• Title/Summary/Keyword: arm position

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Total Spinal Block and Cortical Epidural Block for Whiplash Syndrome and Reflex Sympathetic Dystrophy (Report of Four Cases) (전척수(全脊髓) 및 경막외차단(硬膜外遮斷)으로 편타성(鞭打性) 손상(損傷)의 통증치험(痛症治驗) (4례(例) 보고(報告)))

  • Park, Wook;Ok, See-Young;Song, Hoo-Bin
    • The Korean Journal of Pain
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    • v.1 no.1
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    • pp.106-119
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    • 1988
  • For the relief of pain in 3 cases of whiplash syndromes (case I, II and IV) and in one of reflex sympathetic dystrophy (case III), we have carried out six intentional. total spinal blocks (TSB) which attempted two times in case I, three in case II and one in carte III whoso various symptoms were chronically unresponsive to the usual conservative treatments, and a time of cervical epidural and right suprascapular nerve block in case W whose acute symptom lasted 4 drys following the cervical injury (see fables from 1 to 9). During the 753, we have observed clinically the sequential charges of respiration, lid and pupil reflexes, body motion and consciousness. And checked the blood pressure, pulse rate and arterial Pco2. The effectiveness of those blocks has been assessed by using the Visual Analog Scale which is designed to measure the patient$\acute{s}$ subjective intensity of pain and also we have found out the sequelae following those blocks. The methods of the blocks were as the following: 1. Under the N.P.O. for 8~10 hours, the preparations of immediate cardiopulmonary resuscitation and premedication with atropine 0.5mg at thirty minutes before the TSB, it was performed by injecting the mixture of 2% mepivacaine 10 or 15ml and normal saline 10 or 5ml through No. 23 G. spinal needle into the subarachnoid space of $C_7-T_1$ interspinous region with fully flexed neck on the lateral posture. Immediately after the injection of the local anesthetic in the lateral position, the patient$\acute{s}$ were hasten to change Trendelenburg$\acute{s}$ position in order to act the drugs cephalad and to make easy controlled respiration with oxygen. 2. The cervical epidural block was done by injecting the mixture of 0.5% bupivacaine 4ml, normal saline 4ml and triamcinolone 15mg through No. 18 G. Tuohy needle into the epidural space on the same region and posture as the above without premedication.7he suprascapular nerve block was done by injecting of 0.5% bupivacaine 3ml only into the right suprascapular fossa on the sitting posture. The results were as the following: 1. The cessation of respiration was seen within 5 minutes following the subarachnoidal injection of the above 20ml mixture in 2 to 3 minutes and then soon the consciousness began to disappear. The loss of Lid and pupil reflexes noted between 5 to 10 minutes and the size of the dilated pupils was equal between 5 to 20 minutes, but the pupil of the dependent side on tile lateral position was dilated 1 to 3 minutes earlier than that of the independent. The patients had r=ever responded to any stimulations during the TSB except their heart funtion. 2. The recovery of the TSB was as the following, firstly the ankle and lower limb of the independent side began to move slightly with in 34 to 75 minutes after the injection and then that of the dependent Secondly the neck and upper limb moved 6 to 15 minutes later than the lower limb. Thirdly the self respiration began to appear between 40 to 80 minutes from the block. The lid and pupil reacted to touch and light respectively between 40 to 80 minutes but the pupil of the independent side responded earlier than that of the depends. Lastly the consciousness recovered completely between 80 to 125 minutes from the block. 3. In the cardiopulmonary function during the TSB, the blood pressure were stable except the 210/130 tory at the and block of case I. There were bradycardias between 65 to 85 minutes in case I and II but no arrythmia on the EKG. The level of the arterial Pco2 was maintained to 43~45 torr during the TSB. 4. The effectiveness of the above blocks was no pain(0%) in case IV, and light (10~20%) in case I and II but no improvement in case III. 5. The right arm weakness has been complicated as to be Injected accidently the "COLD" local anesthetic at the End block of case I.

