• Title/Summary/Keyword: Autonomic dysfunction

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A Study on Postabortal Symptoms and Depression Measured by EPDS (유산 후 내원한 환자에 대한 증상조사 및 EPDS 평가)

  • Lee, Yoon-Jae;Hwang, Deok-Sang;Lee, Chang-Hoon;Lee, Kyung-Sub
    • The Journal of Korean Obstetrics and Gynecology
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    • v.21 no.1
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    • pp.206-215
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    • 2008
  • Purpose: After abortion, many women could have psychologic problems and physical symptoms. But in Korea, the symptoms and psychologic problems and after abortion had rarely been researched. Methods: The subjects were 29 women who visited Kangnam Korean hospital for postabortion management from May 2007 to December 2007. From questionnaire, we researched the variable symptoms after abortion and depression as Edinburgh Postnatal Depression Scale. Results: The 79% of patients took a rest only less than 1 week after abortion. As the rest time was shorter, the number of symptoms was higher. The frequent symptoms were related to the dysfunction of autonomic nerve system and the circulating system. The patients after abortion had high Edinburgh Postnatal Depression Scale scores, the mean score was $13.33{\pm}7.11$. The high EPDS scores and the number of symptoms was related with methods of abortion and age. Conclusions: Postabortal symptoms are related with physical symptoms and depression. So psychological evaluation would be needed. And for prevention of postabortal symptoms, the adequate rest time would be demanded after abortion.

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Botulinum Toxin : Basic Science and Clincal Uses in Otolaryngology (Botulinum Toxin : 기초과학과 이비인후과 영역에서의 임상적 사용)

  • 최홍식;문인석;김한수;김현직
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.13 no.2
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    • pp.164-172
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    • 2002
  • The role of botulinum toxin as a therapeutic agent is expanding rapidly in otolaryngology. Botulinum toxin is a protease that blocks the release of acetylcholine from nerve terminals. Its effects are transient and nondestructive, and largely limited to the area in which it is administered These effects are also graded according to the dose, allowing for individualized treatment of patients and disorders. Botulinum toxin has been used primarily to treat disorders of excessive or inappropriate muscle contraction. In the field of otolaryngology, these include spasmodic dysphonia, oromandibular dystonia, and blepharospasm, vocal tics and stuttering, cricopharyngeal achalasia, various tremors and tics, hemifacial spasm, temporomandibular joint disorders and a number of cosmetic applications. Botulinum toxin treatment has recently begun to show some benefit in the control of pain from migraine and tension headache. It may also prove useful in the control of autonomic dysfunction, as in Frey syndrome, sialorrhea, and rhinorrhea. In over 20 yews of use in humans, botulinum toxin has accumulated a considerable safety record, and in many cases represents relief for thousands of patients unaided by other therapy.

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Experience of Epidural Steroids in Transverse Myelitis -A case report- (횡단척수염 환자에서 경막외 스테로이드 투여에 의한 치료 경험 -증례보고-)

  • Nam, Voki;Mun, Ho Sik;Kim, Jung Hak;Kim, Dae Sung;Sung, Choon Ho
    • The Korean Journal of Pain
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    • v.22 no.1
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    • pp.92-95
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    • 2009
  • Transverse myelitis is a focal inflammatory disorder of the spinal cord characterized by motor, sensory, and autonomic dysfunction. A 41-year-old man with transverse myelitis and no pre-existing neurologic disease presented with hypesthesia, numbness, weakness in the both lower extremities, back pain, decreased libido, constipation, and dysuria. A MRI test showed intramedullary high signal intensity between T4 and T8 on a T2-weighted image. After high-dose intravenous methylprednisolone and oral prednisolone therapy, he showed facial swelling and acneiform eruption. Therefore, we injected 40 mg methylprednisolone via an epidural route. A 7-dose serial treatment improved most symptoms. A follow up MRI showed radiological improvement. We report a case of transverse myelitis treated by epidural steroids.

Modern Medical Scientific Study on the String Pulse (현맥의 특징에 대한 현대 의학적 고찰)

  • Ryu, Hyun-Hee;Lee, Jeon;Jeon, Young-Ju;Lee, Yu-Jung;Lee, Si-Woo;Kim, Jong-Yeol
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.22 no.3
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    • pp.535-539
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    • 2008
  • Pulse diagnosis is one of the typical examination methods in traditional oriental medicine. Pulse type classification is a major element of this diagnosis. There are more than 20 pulse types which have each clinical significance. However, pulse type's indications are implicative and obscure. In this study, we reviewed string pulse which is often diagnosed in Traditional Korean Medicine by analysis of Traditional Oriental Medical Literatures and modern medical papers. String pulse is taut and stiff pulse with high tension and low softness. It appears in 'blood vessel endothelial dysfunction', 'autonomic imbalance', 'arteriosclerosis'. Persistent string pulse can bring about cardiovascular or central nervous disease.

