• 대한신경과학회지
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• 제35권1호
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• pp.8-15
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• 2017

Near-infrared spectroscopy (NIRS), a noninvasive optical method, utilizes the characteristic absorption spectra of hemoglobin in the near-infrared range to provide information on cerebral hemodynamic changes in various clinical situations. NIRS monitoring have been used mainly to detect reduced perfusion of the brain during orthostatic stress for three common forms of orthostatic intolerance (OI); orthostatic hypotension, neurally mediated syncope, and postural orthostatic tachycardia syndrome. Autonomic function testing is an important diagnostic test to assess their autonomic nervous systems for patients with symptom of OI. However, these techniques cannot measure dynamic changes in cerebral blood flow. There are many experimentations about study of NIRS to reveal the pathophysiology of patients with OI. Research using NIRS in other neurologic diseases (stroke, epilepsy and migraine) are ongoing. NIRS have been experimentally used in all stages of stroke and may complement the established diagnostic and monitoring tools. NIRS also provide pathophysiological approach during rehabilitation and secondary prevention of stroke. The hemodynamic response to seizure has long been a topic for discussion in association with the neuronal damage resulting from convulsion. One critical issue when unpredictable events are to be detected is how continuous NIRS data are analyzed. Besides, NIRS studies targeting pathophysiological aspects of migraine may contribute to a deeper understanding of mechanisms relating to aura of migraine. NIRS monitoring may play an important role to trend regional hemodynamic distribution of flow in real time and also highlights the pathophysiology and management of not only patients with OI symptoms but also those with various neurologic diseases.

• The Korean Journal of Pain
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• 제12권2호
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• pp.238-241
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• 1999

Intractable pain arising from disorders of the viscera and somatic structures within the pelvis and perineum often poses difficult problems for the pain pratitioner. The reason for this difficulty is that the region contains diverse anatomic structures with mixed somatic, visceral, and autonomic innervation affecting bladder and bowel control and sexual function. Clinically, sympathetic pain in the perineum has a distinctly vague, burning, and poorly localized quality and is frequently associated with the sensation of urgency. Although various approaches have been proposed for the management of intractable perineal pain, their efficacy and applications are limited. Historically, neurolytic blockade in this region has been focused mainly on somatic rather than sympathetic components. The efficacy of neurolytic ganglion impar block has been demonstrated in treating perineal pain without significant somatovisceral dysfunctions for patient with advanced cancer in 1990. The introduction of superior hypogastric plexus block in 1990 demonstrated its effectiveness in patients with cancer related pelvic pain. In our report, five patients had advanced cancer (rectal caner 3; cervix cancer 1; metastases to sacral portion of renal cell cancer 1). Localized perineal pain was present in all cases and was characterized as burning and urgent with 9~10/10 pain intensity. After neurolytic block of ganglion impar, patients experiened incomplete pain reduction (7~8/10), as determined by the VAS (visual analogue scale), and change in pain site. We then treated with superior hypogastric plexus block, which produced satisfactory pain relief (to less than 4/10), without complication.

• Clinical and Experimental Pediatrics
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• 제49권4호
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• pp.446-450
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• 2006

Congenital central hypoventilation syndrome은 혈중 이산화탄소 증가와 저산소에 대한 자율 신경계와 호흡 조절 기능의 선천성 결함으로 호흡의 저환기가 주로 수면시에 발생하는 질환이다. 이는 신경 이주장애 질환(neurocristopathy)에 속한다고 알려져 있으며 선천성 거대결장 등의 질환과 잘 동반된다. 아직까지 확실한 완치법은 없는 상태이고 환아들은 평생을 환기 보조에 의존하여 생존해야 하며 적절한 환기 보조를 통해서 생존 기간을 연장할 수 있다. 저자들은 출생시부터 반복되는 수면시의 무호흡과 청색증이 있는 환아에서 congenital central hypoventilation 및 선천성 거대 결장이 동반된 1례를 경험하였기에 보고하는 바이다.