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A Clinical Evaluation of Splanchnic Nerve Block (내장신경차단에 관한 임상적 연구)

  • Kim, Soo-Yeoun;Oh, Hung-Kun;Yoon, Duek-Mi;Shin, Yang-Sik;Lee, Youn-Woo;Kim, Jong-Rae
    • The Korean Journal of Pain
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    • v.1 no.1
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    • pp.34-46
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    • 1988
  • Intractable pain from advanced carcinoma of the upper abdomen is difficult to manage. One method used to control pain associated with these malignancies is to block off the splanchnic nerve. In 1919 Kappis described a technique by which the splanchnic nerve of the upper abdomen could be anesthetized, using a percutaneous injection. This method has been used for the relief of upper abdominal pain due to hematoma and cancer of the pancreas, stomach, gall bladder, bile duct, and colon. During the Period from November 1968 to January 1986, this method was used in 208 cases of malignancy at Severance Hospital and clinically evaluated. Patients were retroactively grouped according to the stage of development of technique used. Twelve patients who received the treatment in the period from November 1968 to March 1977 were designate4i as group 1, 26 patients from April 1977 to April 1979 as group 2, and 170 from May 1979 to January 1986 as group 3. The results are as follows: 1) The number of patients receiving splanchnic nerve block has been increasing since 1977. 2) A total of 208 patients, including 133 males and 75 females, ranging in age from 18 to 84 and averaging 51. 3) The causes of pain were stomach cancer 90, pancreatic cancer 69, and miscellaneous cancer 49 cases respectively. 4) There were 57.7% who had surgery. and 3.7% of whom had chemotherapy before the splanchnic nerve block was done. 5) These blocks were carried out with the patient in the prone position as described by Dr. Moore. For group 2 and 3, C-arm image intensifier was used. In group 1, a 22 gauze loom long needle was inserted at the lower border of the 12th rib on each aide about 7\;cm from the midline. The average distance from the midline was $6.60{\pm}0.61\;cm$ on the left side and $6.60{\pm}0.83\;cm$ on the right side in group 2, and $5.46{\pm}0.76\;cm$ on the left side and $5.49{\pm}0.69\;cm$ on the right side in group 3. The average depth to which the needle was inserted was $8.60{\pm}0.52\;cm$ on the left side and $8.74{\pm}0.60\;cm$ on the right side in group 2, and $8.96{\pm}0.63\;cm$ on the left side and $9.18{\pm}0.57\;cm$ on the right side in group 3. 6) The points of the inserted needles were positioned in the upper quarter anteriorly, 51.8% on the left side and 54.4% n the right side of the L1 vertebra by lateral roentgenogram in group 3. The inserted needle points were located in the upper and anterolateral part, of the L1 vertebra 68.5% on the left side and 60.6won the right side, on the anteroposterior rentgenogram in group 3. The needle tip was not advanced beyond the anterior margin of the vertebral body. 7) In some case of group 3, contrast media was injected before the block was done. It shows, the spread upward along the anterior mal gin of the vertebral body. 8) The concentration and the average amount of drug used in each group was as follows: In group 1, $39.17{\pm}6.69\;ml$ of 0.5% -l% lidocaine or 0.25% bupivacaine were injected for the test block and one to three days after the test block $40.00{\pm}4.26\;ml$ of 50% alcohol was injected for the semipermanent block. In group 2, $13.75{\pm}4.88\;ml$ of 1% lidocaine were used as the test block and followed by $46.17{\pm}4.37\;ml$ of 50% alcohol was injected as the semipermanent block. In group 3, $15.63{\pm}1.19\;ml$ of 1% lidocaine for test block followed by $15.62{\pm}1.20\;ml$ of pure alcohol and $16.05{\pm}2.58\;ml$ of 50% alcohol for semipermanent block were injected. 9) The result of the test block was satisfactory in all cases. However the semipermanent block was 83.3 percent of the patients in group 1 who received relief from pain for at least 2 weeks after the block, 73.1% in group 2, and 91.8% in group 3. In these unsuccessful cases, 2 cases in group 1 were controlled by narcotics but 7 cases in group 2 and 14 cases in group 3 received the same splanchnic nerve block 1 or 2 times again within 2 weeks. But, in some cases it was 3 to i months before the 2nd block and in 1 cases even 7 years. 10) The most common complications of splanchnic nerve block were hypotensino(25.5%) occasional flushing of the face, nausea, vomiting, and chest discomfort. 11) For the patients in group 3, the supplemental block most commonly used was a continuous epidural block; it was used as a diagnostic block and to afford relief from pain before the splanchnic nerve block was done. 12) The interval between the receiving of the alcohol block and discharge was from 5 to 8 days in 61 cases(31.1%) and from 1 to 2 days in 48 cases(24.5%). From the above results, it can be concluded that the splanchnic nerve block done in the prone position with pure and 50% alcohol immediately after an effective test block with 1% lidocaine under C-arm fluoroscopic control is satisfactory and reliable. How to minimize the repeat block is still a problem to be solved.

