• Title/Summary/Keyword: Autonomic dysfunction

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Clinical Study for Characteristics of Heart Rate Variability in Hwabyung Patients (화병 환자의 심학변이도 특성에 대한 임상적 연구)

  • Bae, Eun-Joo;Kim, Dong-Hyun;Rheu, Kyung-Hwan;Park, Seong-Uk;Yoon, Seong-Woo;Ko, Chang-Nam
    • The Journal of Internal Korean Medicine
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    • v.26 no.4
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    • pp.844-852
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    • 2005
  • Objectives : Through spectral analysis of heart rate variability(HRV) to study autonomic nervous system dysfunction of Hwabyung, culture related disease in Korea. Methods : HRV of 18 patients diagnosed as Hwabyung was measured against 13 healthy controls. HRV was measured by SA-2000p(Mediocre, Korea) for five minutes after 5 minutes resting. Results : 1. In time domain analysis, mean pulse rate(PRT) of in Hwabyung group was significantly higher than healthy controls. Standard deviation of all normal P-P intervals(SDNN), the square root of the mean of the sum of the squares of differences between adjacent normal P-P intervals(RMS-SD) in Hwabyung group was lower than healthy controls, but not significant. 2. As for frequency domain analysis, In TP(logarithmic total power), In VLF(logarithmic very low frequency), and In LF(logarithmic low frequency )in Hwabyung group was significantly lower than healthy controls. Ln HF(logarithmic high frequency), LF/HF ratio in Hwabyung group was also lower but not significant. Conclusions : This study suggests tile activity and imbalance of cardiac autonomous nervous system in Hwabyung patient is significantly lower than healthy individuals.

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A Case of Acute Renal Failure due to Rhabdomyolysis Associated with Neuroleptic Malignant Syndrome (항정신병약물악성증후군에 동반한 횡문근융해증으로 인한 급성 신부전 1례)

  • Park, Kyu-Hee;Jung, Seong-Kwan;Yim, Hyung-Eun;Yoo, Kee-Hwan;Hong, Young-Sook;Lee, Joo-Won
    • Childhood Kidney Diseases
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    • v.13 no.2
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    • pp.267-270
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    • 2009
  • Neuroleptic malignant syndrome (NMS) is a rare, but a potentially life threatening condition associated with the use of antipsychotics. The most frequent signs and symptoms of NMS include fever, muscle rigidity, autonomic dysfunction such as tachycardia, tachypnea, and labile blood pressure. Acute complications of NMS include disseminated intravascular coagulation, sepsis, seizure, myocardial infarction, acute renal failure due to rhabdomyolysis and death. We report a rare case of acute renal failure due to rhabdomyolysis associated with neuroleptic malignant syndrome.

A CASE OF LETHAL CATATONIA IN A 11-YEAR-OLD BOY (11세 남아에서 발생된 치사성 긴장증 1례)

  • Cho, In-Hee;Hong, Sung-Do;Joung, Yoo-Sook
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.10 no.1
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    • pp.121-133
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    • 1999
  • Lethal catatonia is one of catatonic spectrum, but it differentiates itself to a separate entity as a syndrome because of its severity and lethality. The prevalence of this disorder may have declined worldwide, coinciding with the advent of modern psychopharmacologic agents and other advances in medical treatment. The patient reported here was an 11-year old boy, showing catatonic excitement and stuporous condition with high fever, autonomic dysfunction and several catatonic symptoms. This is a case of successful treatment by using intensive medical monitoring and conservative treatment in an intensive care unit, combined with pharmacological treatment and electroconvulsive therapy during the early phase of lethal catatonia with mild symptoms.

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A Retrospective Analysis of MRI-verified 29 Cases of Transverse Myelitis (자기공명촬영으로 확인된 횡단성 척수염 29례에 대한 후향적 분석)

  • Kim, Young-Rae;Song, Jun-Hyeok;Park, Hyang-Kwon;Kim, Sung-Hak
    • Journal of Korean Neurosurgical Society
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    • v.29 no.12
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    • pp.1642-1649
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    • 2000
  • Objectives : Transverse myelitis(TM) is characterized by bilateral motor, sensory, and autonomic dysfunction of the spinal cord in the absence of pre-existing neurologic disease. It is an uncommon but not rare condition. But it remains as poorly understood syndrome not only etiologically but also in terms of its clinical behavior. Neurosurgically, It is often quite difficult to distinguish from other surgical intramedullary lesions. We present our clinical experiences of TM in order to assess its clinical behavior and to define the radiological characteristics that can distinguish TM from other intramedullary lesions. Methods : From June 1991 to May 1997, twenty-nine patients with transverse myelitis were admitted to our department. All cases revealed acute or subacute syndrome of non-compressive myelopathy and intramedullary lesions in the MRI. We analyze the radiological data and medical records retrospectively. Results : Patients ranged in age from 16 to 66 years, with 22 males and 7 females. Mean follow-up period was 53 months. For the offending levels, cervical was 5, thoracic 21, and lumbar 3 in number. The patients who presented the return of symptoms after a diminution or abatement of initial symptoms were 7(24%). In the MRI, TM showed typical characteristics of high signal intensity lesions in the center of spinal cord in T2 weighted images and low- to iso-signal intensity in T1 weighted images. A focal nodular enhancement pattern was observed in 58.6%(17/29) of the patients. MR follow-up studies were done in the 21 patients and radiological improvement were verified. Biopsies were done in 3 patients. Normal to good outcome was achieved in 62% of the patients. Conclusion : Transverse myelitis has characteristic radiological findings that can be distinguished from other intramedullary lesions. In our series, it is associated with significant recurrence rates thus, should not be considered a selflimiting disease with good prognosis.

