Wrinkle reduction using a Sasang constitutional medicine-based topical herbal cream in So-eum subjects: A split-face randomized double-blind placebo-controlled study.

BACKGROUND: Skin aging is caused by exogenous and endogenous factors and is commonly manifested as wrinkling, sagging, and looseness of the skin. The herbal extract including Zingiber officinale Roscoe, Atractylodes chinensis (Bunge) Kodiz, Curcuma longa L., and Cinnamomum cassia (L.) J.Presl (ZACC extract), is widely used for So-eum (SE) Sasang constitutional type individuals. This study aimed to examine the protective effects of the ZACC extract against skin aging in 21 SE type subjects. METHODS: The safety and clinical efficacy of herbal cream were evaluated after application on human skin in a split-face randomized, double-blind, placebo-controlled study. The Sasang Constitution Analysis Tool (SCAT) was used to select 21 SE type subjects, who applied herbal cream and placebo cream for 12 weeks. Visual assessment, wrinkle parameters, questionnaires, and skin safety were evaluated. RESULTS: The visual assessment score was decreased by using of the herbal cream, but there were no significant differences between groups. Among the wrinkle parameters, R1 (skin roughness) and R4 (smoothness depth) values were significantly improved after the application of the herbal cream compared to those observed after application of the placebo cream for 12 weeks. No significant differences were observed in evaluation of the product efficacy and usability by questionnaires. There were no adverse dermatologic reactions in the SE type subjects during the evaluation period. CONCLUSION: The ZACC herbal cream may be used to prevent or slow skin aging, including wrinkle formation, in SE type individuals.

Long-term progression-free survival in a patient with advanced non-small-cell lung cancer treated with low-dose gefitinib and traditional herbal medicine: A case report.

RATIONALE: Gefitinib is a first-line palliative chemotherapy drug used to treat advanced non-small-cell lung cancer (NSCLC) in patients who have an epidermal growth factor receptor (EGFR) mutation. However, approximately two-thirds of NSCLC patients with EGFR-tyrosine kinase inhibitor experience dermatological toxicity. Cutaneous toxicity is usually not life threatening but can necessitate modification or discontinuation of medication in severe cases. In this case, despite a reduction in the dose of gefitinib due to side effects, combined treatment with modified Bojungikki-tang (BJKIT) increased progression-free survival (PFS) in an advanced NSCLC patient. PATIENT CONCERNS: An 83-year-old Asian woman presented with chief complaints of chronic cough, dyspnea, weight loss, and anorexia. DIAGNOSES: The patient was diagnosed with stage IV NSCLC (T2aN3M1), adenocarcinoma with metastasis to the lymph node, brain, and bone based on image scan and biopsy. An EGFR deletion was detected in exon 19. INTERVENTIONS: The patient was treated with gefitinib (250 mg/d) and traditional herbal medicine, modified Bojungikki-tang (BJIKT). However, after 1 year of combination therapy, gefitinib was tapered down to once per week while modified BJIKT was maintained. OUTCOMES: A partial response was achieved, but after 3 months severe papulopustular skin rashes developed and became aggravated with time. Thus, the gefitinib dose was reduced. However, the PFS has been maintained for approximately 78 months. LESSONS: Despite the reduction in gefitinib dose due to side effects, the combined treatment of gefitinib and the modified BJIKT has maintained a PFS of over 78 months, indicating that modified BJIKT enhanced the anti-cancer effect of gefitinib in a patient with advanced NSCLC harboring the EFGR mutation, and may have delayed acquired resistance, the main limitation on the efficacy of gefitinib. Further investigations including clinical trials are needed to confirm these effects.

Radial Pulse and Electrocardiography Modulation by Mild Thermal Stresses Applied to Feet: An Exploratory Study with Randomized, Crossover Design.

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.

Analysis of Facial Features according to Sasang Types between Native Japanese and Native Korean Populations.