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Calibration Kit for 4-Port Horizontal/Vertical Probing (4-포트 수평/수직 겸용 프로브용 교정키트)

  • Kim, Taeho;Kim, Jonghyeon;Kim, Sungjun;Kim, Kwangho;Pu, Bo;Nah, Wansoo
    • The Journal of Korean Institute of Electromagnetic Engineering and Science
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    • v.25 no.5
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    • pp.559-575
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    • 2014
  • In this paper, we propose a horizontal/vertical calibration kit for calibrating a vector network analyzer(VNA) to measure the vertical connector pin. If the conventional calibration kit is used, we should change the arm for a probe or need an assistant device and it takes a long time. In addition there is a risk of precision degradation caused by the position change of the probe tip sensitive to the surroundings. We suggest a 4-port vertical calibration kit to make up for the aforementioned shortcomings. The calibration kit was manufactured for the SOLT calibration method. 'Short', 'Open', and 'Load' are available in the horizontal plane, 'Thru' is available not only in the horizontal plane on the two planes of a PCB, but in the vertical plane between the two planes according to the positions of the probes. We complemented the conventional calibration kit to make a vertical calibration kit to be used for the vertical measurement method. We compared and analysed their reflection/transfer characteristics of the SOLT calibration standards of the proposed calibration kit and conventional one, we get a ${\pm}0.1$ dB differences of transfer characteristics in the range from 300 kHz to 8.5 GHz. In order to demonstrate usefulness, and we performed a case study for horizontal and vertical cases, and compared the results of the proposed calibration kit and conventional one.

A Study of Accuracy and Usability for Acupuncture Points Locating Devices (경혈정위 보조도구의 정확성 및 편의성 평가 연구)

  • Chae, Youn-Byoung;Kang, O-Seok;Hahm, Dae-Hyun;Lee, Seung-Ho;Kim, Jai-Soon;Kim, Kwan-Hyung;Kim, Hee-Young;Lee, Hye-Jung;Park, Hi-Joon
    • Korean Journal of Acupuncture
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    • v.24 no.2
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    • pp.61-76
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    • 2007
  • Objectives : Accurate and reproducible location of an acupuncture point (AP) have been considered an essential component of meaningful acupuncture research as well as clinical practice. Several kinds of devices have been developed and widely used for the convenience of locating APs. However, the accuracy and convenience of these devices have not been systematically evaluated. The present study was performed to find out the most suitable tools for the location accuracy and location easiness of APs among the devices respectively. Methods : Twenty subjects attempted to locate APs, including PC5 and SP6 in the arm and leg, using four different AP positioning methods: one Conventional Ruler method and three alternative methods including Cunometer, Transparent AP meter, and Elastic Ruler method. The position marked on each AP was plotted onto a thin, flexible, and transparent plastic film, and the dispersion rate of the positions was determined and recorded. The elapsed time for locating each AP was measured. After that each subject was answered to a short questionnaire regarding the degree of convenience and confidence of use of each method for AP location. Results : All of three alternative methods took less time than Conventional Ruler method did. Among these alternative methods, the accuracy of Elastic Ruler method was markedly higher than others. The degree of convenience of the Cunometer and the confidence of Elastic Ruler method were the highest among these alternative methods. Conclusions : The present study indicates that the Elastic Ruler method was the most compatible for the conventional Ruler methods. However, there are many factors need to be reconsidered. Improved devices for locating AP are imperatively needed for clinical practice.