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Effects of 12 Week Regular Aerobic Exercise on ST-segment and QTc Interval in Type 2 Diabetes Mellitus Patients (12주 규칙적인 유산소 운동이 제 2형 당뇨환자의 ST 분절과 QTc 연장에 미치는 영향)

  • Kim, Young-Il;Paik, Il-Young;Jin, Hwa-Eun;Suh, Ah-Ram;Kwak, Yi-Sub;Woo, Jin-Hee
    • Journal of Life Science
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    • v.19 no.1
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    • pp.81-86
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    • 2009
  • The purpose of the present study was to examine effect of 12 week regular aerobic exercise on ST-segment and QTc interval in middle age type 2 diabetes mellitus (T2DM) patients. The subjects consist of 13 type 2 diabetes mellitus (T2DM) patients in middle age men and all of them had no other complications. Subjects participated in aerobic exercise training for 12 weeks. They started to exercise for $20{\sim}60$ min at $60{\sim}80%$ of $HR_{max}$, (exercise intensity has been increased gradually) per day, $3{\sim}5$ times a week. The results were compared before and after. Weight and BMI, % body fat, fasting glucose, HOMA-IR, $_{peak}DBP$ were significantly decreased and $_{peak}HR$, $_{peak}VO_2$, exercisre time were significantly increased after 12 week aerobic exercise. Also, QTc interval and ST-segment were significantly decreased during at rest, peak exercise after 12 week aerobic exercise. Conclusionally, 12 week aerobic exercise may be improvement in decreased cardiovascular mortality factors (ST-segment) and abnormal autonomic dysfunction (QTc interval) and potentially increased exercise capacity.

Review on Diagnostic Criteria of Neurasthenia : Suggesting Pathway of Culture-bound dieases

  • Lee, Myeong Hun;Kim, Yunna;Cho, Seung-Hun
    • Journal of Pharmacopuncture
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    • v.20 no.4
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    • pp.230-234
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    • 2017
  • Objective: Neurasthenia is a disease which consists of increased fatigue or bodily weakness and exhaustion plus pantalgia, dizziness, headache and other symtoms relevant to autonomic nerve dysfunction. There are plenty of studies investigating the history of diagnostic criteria of neurasthenia, which is influenced by diverse cultural(or social) environment. The obejective of this study is to provide review of the previous studys on the changes of neurasthenia diagnoses in the context of local area to find meanings of these transition and improve health care for psychiatric patient. Methods: Literature review was conducted on studies demonstrating diagnostic criteria of neurasthenia with cultural(or social) environment. We investigated the literature reviews or observative studies which described alteration of diagnostic criteria of neurasthenia and assessed its significance. After selecting eligible studies, the authors read the articles and summarized the meaningful contents those were significant in clinical practice. Results: Transformation of Chinese Classification of Mental Disorder(CCMD) integrated with internationally utilized DSM-IV or ICD-10 is controversial about its significance in that it had limited effect on public health care due to the variables of sociocultural context, but primarily differentiated neurasthenia from other disorders. The latter one can be the directing point of the diagnostic criteria of other culture-bound diseases, which is the traits of not outstanding mood(or affect) than other neurotic disorders. Conclusion: As diagnostic criteria of neurasthenia varies, the significance of this variation is controversial, but could be the paragon of other culture-bound diseases.

Multiple Symmetric Lipomatosis: Characteristics and Treatment in Korean Patients (다발성 대칭성 지방종증: 한국인에서의 특징 및 치료)

  • Cheon, Young Woo;Roh, Tae Suk;Kim, Yong Oock;Kwon, Ji Eun;Tark, Kwan Chul;Yoo, Won Min
    • Archives of Plastic Surgery
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    • v.34 no.4
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    • pp.478-484
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    • 2007
  • Purpose: Multiple symmetric lipomatosis (MSL) is a relatively rare disorder characterized by presence of multiple, symmetric, nonencapsulated fat masses in face, neck, shoulder and other areas. There has been only a few cases reported in Korea. The main purpose of this research is to examine the Korean patients to see what kinds of special characteristics occurred due to this disease and to decide the proper treatment.Methods: A total of 16 patients were evaluated retrospectively. 5 patients were treated at our hospital. The other patients were reviewed from literature. We analyzed the biological characters of patients, location of fat deposit, morphologic characters of patients, clinical evidence of neuropathy, associated metabolic disorders and treatment modality.Results: All cases were male patient. The mean age of onset was 47.43 years. All patients were moderate to heavy alcoholics. The most common location of fat deposition was posterior neck and abdomen. In neurologic exam of 9 patients, 5 patients showed muscle weakness, tremor, pain and autonomic nerve dysfunction. In metabolic studies of 9 patients, total cholesterol values were higher in 1 patient. A glucose tolerance test was abnormal in 1 patient. In treatment modality, 14 patients were treated with surgical resection, 1 patient was treated with liposuction and surgical excision, 1 patient was treated only with liposuction. Conclusion: To treat MSL patients successfully, we should concentrate not only on the removal of the fatty tissue but also on neurologic abnormities, metabolic disorders and associated diseases.