BACKGROUND: Facial diagnosis is a common practice and essential diagnostic method used in the Sasang Constitution Medicine (SCM). SCM is a kind of personalized medicine in Traditional Korean Medicine which categorizes people into four types, namely, Tae-Yang (TY) type, Tae-Eum type (TE), So-Yang (SY) type, and So-Eum (SE) type. This study was conducted to compare and analyze the differences in the facial feature across Sasang types among native Japanese and native Koreans. METHODS: A total of 843 subjects were recruited for this study, 127 native Japanese and 716 native Koreans, respectively. Facial feature points and the measurements of facial features were assigned and calculated automatically using a facial analysis program. Data of each Sasang type for both genders were also extracted and analyzed. Analysis of covariance was then used to examine the differences in facial feature variables among native Japanese and native Koreans and Sasang types. RESULTS: Significant differences were seen in the facial feature variables related to lower face area and eye shape. In males, TE types had wider mid-face and lower face as compared to other constitutions. Male TE types were also seen to have narrower eyes whereas male SY types had rounder eyes. In females, TE types had wider lower face width and area compared to SY types and SE types. Female SY types also had rounder eyes. CONCLUSIONS: This study presented distinctive feature in the lower face area and eye shape among the Sasang types in both native Japanese and native Koreans. This proposed that facial feature variables can also be used as an objective tool in distinguishing the Sasang types in native Japanese. Further studies are needed in the future to generalize these results.

Pulmonary Function Difference in Sasang Constitutional Types.

The purpose of this study was to determine the differences in pulmonary function among Sasang constitutional types in young adults. The Sasang Constitutional Analysis Tool (SCAT), pulmonary function tests (PFTs), and cardiopulmonary exercise tests were conducted in 417 participants from 2009 to 2015. Subjects with the Tae-Eum (TE) type had significantly higher inspiratory capacity (IC) and inspiratory reserve volume (IRV) values than those with the So-Yang (SY) and So-Eum (SE) types (P < 0.0001). The TE and SY types showed higher forced vital capacity (FVC) and forced expiratory volume in 1 sec (FEV1) values than the SE type (P < 0.0001). An increase in IRV and a decrease in expiratory reserve volume (ERV) in TE type males remained even after adjusting for covariate factors. These results indicate that young adults with the TE type have weaker lung function than those with the other constitutional types, suggesting its innate physiological pulmonary features.

Prediction of cold and heat patterns using anthropometric measures based on machine learning.

OBJECTIVE: To examine the association of body shape with cold and heat patterns, to determine which anthropometric measure is the best indicator for discriminating between the two patterns, and to investigate whether using a combination of measures can improve the predictive power to diagnose these patterns. METHODS: Based on a total of 4,859 subjects (3,000 women and 1,859 men), statistical analyses using binary logistic regression were performed to assess the significance of the difference and the predictive power of each anthropometric measure, and binary logistic regression and Naive Bayes with the variable selection technique were used to assess the improvement in the predictive power of the patterns using the combined measures. RESULTS: In women, the strongest indicators for determining the cold and heat patterns among anthropometric measures were body mass index (BMI) and rib circumference; in men, the best indicator was BMI. In experiments using a combination of measures, the values of the area under the receiver operating characteristic curve in women were 0.776 by Naive Bayes and 0.772 by logistic regression, and the values in men were 0.788 by Naive Bayes and 0.779 by logistic regression. CONCLUSIONS: Individuals with a higher BMI have a tendency toward a heat pattern in both women and men. The use of a combination of anthropometric measures can slightly improve the diagnostic accuracy. Our findings can provide fundamental information for the diagnosis of cold and heat patterns based on body shape for personalized medicine.

Sasang constitutional types for the risk prediction of metabolic syndrome: a 14-year longitudinal prospective cohort study.

BACKGROUND: To examine whether the use of Sasang constitutional (SC) types, such as Tae-yang (TY), Tae-eum (TE), So-yang (SY), and So-eum (SE) types, increases the accuracy of risk prediction for metabolic syndrome. METHODS: From 2001 to 2014, 3529 individuals aged 40 to 69 years participated in a longitudinal prospective cohort. The Cox proportional hazard model was utilized to predict the risk of developing metabolic syndrome. RESULTS: During the 14 year follow-up, 1591 incident events of metabolic syndrome were observed. Individuals with TE type had higher body mass indexes and waist circumferences than individuals with SY and SE types. The risk of developing metabolic syndrome was the highest among individuals with the TE type, followed by the SY type and the SE type. When the prediction risk models for incident metabolic syndrome were compared, the area under the curve for the model using SC types was significantly increased to 0.8173. Significant predictors for incident metabolic syndrome were different according to the SC types. For individuals with the TE type, the significant predictors were age, sex, body mass index (BMI), education, smoking, drinking, fasting glucose level, high-density lipoprotein (HDL) cholesterol level, systolic and diastolic blood pressure, and triglyceride level. For Individuals with the SE type, the predictors were sex, smoking, fasting glucose, HDL cholesterol level, systolic and diastolic blood pressure, and triglyceride level, while the predictors in individuals with the SY type were age, sex, BMI, smoking, drinking, total cholesterol level, fasting glucose level, HDL cholesterol level, systolic and diastolic blood pressure, and triglyceride level. CONCLUSIONS: In this prospective cohort study among 3529 individuals, we observed that utilizing the SC types significantly increased the accuracy of the risk prediction for the development of metabolic syndrome.