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Effect of Bundle icing Forces on the Shattering Loss of Grains (바인다의 효출력이 곡물탈립손실에 미치는 영향)

  • 백풍기;정창주
    • Journal of Biosystems Engineering
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    • v.3 no.1
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    • pp.20-36
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    • 1978
  • The effect of binder kicking forces on the shattering losses of paddy rice, which has been widely understood as an outstanding loss factor in harvesting with a binder, were experimentally assessed in this thesis.Through the field tests the optimum time of harvest, in terms of grain moisture contents, was found by considering harvesting losses for two rice varieties, harvested by two different binders, at four or five grain moisture levels.A device was designed and manufactured to apply various kicking forces to the bundles and was used in the bundle kicking tests. It was intended to find out the optimum range of kicking force to minimize the kicking losses. Based on the study, modification of the existing binder kicking mechanism was suggested. The following is a summary of the results of this thesis. 1. In Suweon 258 variety, as the grain moisture content is reduced, so the cutting loss and the kicking loss increase. The grain losses range from 0.77 to 0.82 percent of total field yield for the cutting loss, from 1.83 to 2.01 percent for the kicking loss, and from 2.60 to 2.83 percent for the field loss, when the moisture content is about 22 percent. 2. In Jinheung variety , the field losses increased as the grain moisture content decreased . When the moisture content was 20 percent, the field loss, cutting loss and kicking loss was 0.42-0.49 % , 0.30-0.35, and 0.12 -0.14% of the total field yield, respectively. 3. The difference in the field loss , cutting loss, and kicking loss for the two binders was 0.23% , 0.05% and 0.18% respectively in Suweon 258 variety, and 0.07% , 0.02% and 0.05% respectively ini Jinheung variety. The grain losses for binder B were slightly higher than those for binder A. 4. In the statistical analysis of each variety , the kicking force and the moisture content of the grain, and its interaction were all highly significant at 1% level by T test .The optimum kicking force was found to be in the 3.0-0.4kg range. This does not interrupt the binder operation, while ioses are kept to an acceptale level. 5. To reduce the kicking force of the eXlstmg binder mechanism, the speed of rotation of the kicking arm needs to be redued by increasing the number of driving sprocket teeth, and the position and gear ratio of the knotter-bill and driving bevelgear have to be change to give a !motter-bill speed of 1110 rpm. It is also desirable to attach a belt conveyor which smoothly carries the bundle to the ground. 6. The optimum harvesting time cased on maximum field yield was found to be at a grain moisture content of around 22 percent for Suweon 258 variety, and 20 percent for Jinheung variety. Tota] field yield and field yield at the time amounted to 9, 812.5 kg/ha, 9, 302. 5kg/ha respectively for the Suweon 258, and 7, 819.5 kg/ ha, 7, 158.7 kg/ha respectively for the Jinheung variety.

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Kinematical Analysis of Endo 360° El-grip in Horizontal Bar (철봉 엔도 360°엘그립 동작의 기술분석)