• BMB Reports
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• 제35권4호
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• pp.420-427
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• 2002

Partial nerve injury is the main cause of neuropathic pain disorders in humans. Acupuncture has long been used to relieve pain. It is known to relieve pain by controlling the activities of the autonomic nervous system. Although the mechanism of neuropathic pain and analgesic effects of electroacupuncture (EA) have been studied in a rat model system, its detailed mechanism at the molecular level remains unclear. To identify genes that might serve as either markers or explain these distinct biological functions, a cDNA microarray analysis was used to compare the expression of 8,400 genes among three sample groups. Messenger RNAs that were pooled from the spinal nerves of 7 normal. 7 neuropathic pain, and 7 EA treatment rat models were compared. Sixty-eight genes were differentially expressed more than 2-fold in the neuropathic rat model when compared to the normal, and restored to the normal expression level after the EA treatment. These genes are involved in a number of biological processes, including the signal transduction, gene expression, and nociceptive pathways. Confirmation of the differential gene expression was performed by a dot-blot analysis. Dot-blotting results showed that the opioid receptor sigma was among those genes. This indicates that opioid-signaling events are involved in neuropathic pain and the analgesic effects of EA. The potential application of these data include the identification and characterization of signaling pathways that are involved in the EA treatment, studies on the role of the opioid receptor in neuropathic pain, and further exploration on the role of selected identified genes in animal models.

• 대한불안의학회지
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• 제16권2호
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• pp.83-90
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• 2020

Objective : Heart rate variability (HRV) is known to reflect autonomic nervous system activity. Individuals with posttraumatic stress disorder (PTSD) are reported to have lower HRVs. We attempted to find HRV indices with head up tilt position that reflect the symptoms well in order to evaluate PTSD symptoms. Methods : Sixty-seven patients with PTSD and 72 patients without PTSD were assessed using the PTSD Checklist for DSM-5 (PCL-5), the Beck Depression Inventory, the Beck Anxiety Inventory and the Pittsburgh Sleep Quality Index. HRV was measured in the head-up tilt position. We collected data regarding heart rate (HR), standard deviation of the NN intervals (SDNN), the square root of the mean squared differences of successive NN intervals (RMSSD), log low-frequency (LNLF) and log high-frequency (LNHF). Results : The value of LNHF was different according to presence or absence of PTSD after head-up tilt position. In the findings of the association between PTSD symptoms and HRV indices as based on head-up tilt, LNHF had a significant correlation with the total score of PCL-5. Conclusion : The reduction of the high-frequency component of HRVs in the PTSD group might reflect more PTSD symptoms.

• Korean Journal of Acupuncture
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• 제33권4호
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• pp.176-182
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• 2016

Objectives : This study was designed to analyze the characteristic of heart rate variability(HRV) changes between Deficiency Pattern and Excess Pattern in Stroke Patients admitted to the hospital. Methods : We measured heart rate variability of stroke patients who were admitted to the Department of Korean Internal medicine, Stroke and Neurological Disorders Center from February 1, 2015 to May 30, 2016. We recruited a total of 28 stroke patients and heart rate variability tests were performed on the first day of admission, 2weeks after admission, and 4 weeks after admission. Results : VLF and LF/HF ratio significantly increased over time in Deficiency Pattern group compared with those in the Excess Pattern group. Conclusions : This results suggest that the parasympathetic function of Deficiency Pattern group is lower than that of the Excess Pattern group, resulting in imbalance of the autonomic nervous system.

• Safety and Health at Work
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• 제3권4호
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• pp.257-267
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• 2012