Usefulness of infrared thermography in diagnosing and evaluating severity of carpal tunnel syndrome

  • Yang, Jiwon;Lee, Yeong-Bae;Sung, Young-Hee;Shin, Dong-Jin;Kim, Yong-Jin;Park, Hyeon-Mi
    • Annals of Clinical Neurophysiology
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    • v.23 no.2
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    • pp.99-107
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    • 2021
  • Background: Pain and autonomic dysfunction are prominent symptoms in some patients with carpal tunnel syndrome (CTS). Infrared thermography (IRT) has been used to evaluate CTS by measuring the cutaneous temperature and sympathetic vasomotor function. Methods: This study enrolled the 66 hands of 33 subjects, some of which had clinical CTS and the others were healthy. The enrolled patients completed the Boston Carpal Tunnel Questionnaire (BCTQ) and Historical-Objective scale, and underwent nerve conduction studies (NCSs) and IRT. Skin temperature was measured at the fingertips and the thenar and hypothenar regions in each hand. We analyzed (1) the correlations between self-reported severity, physician-assessed severity, and test results, and (2) the sensitivity and specificity of IRT in diagnosing CTS. Results: No significant correlation was observed between the results of the BCTQ, NCS, and IRT. IRT had a low sensitivity and high specificity in diagnosing CTS. Conclusions: IRT cannot replace NCS in diagnosing CTS, nor did it provide an advantage in combination with NCS. However, lower temperatures at the median nerve in some hands with moderate-to-severe CTS suggested the involvement of sympathetic nerve fiber function. Follow-up studies with a larger-scale and complementary design are required to elucidate the relationships.

Heart Rate Variability and Autonomic Activity in Patients Affected with Rett Syndrome (Rett 증후군 환자에서의 자율신경 활성도 및 심박수 변이도 측정)

  • Choi, Deok Young;Chang, Jin Ha;Chung, Hee Jung
    • Clinical and Experimental Pediatrics
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    • v.46 no.10
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    • pp.996-1002
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    • 2003
  • Purpose : In Rett syndrome patients, the incidence of sudden death is greater than that of the general population, and cardiac electrical instability including fatal cardiac arrhythmia is a main suspected cause. In this study, we are going to find out the possible cause of the higher risk of sudden death in Rett patients by the evaluation of heart rate variability, a marker of cardiac autonomic activity and corrected QT intervals. Methods : Diagnosis of Rett syndrome was made by molecular genetic study of Rett syndrome (MECP2 gene) or clinical diagnostic criteria of Rett syndrome. Heart rate variability and corrected QT intervals were measured by 24 h-Holter study in 12 Rett patients, and in 30 age-matched healthy children with chief complaints of chest pain or suspected heart murmurs. The were compared with the normal age-matched control. Results : Patients with total Rett syndrome, classic Rett syndrome, and Rett variants had significantly lower heart rate variability(especially rMSSD)(P<0.05) and longer corrected QT intervals than age-matched healthy children(P<0.05). Sympathovagal balance expressed by the ratio of high to low frequency(LF/HF ratio) also showed statistically significant differences between the three groups considered(P<0.05). Conclusion : A significant reduction of heart rate variability, a marker of autonomic disarray, suggests a possible explanation of cardiac dysfunction in sudden death associated with Rett syndrome.

What is the meaning of hs-CRP and HbA1c in patients with dry eye syndrome in diabetes?

  • Kang, Ji-Hun;Shin, Sang-Yol
    • Journal of the Korea Society of Computer and Information
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    • v.25 no.3
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    • pp.185-190
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    • 2020
  • The purpose of this study was to investigate the effects of systemic chronic inflammatory state on dry eye syndrome as a local chronic inflammatory condition. From June 16, 2016 to December 31, 2016, 726 patients who visited the general health examination center were screened using the Schirmer's test and the metabolic syndrome screening test. A total of 214 patients who were studied for hs-CRP and HbA1c were simultaneously selected for the study as well. Dry eye syndrome significantly increased in higher age groups (p<0.001) and women (p=0.020); there was no significant relationship with fasting plasma glucose, hs-CRP. In addition, as HbA1c increased the risk for dry eye syndrome also increased (β=1.960, p=0.025). Therefore, dry eye syndrome may not caused by microvascular changes in the lacrimal gland due to chronic inflammatory conditions. In diabetic patients, long-term blood glucose control may be more important than short-term blood glucose control. The high prevalence of dry eye syndrome in diabetic patients is thought to be due to autonomic dysfunction rather than microvascular changes caused by chronic inflammation.