• Journal of Genetic Medicine
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• v.11 no.1
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• pp.11-15
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• 2014

Congenital central hypoventilation syndrome (CCHS) is a disorder of the autonomic nervous system characterized by a decreased response to hypercarbia. CCHS is frequently associated with congenital megacolon; the combination is called Haddad syndrome. CCHS is associated with dysfunction in respiratory features of the autonomic nervous system and with other disorders, including facial deformities, cardiovascular symptoms, and tumors. Patients with CCHS frequently have a mutation in the homeobox protein 2b (PHOX2B) gene. Most mutations involve heterozygous expansion of alanine repeats (GCN). Interestingly, a higher polyalanine repeat number is associated with a more severe clinical phenotype. To clarify the role of PHOX2B in disease pathogenesis, we introduce and review the clinical and molecular features of CCHS and Haddad syndrome.

• Journal of the Korean neurological association
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• v.36 no.4
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• pp.396-398
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• 2018

• Journal of Chest Surgery
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• v.39 no.9 s.266
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• pp.702-705
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• 2006

Severe left ventricular dysfunction after relief of massive pericardial effusion has been rarely reported. Interventricular volume mismatch, acute distention of the cardiac chambers and interplay of autonomic none system are believed to be the possible causes for ventricular dysfunction. Presenting two patients who had marked decrease in global ventricular systolic function after relief of pericardial tamponade by subxyphoid pericardial window, we recommend gradual removal of pericardial fluid under hemodynamic monitoring, especially in patient with postcardiotomy tamponade.

• Journal of Yeungnam Medical Science
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• v.40 no.4
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• pp.328-334
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• 2023

An aging population and changes in dietary habits have increased the incidence of diabetes, resulting in complications such as diabetic foot ulcers (DFUs). DFUs can lead to serious disabilities, substantial reductions in patient quality of life, and high financial costs for society. By understanding the etiology and pathophysiology of DFUs, their occurrence can be prevented and managed more effectively. The pathophysiology of DFUs involves metabolic dysfunction, diabetic immunopathy, diabetic neuropathy, and angiopathy. The processes by which hyperglycemia causes peripheral nerve damage are related to adenosine triphosphate deficiency, the polyol pathway, oxidative stress, protein kinase C activity, and proinflammatory processes. In the context of hyperglycemia, the suppression of endothelial nitric oxide production leads to microcirculation atherosclerosis, heightened inflammation, and abnormal intimal growth. Diabetic neuropathy involves sensory, motor, and autonomic neuropathies. The interaction between these neuropathies forms a callus that leads to subcutaneous hemorrhage and skin ulcers. Hyperglycemia causes peripheral vascular changes that result in endothelial cell dysfunction and decreased vasodilator secretion, leading to ischemia. The interplay among these four preceding pathophysiological factors fosters the development and progression of infections in individuals with diabetes. Charcot neuroarthropathy is a chronic and progressive degenerative arthropathy characterized by heightened blood flow, increased calcium dissolution, and repeated minor trauma to insensate joints. Directly and comprehensively addressing the pathogenesis of DFUs could pave the way for the development of innovative treatment approaches with the potential to avoid the most serious complications, including major amputations.

• Journal of Korean Academy of Nursing
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• v.41 no.6
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• pp.788-794
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• 2011

Purpose: Reduced heart rate variability significantly increases cardiovascular mortality. Metabolic syndrome increases the cardiac autonomic dysfunction. Recently, increasing cardiovascular mortality has been reported in patients with schizophrenia. This study was done to compare heart rate variability between adults with and without schizophrenia and to compare the relationship of heart rate variability to metabolic syndrome in hospitalized patients with schizophrenia. Methods: This was a descriptive and correlational study in which 719 adults without schizophrenia and 308 adults with schizophrenia took part between May and June 2008. We measured the following: five-minute heart rate variability; high-frequency, low-frequency, the ratio of low-frequency to high-frequency, and the Standard Deviation of all the normal RR intervals. Data was also collected on metabolic syndrome, abdominal obesity, triglycerides, HDL cholesterol, blood pressure and fasting glucose. Results: The Standard Deviation of all the normal RR intervals values of heart rate variability indices were $1.53{\pm}0.18$. The low-frequency and high-frequency values of heart rate variability indices were significantly higher in hospitalized patients with schizophrenia ($3.89{\pm}1.36$; $3.80{\pm}1.20$) than those in the healthy participants ($2.20{\pm}0.46$; $2.10{\pm}0.46$). There were no significant differences between the schizophrenic patients with and without metabolic syndrome. Conclusion: The results of this study indicate that schizophrenia patients have significantly lower cardiac autonomic control, but they have significantly higher low-frequency and high-frequency values than those of healthy adults. Use of antipsychotic drug may affect the autonomic nervous system in schizophrenic patients. Metabolic syndrome was not associated with cardiac autonomic control in schizophrenia patients.