Differences in Complexion between Cold- and Heat-Prescription Groups in Sasang Medicine.

Sasang constitutional medicine (SCM) is a type of traditional Korean medicine (TKM) that classifies the human constitution into four types. The appearance of the complexion is one of the diagnostic factors of SCM but is rarely used in a quantitative and objective manner for diagnosis. In this study, an analysis using actual clinical data was conducted to assess the use of the complexion as a diagnostic element. A total of 528 Sasang medicine prescriptions from Korea Constitutional Multicenter Bank (KCMB) were classified into either a Cold-prescription group or a Heat-prescription group, and the complexion differences of the patients were analyzed using the L⁎a⁎b⁎ color space. After adjusting for age, BMI, and systolic blood pressure, significant differences were observed among the Cold- and Heat-prescription groups within each Sasang constitution. However, when the Sasang constitution was ignored, no significant difference was observed for either sex. This study quantitatively analyzed the complexion of patients, which is used as a diagnostic element in clinical practice. It is hoped that the results will contribute to objective medical treatments in the future, such as determining an appropriate herbal prescription based on the patient's complexion.

Body composition and personality traits in so-Yang type males.

BACKGROUND: The purpose of the present study was to examine the body composition of So-Yang type males according to Sasang constitutional medicine, which is popular in Korea. Different Sasang constitutional types are associated with different muscle distributions, body shapes, and disease susceptibilities. We used the Sasang Personality Questionnaire (SPQ) as a measure of the temperament of each Sasang type. METHODS: In total, 953 subjects aged over 20 years were recruited in Korea. We collected anthropometric parameters and bioimpedence information from the subjects and administered the SPQ. A logistic regression was conducted to calculate propensity scores. RESULTS: The percentage of skeletal muscle mass in So-Yang (SY) and non-So-Yang (non-SY) males was 45.8 ± 2.7 and 44.2 ± 3.3, respectively, before matching and 45.8 ± 2.6 and 44.9 ± 3.0, respectively, after propensity score matching. The extracellular water (ECW)/intracellular water (ICW) and extracellular water (ECW)/total body water (TBW) ratios and SPQ scores were significantly different between the SY and non-SY types. CONCLUSIONS: This study suggested that the SY type may be significantly and independently associated with body composition and could be associated with personality.

Differences in the Tongue Features of Primary Dysmenorrhea Patients and Controls over a Normal Menstrual Cycle.

BACKGROUND: The aims of this study were to investigate the relationships between tongue features and the existence of menstrual pain and to provide basic information regarding the changes in tongue features during a menstrual cycle. METHODS: This study was conducted at the Kyung Hee University Medical Center. Forty-eight eligible participants aged 20 to 29 years were enrolled and assigned to two groups according to their visual analogue scale (VAS) scores. Group A included 24 females suffering from primary dysmenorrhea (PD) caused by qi stagnation and blood stasis syndrome with VAS ≥ 4. In contrast, Group B included 24 females with few premenstrual symptoms and VAS < 4. All participants completed four visits (menses-follicular-luteal-menses phases), and the tongue images were taken by using a computerized tongue image analysis system (CTIS). RESULTS: The results revealed that the tongue coating color value and the tongue coating thickness in the PD group during the menstrual phase were significantly lower than those of the control group (P = 0.031 and P = 0.029, resp.). CONCLUSIONS: These results suggest that the tongue features obtained from the CTIS may serve as a supplementary means for the differentiation of syndromes and the evaluation of therapeutic effect and prognosis in PD. TRIAL REGISTRATION: This trial was registered with Clinical Research Information Service, registration number KCT0001604, registered on 27 August 2015.

Modification of the Integrated Sasang Constitutional Diagnostic Model.

