diagnostic method based solely on the individual's physical characteristics, irrespective of psychologic traits, characteristics of clinical medicine, and genetic factors. In this paper, we suggest a novel method for diagnosing constitutional types using only speech and face characteristics. Based on 514 subjects, the area under the receiver operating characteristics curve (AUC) values of classification models in age and gender groups ranged from 0.64 to 0.89. We identified significant features showing statistical differences among three constitutional types by performing statistical analysis. Also, we selected a compact and discriminative feature subset for constitution diagnosis in each age and gender group. Our method may support the direction of improved diagnosis prediction and will serve to develop a personal and automatic constitution diagnosis software for improvement of the effectiveness of prescribed medications and development of personalized medicine.
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Affiliation(s)
- Bum Ju Lee
- Division of Constitutional Medicine Research, Korea Institute of Oriental Medicine, 1672 Yuseongdae-ro, Yuseong-gu, Deajeon 305-811, Republic of Korea
| | - Boncho Ku
- Division of Constitutional Medicine Research, Korea Institute of Oriental Medicine, 1672 Yuseongdae-ro, Yuseong-gu, Deajeon 305-811, Republic of Korea
| | - Kihyun Park
- Division of Constitutional Medicine Research, Korea Institute of Oriental Medicine, 1672 Yuseongdae-ro, Yuseong-gu, Deajeon 305-811, Republic of Korea
| | - Keun Ho Kim
- Division of Constitutional Medicine Research, Korea Institute of Oriental Medicine, 1672 Yuseongdae-ro, Yuseong-gu, Deajeon 305-811, Republic of Korea
| | - Jong Yeol Kim
- Division of Constitutional Medicine Research, Korea Institute of Oriental Medicine, 1672 Yuseongdae-ro, Yuseong-gu, Deajeon 305-811, Republic of Korea
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Do JH, Jang E, Ku B, Jang JS, Kim H, Kim JY. Development of an integrated Sasang constitution diagnosis method using face, body shape, voice, and questionnaire information. Altern Ther Health Med 2012; 12:85. [PMID: 22762505 PMCID: PMC3502327 DOI: 10.1186/1472-6882-12-85] [Citation(s) in RCA: 72] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2012] [Accepted: 06/13/2012] [Indexed: 12/03/2022]
Abstract
Background Sasang constitutional medicine (SCM) is a unique form of traditional Korean medicine that divides human beings into four constitutional types (Tae-Yang: TY, Tae-Eum: TE, So-Yang: SY, and So-Eum: SE), which differ in inherited characteristics, such as external appearance, personality traits, susceptibility to particular diseases, drug responses, and equilibrium among internal organ functions. According to SCM, herbs that belong to a certain constitution cannot be used in patients with other constitutions; otherwise, this practice may result in no effect or in an adverse effect. Thus, the diagnosis of SC type is the most crucial step in SCM practice. The diagnosis, however, tends to be subjective due to a lack of quantitative standards for SC diagnosis. Methods We have attempted to make the diagnosis method as objective as possible by basing it on an analysis of quantitative data from various Oriental medical clinics. Four individual diagnostic models were developed with multinomial logistic regression based on face, body shape, voice, and questionnaire responses. Inspired by SCM practitioners’ holistic diagnostic processes, an integrated diagnostic model was then proposed by combining the four individual models. Results The diagnostic accuracies in the test set, after the four individual models had been integrated into a single model, improved to 64.0% and 55.2% in the male and female patient groups, respectively. Using a cut-off value for the integrated SC score, such as 1.6, the accuracies increased by 14.7% in male patients and by 4.6% in female patients, which showed that a higher integrated SC score corresponded to a higher diagnostic accuracy. Conclusions This study represents the first trial of integrating the objectification of SC diagnosis based on quantitative data and SCM practitioners’ holistic diagnostic processes. Although the diagnostic accuracy was not great, it is noted that the proposed diagnostic model represents common rules among practitioners who have various points of view. Our results are expected to contribute as a desirable research guide for objective diagnosis in traditional medicine, as well as to contribute to the precise diagnosis of SC types in an objective manner in clinical practice.