  • Back, Jin-Ho;Park, Jong-Chul;Yoon, Jong-Wan;Lee, Yong-Sik;Park, Jong-Hoon
    • Korean Journal of Applied Biomechanics
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    • v.16 no.3
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    • pp.65-74
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    • 2006
  • This study was attempted to Kinematical characteristics of the Endo $360^{\circ}$El-grip Swing on the horizontal bar. To do this, we selected and analyzed the performance of two athletes who did Endo $360^{\circ}$El-grip Swing in the horizontal bar competition of male artistic gymnastic in the 22nd Universiad Games 2003 Daegu. We drew the conclusions from the kinematical factors that were came out through analyzing three-dimensional cinematography of the athletes' movements, by using two video cameras. In point of analyzing the actual competition situation, it is expected that gymnastics and coaches have the effective informations, and the following conclusion had resulted. 1. When performing Endo $360^{\circ}$El-Grip, the average for entire required time was $1.93{\pm}0.06sec$. The average for descent phase time was $0.24{\pm}0.02sec$, ascent phase time was 0.22${\pm}0.07sec$, connecting phase time was $0.87{\pm}0.07sec$, and El-Grip phase time was $0.61{\pm}0.02sec$. The descent phase need short period of time but however to have a stable performance, ensuring ascent and connecting phase time are needed. El-Grip phase need short period of time to have a stable re-grasp. 2. To have a convenient preparation for El-Grip in descent and ascent phase, lowering CM, and ease up in sway and plunge from the High Bar would make descent and ascent even more faster and would have increase effect in trunk rotation. 3. In descent and ascent phase, if shoulder angle and arm slope is dwindling then it would effect rotation angle so might risk it from hitting a Bar when putting legs in and out. 4. In connecting phase, it requires some time to show stable performance when El-Grip phase is continued by using hip angle which would make trunk rotation angle bigger and make descent and ascent time slower. 5. In El-Grip phase, when doing motions like hand standing. using hip angle more than maximum would make CM even faster and it is stable position while performing.

Analysis of Overall Setup Accuracy Using On-Board Imager�� (온-보드 영상장치를 이용한 총체적 셋업의 정확성 분석)

  • Ma, Sun-Young;Lim, Sang-Wook;Kang, Soo-Man;Jeung, Tae-Sig
    • Progress in Medical Physics
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    • v.22 no.2
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    • pp.67-71
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    • 2011
  • We evaluated the overall setup accuracy for the On-Board Imager (OBI, Varian Medical Systems Inc., Palo Alto, CA, USA), with attention to the laser, the gantry, and operator performance. We let experienced technicians place the marker block on the couch using a lock bar system, with alignment to the isocenter of the laser, every morning. A pair of radiographic images of the marker block was acquired at $0^{\circ}$ and $270^{\circ}$ angles to the kV arm to correct the position using a 2D/2D matching technique. Once the desired match was achieved, the couch was moved remotely to correct the setup error and the parameters were saved. The average for the vertical and the longitudinal displacements were 0.65 mm and 0.66 mm, and 0.01 mm for the lateral displacement. The average for the vertical and longitudinal displacements were statistically significant at the 0.05 level (p value=0.000 for both), while the p value for the lateral direction was 0.829. These results show that the tendencies to displacement in vertical and longitudinal directions occur through systematic error, while systematic error was not found in the lateral displacement. This daily overall evaluation is practical and easy to find the systematic and random errors in the setup system; however, a daily QA for laser and OBI alignment is still needed to minimize the systematic error in aligning patients.

Ergonomic Evaluation of Refrigerator Design (냉장고 디자인의 인간공학적 평가)

  • 박재희;황민철;박세진;김명석
    • Archives of design research
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    • v.14
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    • pp.1-7
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    • 1996
  • Designers often hesitate to decide the shape, size, and layout of a product. Though ergonomic principles and data are absolutely needed in this process, they don have enough guidelines to refer. For the refrigerator designers, they also are not convinced of their decision: the vertical position of the freezing and refrigerating rooms, the height of shelves, the shape of door-handle, etc. To support the refrigerator design, we applied several ergonomic methods to the evaluation of refrigerator. EMG was measured to evaluate the load of users lumbar muscle. Based upon the experimental EMG data, we developed a model to estimate the relative load corresponding to the height of refrigerator shelves. Two different layouts of a refrigerator, R/F and F/R styles, were compared with the model. A three-dimensional motion analysis method was used to evaluate the users motion of using a refrigerator. Ten door-handles with the different shapes and positions were evaluated by tracking the rotations of the users arm. Video protocol analysis was used to evaluate the user interface of a control panel in a refrigerator. Finally, we suggested several ergonomic design guidelines based on the facts found in this research and the anthropometric data of the Korean adults. The results of this study can be applied to the ergonomic design of refrigerators