In 2012, the Korea Institute of Oriental Medicine proposed an objective and comprehensive physical diagnostic model to address quantification problems in the existing Sasang constitutional diagnostic method. However, certain issues have been raised regarding a revision of the proposed diagnostic model. In this paper, we propose various methodological approaches to address the problems of the previous diagnostic model. Firstly, more useful variables are selected in each component. Secondly, the least absolute shrinkage and selection operator is used to reduce multicollinearity without the modification of explanatory variables. Thirdly, proportions of SC types and age are considered to construct individual diagnostic models and classify the training set and the test set for reflecting the characteristics of the entire dataset. Finally, an integrated model is constructed with explanatory variables of individual diagnosis models. The proposed integrated diagnostic model significantly improves the sensitivities for both the male SY type (36.4% → 62.0%) and the female SE type (43.7% → 64.5%), which were areas of limitation of the previous integrated diagnostic model. The ideas of these new algorithms are expected to contribute not only to the scientific development of Sasang constitutional medicine in Korea but also to that of other diagnostic methods for traditional medicine.

A Study on the Diagnostic Elements of Cold-Heat Pattern Identification by Korean Medicine Doctors: Association with Objective and Subjective Body Temperature.

Although the Cold-Heat Pattern is the most important diagnostic factor in Traditional Korean Medicine (TKM), its relationship to body temperature and subjective temperature has not been clearly revealed. In this study, based on clinical data from 551 patients, we classified patients treated with herbal medicines into a Cold-prescription group (CG) and a Heat-prescription group (HG), and we compared the ordinary symptoms between the two groups. Subjective body temperature was higher in the HG than in the CG (OR = 1.68, p < 0.01) and digestive ability was better in the HG than in the CG (expert's questionnaire, OR = 1.91, p < 0.001). However, objectively measured body temperature did not show any significant difference between the HG and CG in both gender groups (p = 0.383 and 0.181 for males and females, resp.). Our study suggests that the subjective body temperature and digestive ability may be the principal diagnostic elements of Cold-Heat Pattern identification by Korean Medicine Doctors. These findings may contribute to the investigation of an objective method to measure the Cold-Heat Pattern.

Association of Sasang Constitutional Types with Incident Hypertension: A 12-Year Follow-Up Study.

OBJECTIVES: Sasang constitutional types (SCTs) are four distinct classifications of people based on physiologic and physical characteristics. The different types have been reported to have different disease susceptibility, but there are no studies reporting the association of SCT and hypertension (HTN) over a long-term follow-up period. This study prospectively investigated the association between SCT and incidence of HTN. DESIGN: This was a prospective study in a population-based cohort study in Korea. SUBJECTS: Data from two independent population-based cohorts that are embedded within the Korean Genome and Epidemiology Study were used. A total of 2083 subjects who were free of HTN at baseline were selected for the analysis. OUTCOME MEASURES: HTN was diagnosed as systolic blood pressure (BP) ≥140 mmHg and diastolic BP ≥90 mmHg, use of antihypertensive medication, or diagnosis by doctor. The SCTs were classified using an integrated diagnostic method that included facial features, body shape, voice, and questionnaire responses. The association between the SCT and the incidence of HTN was investigated by Cox proportional hazard regression analysis and calculation of estimated survival functions. RESULTS: The Tae-eum (TE) type showed a significantly increased risk for HTN (hazard ratio [HR] = 1.55, 95% confidence interval [CI] 1.15-2.10; p = 0.005), even after adjusting for all possible confounders. In a stratified analysis by body mass index (BMI) conducted only in the TE type, even those in the TE type with normal BMI had a significantly higher risk for HTN (HR = 1.47, 95% CI 1.07-2.03; p = 0.016). Furthermore, survival analysis showed that the TE type had a higher rate of developing HTN than the So-eum and So-yang types had, regardless of obesity status. CONCLUSIONS: These results show that the TE type is an independent risk factor for HTN. Thus, early prevention and treatment for HTN in this type are needed.

Confirmatory and Exploratory Factor Analysis for Validating the Phlegm Pattern Questionnaire for Healthy Subjects.