Occupational neurotoxic diseases have become increasingly common in Taiwan due to industrialization. Over the past 40 years, Taiwan has transformed from an agricultural society to an industrial society. The most common neurotoxic diseases also changed from organophosphate poisoning to heavy metal intoxication, and then to organic solvent and semiconductor agent poisoning. The nervous system is particularly vulnerable to toxic agents because of its high metabolic rate. Neurological manifestations may be transient or permanent, and may range from cognitive dysfunction, cerebellar ataxia, Parkinsonism, sensorimotor neuropathy and autonomic dysfunction to neuromuscular junction disorders. This study attempts to provide a review of the major outbreaks of occupational neurotoxins from 1968 to 2012. A total of 16 occupational neurotoxins, including organophosphates, toxic gases, heavy metals, organic solvents, and other toxic chemicals, were reviewed. Peer-reviewed articles related to the electrophysiology, neuroimaging, treatment and long-term follow up of these neurotoxic diseases were also obtained. The heavy metals involved consisted of lead, manganese, organic tin, mercury, arsenic, and thallium. The organic solvents included n-hexane, toluene, mixed solvents and carbon disulfide. Toxic gases such as carbon monoxide, and hydrogen sulfide were also included, along with toxic chemicals including polychlorinated biphenyls, tetramethylammonium hydroxide, organophosphates, and dimethylamine borane. In addition we attempted to correlate these events to the timeline of industrial development in Taiwan. By researching this topic, the hope is that it may help other developing countries to improve industrial hygiene and promote occupational safety and health care during the process of industrialization.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제13권1호
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• pp.3-14
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• 2002

아동에 가해지는 정신적 외상의 충격은 아동의 심리발달에 지울 수 없는 상처를 남김으로써 향후 심각한 정신장애를 일으키는 결정적 원인이 된다. 아동기 외상의 현상학적 특징과 외상에 관여하는 신경생물학적 기전을 살펴보았고, 아동기에 경험하는 외상이 인격의 발달에 미치는 영향과 그와 관련한 정신병리를 알아보았다. 외상에 노출된 아동은 공통적으로 자신이 경험한 공포사건을 시각적으로 재경험하거나 그 기억을 반복하며, 놀이나 행동을 통해서도 외상사건을 반복하려는 경향을 보인다. 일회의 충격적 사건에 노출된 아동은 사건에 대한 지나친 기억과 집착을 보이고 지각왜곡이 심한 반면 장기간 반복되는 외상을 경험하는 아동은 정신적 무감각과 자기최면, 해리, 분노의 경향이 두드러진다. 소아·청소년에서는 외상 후 퇴행이 보다 현저하고 시간감각의 왜곡이 더 심하게 나타나며 아동의 연령이 어릴수록 자율신경계의 반응성이 증가하는 경향을 보인다. 외상적 충격에 노출되면 뇌내에서 즉각적이고 방대한 신경전달물질의 방출이 있게되는데, 자율신경계, 면역계, 시상하부-뇌하수체-부신피질 축(hypothalamic-pituitary-adrenal axis)이 활성화된다. 외상시 internal opiate가 활발한 작용을 하면서 아동으로 하여금 외상에 반응하지 않도록 하고 외상에 대한 감정반응 자체를 봉쇄할 수 있도록 해준다. 아동기 외상의 경우 central noradrenergic system에 변화가 초래되어 카테콜아민에 대해 과민감한 비정상적 소견을 보이게 된다. 체내 순환되는 cortisol 수치는 감소하고, glucocorticoid 수용체 농도와 반응성이 증가한다. 외상 후 발견되는 기억력 장애는 해마의 구조적 변화와 관련이 있는 것으로 보고되고 있다. 아동기 외상은 자기(self)와 대상(object)에 대한 내적 표상(internal representation)이 지속적으로 분화 발전하는 발달과정에서 일어난다는 점에서 인격의 발달에 심각한 영향을 미치게 된다. 해리, 신체화, 자학성, 자기애 장애의 정신병리로 발전하면서 경계성 인격장애, 자기애성 인격장애, 다중인격장애 등을 초래하게 된다.

• 정신신체의학
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• 제9권1호
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• pp.81-92
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• 2001