Effects of Intramuscular Electrical Stimulation Using Inversely Placed Electrodes on Myofascial Pain Syndrome in the Shoulder - A Case Series

  • Shanmugam, Sukumar;Mathias, Lawrence;Thakur, Ajay;Kumar, Dhanesh
    • The Korean Journal of Pain
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    • v.29 no.2
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    • pp.136-140
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    • 2016
  • Myofascial pain syndrome (MPS) is one of the common musculoskeletal conditions of the shoulder which may develop sensory-motor and autonomic dysfunctions at the various level of the neuromuscular system. The pain and dysfunction caused by MPS were primarily treated with physical therapy and pharmacological agents in order to achieve painfree movements. However, in recent years intramuscular electrical stimulation (IMES) with conventional electrode placement was used by researchers to maximise therapeutic values. But, in this study an inverse electrode placement was used to deliver electrical impulses intramuscularly to achieve neuro-modulation at the various level of the nervous system. Nine patients with MPS were treated with intramuscular electrode stimulation using inversely placed electrodes for a period of three weeks. All nine subjects recovered from their shoulder pain and disability within the few weeks of intervention. So, this inverse electrode placement may be more appropriate for chronic pain management.

Myths and truths about pediatric psychogenic nonepileptic seizures

  • Yeom, Jung Sook;Bernard, Heather;Koh, Sookyong
    • Clinical and Experimental Pediatrics
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    • v.64 no.6
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    • pp.251-259
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    • 2021
  • Psychogenic nonepileptic seizures (PNES) is a neuropsychiatric condition that causes a transient alteration of consciousness and loss of self-control. PNES, which occur in vulnerable individuals who often have experienced trauma and are precipitated by overwhelming circumstances, are a body's expression of a distressed mind, a cry for help. PNES are misunderstood, mistreated, under-recognized, and underdiagnosed. The mind-body dichotomy, an artificial divide between physical and mental health and brain disorders into neurology and psychiatry, contributes to undue delays in the diagnosis and treatment of PNES. One of the major barriers in the effective diagnosis and treatment of PNES is the dissonance caused by different illness perceptions between patients and providers. While patients are bewildered by their experiences of disabling attacks beyond their control or comprehension, providers consider PNES trivial because they are not epileptic seizures and are caused by psychological stress. The belief that patients with PNES are feigning or controlling their symptoms leads to negative attitudes of healthcare providers, which in turn lead to a failure to provide the support and respect that patients with PNES so desperately need and deserve. A biopsychosocial perspective and better understanding of the neurobiology of PNES may help bridge this great divide between brain and behavior and improve our interaction with patients, thereby improving prognosis. Knowledge of dysregulated stress hormones, autonomic nervous system dysfunction, and altered brain connectivity in PNES will better prepare providers to communicate with patients how intangible emotional stressors could cause tangible involuntary movements and altered awareness.

Intraoperative Neurophysiology Monitoring for Spinal Dysraphism

  • Kim, Keewon
    • Journal of Korean Neurosurgical Society
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    • v.64 no.2
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    • pp.143-150
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    • 2021
  • Spinal dysraphism often causes neurological impairment from direct involvement of lesions or from cord tethering. The conus medullaris and lumbosacral roots are most vulnerable. Surgical intervention such as untethering surgery is indicated to minimize or prevent further neurological deficits. Because untethering surgery itself imposes risk of neural injury, intraoperative neurophysiological monitoring (IONM) is indicated to help surgeons to be guided during surgery and to improve functional outcome. Monitoring of electromyography (EMG), motor evoked potential, and bulbocavernosus reflex (BCR) is essential modalities in IONM for untethering. Sensory evoked potential can be also employed to further interpretation. In specific, free-running EMG and triggered EMG is of most utility to identify lumbosacral roots within the field of surgery and filum terminale or non-functioning cord can be also confirmed by absence of responses at higher intensity of stimulation. The sacral nervous system should be vigilantly monitored as pathophysiology of tethered cord syndrome affects the sacral function most and earliest. BCR monitoring can be readily applicable for sacral monitoring and has been shown to be useful for prediction of postoperative sacral dysfunction. Further research is guaranteed because current IONM methodology in spinal dysraphism is still deficient of quantitative and objective evaluation and fails to directly measure the sacral autonomic nervous system.