Background. Phlegm pattern questionnaire (PPQ) was developed to evaluate and diagnose phlegm pattern in Korean Medicine and Traditional Chinese Medicine, but it was based on a dataset from patients who visited the hospital to consult with a clinician regarding their health without any strict exclusion or inclusion. In this study, we reinvestigated the construct validity of PPQ with a new dataset and confirmed the feasibility of applying it to a healthy population. Methods. 286 healthy subjects were finally included and their responses to PPQ were acquired. Confirmatory factor analysis (CFA) was conducted and the model fit was discussed. We extracted a new factor structure by exploratory factor analysis (EFA) and compared the two factor structures. Results. In CFA results, the model fit indices are acceptable (RMSEA = 0.074) or slightly less than the good fit values (CFI = 0.839, TLI = 0.860). Many average variances extracted were smaller than the correlation coefficients of the factors, which shows the somewhat insufficient discriminant validity. Conclusions. Through the results from CFA and EFA, this study shows clinically acceptable model fits and suggests the feasibility of applying PPQ to a healthy population with relatively good construct validity and internal consistency.

Predictors of metabolic abnormalities in phenotypes that combined anthropometric indices and triglycerides.

BACKGROUND: The hypertriglyceridemic waist (HW) phenotype has been shown to be strongly associated with metabolic abnormalities; however, to date, no study has reported the prediction of metabolic abnormalities using the HW phenotype along with waist circumference (WC) and the triglyceride (TG) level or various phenotypes consisting of an individual anthropometric index combined with the TG level. The objectives of this study were to assess the association of the HW phenotype with metabolic abnormalities in Korean women and to evaluate the predictive powers of various phenotypes with regard to metabolic abnormalities. METHODS: Total cholesterol (TC), high- and low-density lipoprotein (HDL and LDL) cholesterol, and TG levels, systolic and diastolic blood pressures (SBP and DBP), and anthropometric indices were measured in 7661 women. The Naive Bayes algorithm and logistic regression were used to determine the predictive powers of the models using different phenotypes. RESULTS: The HW phenotype demonstrated the strongest association with all metabolic components. The best phenotypic predictors were the forehead-to-rib circumference ratio + TG for the HDL level, age + TG for the LDL level, age + TG for SBP, and rib circumference + TG and neck circumference + TG for DBP. The associations between TG and TC or HDL were higher compared with those between WC and TC or HDL, whereas the associations between WC and SBP or DBP were higher compared with those between TG and SBP or DBP. Age was strongly associated with hypercholesterolemia, the HDL and LDL cholesterol levels, and SBP and had good predictive power, but not with respect to DBP. CONCLUSIONS: We have determined that the HW phenotype is a useful indicator of metabolic abnormalities in Korean women; although HW had the strongest association with metabolic abnormalities, the best phenotype combination consisting of a single anthropometric index and the TG level may differ depending on the metabolic factors in question. Our findings provide insights into the detection of metabolic abnormalities in complementary and alternative medicine.

Association of Sasang Constitutional Type with Sarcopenia.

Sasang constitutional medicine (SCM) is a unique Korean traditional medicine that classifies human beings as four distinct types named Sasang constitutional types (SCTs), based on physiologic, physical, and psychological traits. Accumulating evidence has demonstrated that specific constitutional types are associated with chronic diseases, but no study has investigated the relationship between SCTs and sarcopenia. The aim of this study was to examine the association in a large population-based study. Data from 1,204 participants who completed questionnaires for life style, anthropometric evaluation, and biochemical analysis were analyzed. Classification of the SCTs was done using an integrated diagnostic method. Sarcopenia was defined as appendicular skeletal muscle mass/height(2) less than one standard deviation below the gender-specific normal mean of a younger group. Dual-energy X-ray absorptiometry was used to assess whole body composition. The prevalence of sarcopenia was 8.6% in the Tae-eum (TE) type, 44.7% in the So-eum (SE) type, and 20.7% in the So-yang (SY) type. Multivariate analysis revealed that the SE and SY types had 9.22 (5.06-16.81; P < 0.0001) and 2.90 (1.76-4.76; P < 0.0001) greater odds of sarcopenia compared to the TE type, respectively. Our results show that the SE and SY types are significantly associated with increased prevalence of sarcopenia.

Non-alcoholic fatty liver disease among sasang constitutional types: a population-based study in Korea.