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Kinematic and Ground Reaction Force Analyses of the Forehand Counter Drive in Table Tennis (탁구 포핸드 카운터 드라이브 동작의 운동학적 변인 및 지면 반력 분석)

  • Lee, Young-Sik;Lee, Chong-Hoon
    • Korean Journal of Applied Biomechanics
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    • v.20 no.2
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    • pp.155-165
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    • 2010
  • The purpose of this study was to analyze kinematic quantitative factors required of a forehand counter drive in table tennis through 3-D analysis. Four national table tennis players participated in this study. The mean of elapsed time for total drive motion was $1.009{\pm}0.23\;s$. At the phase of impact B1 was the fastest as 0.075 s. This may affect efficiency in the initial velocity and spin of the ball by making a powerful counter drive. The pattern of center of mass showed that it moved back and returned to where it was then moved forward. At the back swing, lower stance made wide base of support and a stronger and safer stance. It may help increasing the ball spin. Angle of the elbow was extended up to $110.75{\pm}1.25^{\circ}$ at the back swing and the angle decreased by $93.75{\pm}3.51^{\circ}$ at impact. Decreased rotation range of swinging arm increased linear velocity of racket-head and impulse on the ball. Eventually it led more spin to the ball and maximized the ball speed. Angle of knee joint decreased from ready position to back swing, then increased from the moment of the impact and decreased at the follow thorough. The velocity of racket-head was the fastest at impact of phase 2. Horizontal velocity was $7796.5{\pm}362\;mm/s$ and vertical velocity was $4589.4{\pm}298.4\;mm/s$ at the moment. It may help increase the speed and spin of the ball in a moment. The means of each ground reaction force result showed maximum at the back swing(E2) except A2. Vertical ground reaction force means suggest that all males and females showed maximum vertical power(E2), The maximum power of means was $499.7{\pm}38.8\;N$ for male players and $519.5{\pm}136.7\;N$ for female players.

Development of an Measuring System for Pulse Wave Corresponding to Different Radial Artery Diameters Caused by Indentation (요골동맥 직경 변화에 따른 맥파 측정 시스템 개발)

  • Lee, Jeon;Woo, Young-Jae;Jeon, Young-Ju;Lee, Yu-Jung;Kim, Jong-Yeol
    • The Transactions of The Korean Institute of Electrical Engineers
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    • v.57 no.12
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    • pp.2351-2357
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    • 2008
  • Noninvasive radial artery pulse wave has been widely used not only for the pulse wave analysis(PWA) itself but also for assessment of arterial stiffness with estimated aortic pulse wave from peripheral pulse wave. However, it has been found that the deformation of pulse shape can be caused readily by changing measuring position, indentation pressure, and so on. So, in this study, we have developed a system which can measure radial pulse wave and skin displacement simultaneously while the indentation body goes down to occlude subject's radial artery. This system can be divided into a measuring apparatus part, an indentation control hardware part, a data acquisition part and a control and computation part. And, the measuring apparatus consists of an arm-rest, a step motor, an indentation body, a laser displacement sensor(LK-G30, Keyence Co.) and pulse wave sensor. Under load-free condition and radial artery loaded condition, the evaluation of developed system has been performed. From these results, we can conclude: 1) The developed system can control the indentation body quantitatively and the adopted laser displacement sensor shows linear output characteristic even with skin as a reflector. 2) This system can measure the pulse wave and the displacement of indentation body, that is, skin displacement simultaneously at each specific level of indentation body. 3) This system can provide the number of motor steps used to get down the indentation body, the measured skin displacement, the calculated indentation pressure, the calculated pulse pressure and the pulse waveform as well as the information generated by combining these with each others. 4) This system can reveal the relationship between the morphological changes of pulse wave and the estimated displacement of radial artery wall by indentation. Consequently, the developed system can furnish more abundant information on radial artery than previous diagnosis systems based on tonometric measurement. In further study, we expect to setup the standard measuring process and to concrete the algorithm for the estimation of radial artery's diameter and of displacement of radial artery's wall. Furthermore, with well designed clinical studies, we hope to turn out the usefulness of developed system in the field of cardiovascular system evaluation.