• Journal of Oriental Neuropsychiatry
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• v.21 no.2
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• pp.75-85
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• 2010

Objectives : This study was designed to evaluate the correlation between patterns of dyspepsia(acute dyspepsia, functional dyspepsia, dyspepsia with the organic disease) and autonomic nerve system dysfunction using HRV analysis. Methods : The patient group consisted of 88 patients diagnosed as a dyspepsia (Acute dyspepsia group-35 patients, Functional dyspepsia group-28 patients, Dyspepsia with the organic disease group-28 patients) who visited in the Oriental Medical Hospital of Dong-eui University from 2005.3.OO to 2008.8.OO. And the control group consisted of 33 patients diagnosed as a normal state of stomach during the same period. We checked HRV of the 4 groups over 5 minutes and compared the HRV index between groups. Results : 1. HF, LF, VLF and TP were significantly lower in the acute dyspepsia, functional dyspepsia and organic dyspepsia patient group than in the control group. 2. HF, LF, VLF and TP were higher in the acute dyspepsia patient group than in the organic dyspepsia patient group, but the differences were not statistically significant. 3. HF, LF, VLF and TP were higher in the acute dyspepsia patient group than in the functional dyspepsia patient group, but the differences were not statistically significant. 4. HF, LF, VLF and TP were lower in the functional dyspepsia patient group than in the organic dyspepsia patient group, but the differences were not statistically significant. Conclusions : Compared to the control group, all of the dyspepsia patient groups showed the tendency that the overall activity of the autonomic nervous system and the activity of sympathetic nerves decreased. Although there was no significant difference in the suppression of the autonomic nervous system, chronic dyspepsia patient group was lower than acute dyspepsia patient group, functional dyspepsia patient group was lower than the organic dyspepsia patient group in HRV.

• Mood & Emotion
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• v.15 no.3
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• pp.117-122
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• 2017

Objectives : Early life stress (ELS) may have impact on functions of the autonomic nervous system. Heart rate variability (HRV) is a reliable psychophysiological marker for functions of the autonomic nervous system. The purpose of this study was to investigate characteristics of HRV associated with ELS in patients with major depressive disorder (MDD). Methods : We compared HRV measures of MDD patients with ELS and without ELS in a 5-minute resting-state electrocardiogram recoding. Forty subjects participated in the study (25 with ELS, 15 without ELS). The Mann-Whitney test was conducted to identify group differences. Results : We found significant group differences in standard deviation of the NN interval (SDNN) and total power (TP). SDNN was lower in the ELS group (M=38.80 ms, SD=13.05 ms) than in the Non-ELS group (M=53.53 ms, SD=19.47 ms). TP was lower in the ELS group ($M=7.07ms^2$, $SD=0.69ms^2$) than in the Non-ELS group ($M=7.72ms^2$, $SD=0.77ms^2$). Conclusion : ELS may have a negative impact on the autonomic nervous system function in patients with MDD. ELS and dysfunction of autonomic nervous system should be considered in treatment for patients with MDD.