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Kim KH, Ku B, Kang N, Kim YS, Jang JS, Kim JY. Study of a vocal feature selection method and vocal properties for discriminating four constitution types. Evid Based Complement Alternat Med 2012; 2012:831543. [PMID: 22529874 PMCID: PMC3313581 DOI: 10.1155/2012/831543] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/14/2011] [Revised: 11/15/2011] [Accepted: 11/20/2011] [Indexed: 11/29/2022]
Abstract
The voice has been used to classify the four constitution types, and to recognize a subject's health condition by extracting meaningful physical quantities, in traditional Korean medicine. In this paper, we propose a method of selecting the reliable variables from various voice features, such as frequency derivative features, frequency band ratios, and intensity, from vowels and a sentence. Further, we suggest a process to extract independent variables by eliminating explanatory variables and reducing their correlation and remove outlying data to enable reliable discriminant analysis. Moreover, the suitable division of data for analysis, according to the gender and age of subjects, is discussed. Finally, the vocal features are applied to a discriminant analysis to classify each constitution type. This method of voice classification can be widely used in the u-Healthcare system of personalized medicine and for improving diagnostic accuracy.
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Affiliation(s)
| | | | | | | | | | - Jong Yeol Kim
- Division of Constitutional Medicine Research, Korea Institute of Oriental Medicine, 461-24 Jeonmin-dong, Yuseong-gu, Daejeon 305-811, Republic of Korea
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Oh S, Xiaofei E, Ni D, Pirooz SD, Lee JY, Lee D, Zhao Z, Lee S, Lee H, Ku B, Kowalik T, Martin SE, Oh BH, Jung JU, Liang C. Downregulation of autophagy by Bcl-2 promotes MCF7 breast cancer cell growth independent of its inhibition of apoptosis. Cell Death Differ 2010; 18:452-64. [PMID: 20885445 DOI: 10.1038/cdd.2010.116] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
The anti-apoptotic Bcl-2 protein, which confers oncogenic transformation and drug resistance in most human cancers, including breast cancer, has recently been shown to effectively counteract autophagy by directly targeting Beclin1, an essential autophagy mediator and tumor suppressor. However, it remains unknown whether autophagy inhibition contributes to Bcl-2-mediated oncogenesis. Here, by using a loss-of-function mutagenesis study, we show that Bcl-2-mediated antagonism of autophagy has a critical role in enhancing the tumorigenic properties of MCF7 breast cancer cells independent of its anti-apoptosis activity. A Bcl-2 mutant defective in apoptosis inhibition but competent for autophagy suppression promotes MCF7 breast cancer cell growth in vitro and in vivo as efficiently as wild-type Bcl-2. The growth-promoting activity of this Bcl-2 mutant is strongly correlated with its suppression of Beclin1-dependent autophagy, leading to sustained p62 expression and increased DNA damage in xenograft tumors, which may directly contribute to tumorigenesis. Thus, the anti-autophagic property of Bcl-2 is a key feature of Bcl-2-mediated oncogenesis and may in some contexts, serve as an attractive target for breast and other cancer therapies.
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Affiliation(s)
- S Oh
- Department of Molecular Microbiology and Immunology, University of Southern California, Los Angeles, CA 90033, USA
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Ko B, Seo J, Kwon S, Lee Y, Lim W, Lee J, Kim H, Jang M, Ku B, Son B, Ahn S. Can We Skip Sentinel Lymph Node Biopsy in Patients Who Have Microinvasive Breast Cancer? Cancer Res 2009. [DOI: 10.1158/0008-5472.sabcs-09-1019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Sentinel lymph node(SLN) biopsy in patients with ductal carcinoma in situ(DCIS) was controversial. We may skip SLN biopsy when we performed conserving operation with small sized DCIS. But sometimes we can find DCIS with micro-invasive breast cancer (MIC) after operation. Should another operation be performed? We determined the incidence of positive axillary lymph node (ALNs) in patients with MIC, and the predictive factors of ALNs metastasis in these patients. Methods: Between July 1989 and January 2008, 9046 patients had operations performed on invasive breast cancers at Asan Medical Center. From July1989 to February 2003, ALND was performed to surgically stage the axilla. Since May 2003, SNB has been routinely performed for all cases. Patients who were treated with neoadjuvant chemotherapy and those who had no identifiable ALNs at surgery were excluded from the study. We retrospectively checked clinical and pathologic variables including diagnosis, patient demographics, size of DCIS, grade, multi-focal lesion, hormone receptor status, lymphatic invasion status etc. Results: 265 patients were identified with microinvasive (pathologic stage T1mic) breast cancer. Among these patients, 12 patients didn't have ALN study. 2 patients had bilateral MIC. The research was conducted on the remaining 255 cases. There were 13 cases of ALN metastases identified in this group of patients(5%). Young age (p=0.006), multifocal lesion (p=0.040) and lymphatic invasion (p<0.0001) were predictive factors for ALN metastases. There was no incidence of metastatic ALNs among the old age (≥50) patients of this group. Conclusion: As the incidence of ALN metastases in MIC patients is very small, particularly in those who had no lymphatic invasion, single lesion and among old age patients. So we think conservative treatment is one of the available options for these patients. However, due to the size of the subject group in this study, it needs to be validated through extensive prospective research.
Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 1019.
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Affiliation(s)
- B. Ko
- 1Asan Medical Center, Republic of Korea
| | - J. Seo
- 1Asan Medical Center, Republic of Korea
| | - S. Kwon
- 1Asan Medical Center, Republic of Korea
| | - Y. Lee
- 1Asan Medical Center, Republic of Korea
| | - W. Lim
- 1Asan Medical Center, Republic of Korea
| | - J. Lee
- 1Asan Medical Center, Republic of Korea
| | - H. Kim
- 1Asan Medical Center, Republic of Korea
| | - M. Jang
- 1Asan Medical Center, Republic of Korea
| | - B. Ku
- 1Asan Medical Center, Republic of Korea
| | - B. Son
- 1Asan Medical Center, Republic of Korea
| | - S. Ahn
- 1Asan Medical Center, Republic of Korea
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Ko B, Seo J, Kim H, Lim W, Park E, Ku B, Jang M, Son B, Ahn S. 0085 Is sentinel lymph node biopsy truly reliable as a single predictor for lymph node metastasis? Breast 2009. [DOI: 10.1016/s0960-9776(09)70127-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Ko B, Seo J, Kim H, Lim W, Park E, Ku B, Jang M, Son B, Ahn S. 0087 The follow-up results of patients without axillary lymph node dissection after false negative SLN biopsy. Breast 2009. [DOI: 10.1016/s0960-9776(09)70129-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Chung H, Ku B, Gregory J. Development of an advanced water treatment system for wastewater reuse. Environ Technol 2008; 29:931-939. [PMID: 18844120 DOI: 10.1080/09593330802318894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
The aim of this research was to develop an optimal reuse system applying various types of advanced oxidation processes such as titanium dioxide (TiO2), ozone (O3) and electro-coagulation/oxidation methods. This system is suitable for improving the treatment efficiency of difficult wastewaters, and for the efficient reuse of wastewater. The connecting systems were divided into various types to investigate the stability and treatment efficiency according to the kinds of waste load. Different treatment sequences were examined taking into consideration the characteristics and economical efficiency. In the case of electro-coagulation/oxidation + ozone system, the mean treatment efficiency in terms of BOD5, CODCr and SS removal was 98.7%. The effluent concentration was 50.2 mg l(-1), 38.3 mg l(-1), 30.4 mg l(-1), respectively. In considering the economical efficiency and commercial use, around an eighth of the treatment expenses and around a fifth of the maintenance expenses could be saved compared with existing water treatment systems. The initial construction expenses could be reduced by a third to a fifth. Therefore, if a proper implementation of this research is carried out in relation to site conditions and the purpose of the water reuse, the water reuse rate will be higher and water resources can be protected.
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Affiliation(s)
- H Chung
- Department of Civil Engineering, Keimyung University, 1000 Sindang Dong, Dalseo Gu, Daegu, 704-701, South Korea
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Ku B, Takakuwa K, O’Connor T, Stern E, Baram M, Marik P. 70: Are Glucose Fingersticks Using Bedside Glucometers on Emergency Department Patients Reliable? Ann Emerg Med 2008. [DOI: 10.1016/j.annemergmed.2008.01.037] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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