• Journal of the Korean neurological association
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• v.35 no.1
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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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• v.12 no.2
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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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• v.49 no.4
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• pp.446-450
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• 2006

Congenital central hypoventilation syndrome (CCHS) or Ondine's curse is a very rare sleep disorder that is the result of a congenital failure of the autonomic control of ventilation caused by insensitivity of the chemoreceptor to hypercapnea during sleep. Gastrointestinal motility disorders, particularly a congenital megacolon (Hirschsprung disease) is often combined with CCHS. This combination can be explained by a defect in the migration of neuronal cells from the neural crest (neurocristopathy) during the intrauterine period. A diagnosis of CCHS is made by confirming the failure of adequate ventilation in response to hypercapnea and hypoxia during sleep and the exclusion of other diseases. Young infants frequently show atypical clinical courses, and their conditions are frequently complicated with the long-term sequela of hypoxemic episodes. Therefore, a high index of suspicion and active treatment with mechanical ventilation are important for reducing recurrent hypoxemic episodes in the neonatal period. This paper reports the follow up of a case of CCHS in a neonate who showed frequent intractable apnea and cyanosis and was given artificial mechanical ventilation during sleep.

• BMB Reports
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• v.35 no.4
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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.

• Anxiety and mood
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• v.16 no.2
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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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• v.33 no.4
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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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• v.3 no.4
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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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• v.13 no.1
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• pp.3-14
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• 2002

Childhood psychic trauma appears to be a crucial factor in the development of serious disorders both in childhood and in adulthood. Traumatized children show strong tendency to revisualize or re-feel a traumatic events. Play and behavioral reenactments are frequent manifestations of both the single blow and the long-standing traumas in childhood. Those children who suffer the results of single, intense terror appear to exhibit detailed memory, retrospective reworkings and misperceptions. In long-standing or repetitive trauma, children would show psychic numbing, self-hypnosis, dissociation and rage. Child's brain is undergoing critical and sensitive periods of differentiation. During this time, developing central nervous system is exquisitely sensitive to stress. Stressor-activated neurotransmitters and hormones can play major roles in neurogenesis, migration, synaptogenesis, and neurochemical differentiation. Internal opiate system operates in some trauma and causes the victim to fail to respond, to avoid, to shut off feelings. Evidence is also accumulating in traumatology that dysfuntion of locus coeruleus and ventral tegmental neucleus system leads to catecholamine receptors hypersensitivity. This change result in hypervigilance, increased startle, affective lability, and increased autonomic nervous system hyperreactivity. Another site of action of trauma on the brain is hypothalamic-pituitary-adrenal axis. Individuals with PTSD do not have enough cortisol to halt the alarm reaction. When children are exposed to long-standing extreme events, massive attempts to protect the psyche and to preserve the self are put into gear. These developmental traumas mobilize various kinds of defense mechanisms. Massive denial, dissociation, self anesthesia, identification with aggressor and aggression turned against the self often lead to profound character changes in the youngsters.

• Korean Journal of Psychosomatic Medicine
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• v.9 no.1
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• pp.81-92
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• 2001

Stress has been linked to the pathophysiology and pathogenesis of various psychiatric illnesses. Over the past few years, our understanding of the brain and neuroendocrine systems that are linked to stress responses has increased enormously. This article reviews a series of animal and human studies to understand what are the central pathways by which stress is perceived, processed, and transduced into a neuroendocrine response. We focus on the limbic-hypothalamic-pituitary-adrenal(LHPA) axis and several neurotransmitter systems such as norepinephrine, CRF, serotonin, acetylcholine, and dopamine. LHPA stress circuit is a complex system with multiple control mechanisms which are altered in pathological states. CRF and related peptides in the central nervous system appear to enhance behavioral responses to stressors. Norepinephrine systems are also activated by stressors and cause the release of catecholamines from the autonomic nervous system. CRF-norepinephrine interaction makes a feed-forward system which may be important for an organism to mobilize not only the pituitary system but also the central nervous system, in response to environmental challenges. The interactions among several neurotransmitters and endocrine systems appear to play key roles in mediating various behavioral and psychological stress responses involving abnormal responses to stressors such as anxiety and affective disorders.

• The Journal of Korean Medicine
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• v.19 no.2
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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.