Cerebral fat embolism syndrome: diagnostic challenges and catastrophic outcomes: a case series

  • Hussein A.Algahtani;Bader H. Shirah;Nawal Abdelghaffar;Fawziah Alahmari;Wajd Alhadi;Saeed A. Alqahtani
    • Journal of Yeungnam Medical Science
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    • v.40 no.2
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    • pp.207-211
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    • 2023
  • Fat embolism syndrome is a rare but alarming, life-threatening clinical condition attributed to fat emboli entering the circulation. It usually occurs as a complication of long-bone fractures and joint reconstruction surgery. Neurological manifestations usually occur 12 to 72 hours after the initial insult. These neurological complications include cerebral infarction, spinal cord ischemia, hemorrhagic stroke, seizures, and coma. Other features include an acute confusional state, autonomic dysfunction, and retinal ischemia. In this case series, we describe three patients with fat embolism syndrome who presented with atypical symptoms and signs and with unusual neuroimaging findings. Cerebral fat embolism may occur without any respiratory or dermatological signs. In these cases, diagnosis was established after excluding other differential diagnoses. Neuroimaging using brain magnetic resonance imaging is of paramount importance in establishing a diagnosis. Aggressive hemodynamic and respiratory support from the beginning and consideration of orthopedic surgical intervention within the first 24 hours after trauma are critical to decreased morbidity and mortality.

Difference of the Heart Rate Variability According to the Social Support Level in a County (일 군 주민에서 사회적 지지의 수준에 따른 심박변이도의 차이)

  • Shin, Yoo-Shup;Byun, Ji-Sang;Kim, Seok-Hyeon;Shin, Jin-Ho;Choi, Bo-Youl;Nam, Jung-Hyun;Oh, Dong-Hoon
    • Korean Journal of Psychosomatic Medicine
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    • v.20 no.1
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    • pp.59-65
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    • 2012
  • Objectives : The present study takes part of the agricultural district cohort study of a certain county located in Gyeonggido and aims to investigate the difference of the heart rate variability(HRV) according to the social support level. Methods : We used data from 1727 participants of a health promotion program who are older than 40 years old. A physical examination, as well as a one-to-one interview to obtain sociodemographic characteristics, was performed with each participant. In addition, the participants completed the Medical Outcomes Study-Social Support Survey(MOS-SSS) for their the social support level to be assessed, and their HRV were measured to evaluate their autonomic function. The entire group was divided in two groups according to its MOS-SSS points to facilitate the research. Those who were evaluated as the high 25%(432 persons) were denominated as high social support (HSS) group and those who were evaluated as the low 25%(425 persons) were denominated as poor social support(PSS) group. Results : The two groups showed significant differences on the sociodemographic factor such as mean age and gender composition(p<0.05). Comparing the indices related to the HRV, the HSS group had the following values higher than the PSS group : SDNN(F=4.938, p=0.027), TP(F=8.088, p=0.005), VLF(F=6.220, p=0.013) LF (F=3.873, p=0.049). Conclusion : According to the research, the PSS group showed dysfunction on their autonomic nervous system comparing to the HSS group. The social support helps an individual overcome difficulties, helps the adaptation during the changes of circumstances and in stressful situations it serves like a buffer. Based on that, it's possible to define that a low social support level gave an impact on the autonomic function. Also, using the fact that the HRV can evaluate the autonomic function in an objective view, it was possible to visualize that it has a potential to be used as an assistant factor to evaluate the social support.

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A Study of the Evaluation of the Spinal Cord Injuries (척수 손상 환자에 관한 실태 조사)

  • Kim, Myung-Hoon
    • Journal of Korean Physical Therapy Science
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    • v.3 no.2
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    • pp.1011-1019
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    • 1996
  • The incidence of spinal cord injury increase due to traffic accident, industrial accident and leisure sports. Spinal cord injury damages motor and sensory function below the injury level, also affects autonomic functions associated with voiding and defecation. Sexual dysfunction and psychosocial, vocational maladaptations are also some of the unwanted consequences of injury. The purpose of this study is look for means to prevent and to manage complications in spinal cord injury through investigation and analysis. The subjects of this study in spinal cord injured patients were admitted to the department of physical therapy, Kwangju christian Hospital, Nam Kwang Hospital, Chun Nam university Hospital and Cho Sun university Hospital, from April, 1, 1995 to March, 31, 1996. The results are as follows: 1. The subjects comprised 96 cases of spinal cord injury, ranging from 17 to 85(mean-40.8 yrs) and included 72 males and 24 females. Among these patients, 58 were cervical injury, 20 were thoracic injury and 18 were lumbar injury. 2. As for a major causative of spinal cord injury were traffic accident(59.4%), fall down (27.1 %), and motocycle(4.2%).. 3. The bladder control were taken by indwelling cathetar(41.7%), Crede maneuver(37.5%) and self voiding(16.7%). The bowel control were taken by all aid(61.5%), assitance(32.3%) and self defecation(6.2%). 4. Possible of sexual function were 35 cases (47.9%). 5. The device of transfer used wheel chair(69.8%) and bed(16.7%). 6. The patients with higher cord lesion got more serious pain than lower cord lesion. Also the patients with higher cord lesion got a serious spasticity. 7. The incidence of decubitus ulcer among 96 patients were in case 46(47.9%). The largest group of the pressure sore sites were sacral portion(82.0%), less than 1 month of onset occured a large numbers(50%). Incidence of pressure sore by spasticity occured many patients in case of mild or moderate. Incidence of pressure sore by pain occured many patients in case of severe pain.

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