BACKGROUND: Non-alcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease and is highly prevalent in populations with metabolic conditions such as obesity and type II diabetes. Specific types of Sasang constitution can act as a risk factor for metabolic diseases, but there are no studies addressing the association between the Sasang constitutional types (SCTs) and NAFLD. METHODS: A total of 1184 individuals (508 males, 676 females) that enrolled in the Korean Genome and Epidemiology Study were included in the present study. Classification of SCTs was done with an integrated diagnostic model. NAFLD was diagnosed when the liver attenuation index (LAI) value was <5 Hounsfield units using computed tomography. Relationships between the SCTs and NAFLD were analyzed using multiple logistic regressions. RESULTS: The average LAI was 13.3±6.0 in the So-eum (SE) type, 12.3±7.0 in the So-yang (SY) type, and 6.5±9.9 in the Tae-eum (TE) type. Prevalence of NAFLD was 4.7% in the SE type, 14.0% in the SY type, and 34% in the TE type. Even after adjusting for possible confounders, the SY and TE types continued to show a 3.90-fold (95% CI, 1.60-9.51; P=0.0028) and 3.36-fold (95% CI, 1.42-7.92; P=0.0057) increase in chance of having NAFLD, respectively, compared with the SE type. In the additional analysis including only non-obese subjects, the odds ratio of NAFLD was 3.27 (95% CI, 1.29-8.29; P=0.0126) in the SY type and 3.53 (95% CI, 1.30-9.58; P=0.0134) in the TE type compared with SE type. In the multivariate analysis to determine which parameter had an independent association with NAFLD, higher body mass index, alanine aminotransferase (ALT), triglyceride (TG), and low high-density lipoprotein cholesterol were independently associated with developing NAFLD in the SY type. In contrast, male sex, alcohol consumption, higher ALT, TG, and fasting glucose were risk factors for NAFLD in the TE type. CONCLUSIONS: These results indicated that the SY and TE types are independent risk factors for NAFLD.

Thermoregulatory Responses to Graded Exercise Differ among Sasang Types.

We compared sweat rate and variables such as workload (W e ), metabolic heat production (H prod), and temperature increment load (T inc) across Sasang types. 304 apparently healthy participants aged 20-49 years with their Sasang type determined were enrolled. Local sweat rates on the chest (LSRchest) and back (LSRback) were measured using a perspiration meter during a maximum treadmill exercise test. Oxygen uptake was measured continuously using a breath-by-breath mode indirect calorimeter. The TaeEum (TE) type had a larger body size, a higher percent body fat, and a lower body area surface area (BSA) to body mass compared with the other Sasang types, particularly the SoEum (SE) type. The TE type tended to have a shorter exercise time to exhaustion and lower maximal oxygen uptake (mL·kg(-1)·min(-1)) than the other types. LSRchest in TE types was greater than that of the SE and SoYang (SY) types in men, whereas LSRback was higher in the TE type than that of the other types in women. After normalizing LSR for W e , H prod, T inc, and BSA, this tendency still remained. Our findings suggest that the thermoregulatory response to graded exercise may differ across Sasang types such that the TE type was the most susceptible to heat stress.

Association of hypertension with physical factors of wrist pulse waves using a computational approach: a pilot study.

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.

The obesity-risk variant of FTO is inversely related with the So-Eum constitutional type: genome-wide association and replication analyses.

BACKGROUND: Body constitutional types described in the traditional Korean medicine system, Sasang constitutional medicine, are heritable, as has been revealed by twin and family studies. Thus, individuals with the same constitution type usually have similar pathophysiological and psychological traits. In several recent genome-wide association (GWA) analyses performed to identify constitution-associated variants, the association signals were not replicated due to small sample size and dissimilar, non-objective methods for classification of the constitutional types. METHODS: We conducted GWA analysis and followed replication analysis in two large populations (5,490 subjects: 3,810 subjects at discovery stage and 1,680 subjects at replication stage) to identify the replicable constitution-associated variants, wherein subjects with the highest tertile of constitution probability values versus the reference with the lowest tertile of the values obtained from a recently developed constitution analysis tool were compared. RESULTS: We found that the obesity-risk variant in intron 1 of the fat mass and obesity-associated (FTO) gene was replicably inversely associated with the So-Eum (SE) type, characterized by reduced appetite, slim body, and cautious personality (rs7193144 in combined samples: odds ratio = 0.729, p = 1.47 × 10(-7)), and substantial association signal remained after controlling for body mass index (BMI). In contrast, the association of the variant with the Tae-Eum type, characterized by high body mass, disappeared after controlling BMI. CONCLUSIONS: In summary, the obesity-risk variant in FTO intron 1 was inversely associated with the SE type, independent of BMI, which corresponded well with the characteristics of the SE type, such as the lowest body mass and lowest susceptibility to metabolic disorders among the constitutional types. Therefore, the obesity-risk variant of FTO associated with body mass increase might be involved in the determination of body constitution type.