• Tuberculosis and Respiratory Diseases
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• v.45 no.2
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• pp.404-415
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• 1998

Background: Sleep apnea syndrome, which occurs in 1~4 % of the adult population, frequently has different cardiovascular complications such as hypertension, ischemic heart disease, cardiac arrythmia as well as sleep-wake disorder such as excessive daytime hypersomnolence or insomnia. Mortality and vascular morbidity are reported to be significantly higher in sleep apnea syndrome patients than in normal population. According to the recent studies, autonomic dysfunction as well as hypoxemia, hypercapneic acidosis, and increased respiratory effort, may playa role in the high prevalence of cardiovascular complications in patients with sleep apnea syndrome. However the cause and mechanism of autonomic neuropathy in patients with sleep apnea syndrome are not well understood. We studied the existence of autonomic neuropathy in patients with sleep apnea syndrome and factors which influence the pathogenesis of autonomic neuropathy. Method: We used the cardiovascular autonomic neuropathy(CAN) test as a method for evaluation of autonomic neuropathy. The subjects of this study were 20 patients who diagnosed sleep apnea syndrome by polysomnography and 15 persons who were normal by polysomnography. Results: Body mass index and resting systolic blood pressure were higher in sleep apnea group than control group. Apnea index(Al), respiratory disturbance index(RDI) and snoring time percentage were significantly higher in sleep apnea group compared with control group. But there were no significant differences in saturation of oxygen and sleep efficiency in two groups. In the cardiac autonomic neuropathy test, the valsalva ratio was significantly low in sleep apnea group compared with control group but other tests had no differences between two groups. The CAN scores and corrected QT(QTc) interval were calculated significantly higher in sleep apnea group, but there were no significant correlations between CAN scores and QTc interval. There were no significant data of polysomnography to correlate to the CAN score. It meant that the autonomic neuropathy in patients with sleep apnea was affected by other multiple factors. Conclusion: The cardiovascular autonomic neuropathy test was a useful method for the evaluation of autonomic neuropathy in patients with sleep apnea syndrome and abnormalities of cardiovascular autonomic neuropathy were observed in patients with sleep apnea syndrome. However, we failed to define the factors that influence the pathogenesis of autonomic neuropathy of sleep apnea syndrome. This study warrants futher investigations in order to define the pathogenesis of autonomic neuropathy in patients with sleep apnea syndrome.

• Journal of Sasang Constitutional Medicine
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• v.20 no.2
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• pp.119-128
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• 2008

1. Objectives This case study describes a successful treatment process of a Soyangin patient with somatoform autonomic dysfunction symptoms using Soyangin therapeutic measures, including administration of Dokhwaljihwang-tang (獨活地黃湯) and Sibyimijihwang-tang (十二味地黃湯). 2. Methods The patient was treated with several constitutionally discriminated medicinal agents (獨活地黃湯, 十二味地黃湯) and acupunctural therapy accompanied by simultaneous western medical management. The visual analogue scale (VAS) was applied to assess the severity of flushing. 3. Results and Conclusions As flushing was one of the chief complaints, the patient was treated with Soyangin therapeutic measures including Dokhwaljihwang-tang and Sibyimijihwang-tang. The patient responded positively to the therapy, but further studies are anticipated for more definitive conclusions.

• Korean Journal of Acupuncture
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• v.19 no.2
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• pp.97-117
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• 2002

Chiropractic is very similar to Oriental Medicine in philosophy on the cause of diseases and in utilization of spinal articulations for diagnosis and treatment. In this paper the spinal area used to treat liver dysfunction in S.O.T. technique, one of chiropractic techniques, was compared to the acupncture points used to cure the same conditions. Because both Oriental medicine and Chiropractic are dealing with autonomic nervous system in regulating abnormal conditions, also the innervation of spinal nerves to those areas was checked. The spinal area that S.O.T. technique utilizes to correct liver dysfunction is transverse processes of T8, which corresponds to B16. Acupncture points from this level down to T12/L1, which are B16, B17, B18, B19, B20, B21, B45, B46, B47, B48, B49, B50, GV6, GV7, GV8 and GV9, all have been applied to control liver function. Apparent discrepency exists in therapeutic areas for liver malfunction between the two natural healing arts. According to the neurology texts, liver is innervated by sympathetic fibers from the 7th-10th thoracic segments and by parasympathetic fibers from vagus nerve. Sympathetic afferent nerves from the liver reach the 7th-12th thoracic spinal cord segments. It can be said all the 7th-12th thoracic spinal cord segments are related to liver function. Therefore the areas used for liver dysfunction in both natural medicine are appropriately selected. However, B16, the Oriental medical equivalent of the main spinal area which is used for lowered liver function in C.M.R.T. Technique, is not utilized as frequent as in Oriental medicine.