스트레스는 여러 가지 정신질환의 병태생리와 관련되는 것으로 알려졌다. 최근 여러 가지 동물 모델이 제시되고 뇌에 대한 연구가 활발해지면서 스트레스의 선경생물학적 기전에 대해 많은 사실이 밝혀지고 있다. 저자들은 동물과 사람을 대상으로 스트레스가 지각되고 대뇌에서 처리되고 신경내분비적 반응으로 전환되는 경로를 밝히고자 했던 최근의 연구들을 고찰하였다. 과거 변연계-시상하부-뇌하수체-부신 축(LHPA axis)과 자율신경계가 스트레스반응의 신경생물학적 담당자로 가장 많이 연구되어 왔으나, 최근에는 노르에피네프린(NE), 세로토닌, GABA/Glutamate, 도파민, 아세틸콜린 등의 신경전달물질과 부신피질자극호르몬방출인자(CRF), arginine vasopressin. glucocorticoid 등의 신경호르몬이 상호작용을 하면서 스트레스반응에 관계되는 것으로 알려지고 있다. 이러한 대뇌의 신경전달체계는 LHPA축과 유기적으로 연관되면서 스트레스반응을 매개하며, 구조적으로도 LHPA축은 해마, 편도 등 다양한 대뇌 부위와 연결된다. LHPA축은 이렇게 중층적으로 조절되는데, 여기에 생기는 이상은 만성 스트레스나 우울증 등 병적 상태와 관련된다. CRF는 LHPA축의 호르몬 역할 이외에 대뇌의 광범위한 부위에 분포하면서 신경전달물질로서 기능하며 다양한 스트레스반응을 매개한다. 스트레스를 주변 자율신경계가 활성화되는데, 청색반점에서 기시하는 NE계가 직접 자극되어 카테콜아민을 분비하기도 하지만, CRF나 다른 신경전달계가 먼저 자극되면서 간접적으로 활성화되기도 한다. 특히 CRF와 NE계는 서로 자극시키는 feed-forward 상호작용을 하며, 이것이 생체가 외부환경의 도전에 맞서 내분비계 뿐만 아니라 중추신경계를 동원하는 데 중요한 역할을 할것으로 보인다. 또한 CRF-NE 상호작용은 불안이나 우울 등 비정상적 스트레스반응의 병태생리를 이해하는 데 중요한 역할을 할 것으로 시사된다. 스트레스반응은 구조적, 신경화학적, 유전적 수준의 다양한 신경생물학적 작용을 통해 일어나며, 이에 대한 연구는 스트레스반응의 병태생리를 밝히고 불안장애, 기분장애 등 정신질환의 원인 규명과 치료에도 크게 기여할 것으로 보인다.

• 대한한의학회지
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• 제19권2호
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• pp.194-210
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• 1998

The main purpose of this work is the study on the etiology and pathology of the anorexia in oriental and western medicine. An appetite is stimulated by the need of supply of nutrition for life and the physical desire of hunger which appeared as the alternative of taste. In this paper, I investigated the anatomical and the physiological function system, the Piwei functional system and meridian distribution, and the differentiation of the disease according to the Zangfu(internal organs) in association with the anorexia. And conclusion could be summarized as follows : 1. The tongue, one of the Piwei functional system(脾胃機能系), is connected with Pi(脾), Xin(心), Gan(肝) and Shen(腎) meridian. Especially Pi and Xin meridian have the close relations with taste. 2. The appetite has the close relations with Piwei. The appetite and digestion is influenced by the function of smoothing and regulating and bloodflow of Ki(肝主疏泄), warming the Shen to activate the function of Pi(腎主溫養), cleansing the inspired air and keeping the Ki flowing downward(肺主肅降). 3. The cause of anorexia is the insufficiency of Ki of Piwei(脾胃氣虛), the attack of Wei by hyperactive Gan Ki(脾氣犯胃), the insufficiency of Wei Yin(胃陰不足), the declination of the fire from the vital gate(命門火衰) and the retention or stagnancy of undigested food (飮食停滯). Especially, the main cause of anorexia is the insufficiency of Ki of the Piwei(脾胃氣虛). 4. Recently the attack of Wei by hyperactive Gan Ki(脾氣犯胃) is raised by the main cause of anorexia. 5. The mental function of anorexia, which is induced by the unbalance of Pi, is directly associated with Xin(心) and Xin meridia(心經). 6. The goal of the treatment of the anorexia is dependent on the recovery of the weakness of the Pi. And for this goal, the disorders of the other organs is also treated. 7. In the point of the anatomy and physiology, the main cause of anorexia is the loss of function of the autonomic nerve system and the vagus nerve.