• 제목/요약/키워드: Autonomic regulation

검색결과 52건 처리시간 0.022초

Update on Irritable Bowel Syndrome Program of Research

  • Heitkemper, Margaret;Jarrett, Monica;Jun, Sang-Eun
    • 대한간호학회지
    • /
    • 제43권5호
    • /
    • pp.579-586
    • /
    • 2013
  • Purpose: This article provides an update and overview of a nursing research program focused on understanding the pathophysiology and management of irritable bowel syndrome (IBS). Methods: This review includes English language papers from the United States, Europe, and Asia (e.g., South Korea) from 1999 to 2013. We addressed IBS as a health problem, emerging etiologies, diagnostic and treatment approaches and the importance of a biopsychosocial model. Results: IBS is a chronic, functional gastrointestinal disorder characterized by recurrent episodes of abdominal pain and alterations in bowel habit (diarrhea, constipation, mixed). It is a condition for which adults, particularly women ages 20-45, seek health care services in both the United States and South Korea. Clinically, nurses play key roles in symptom prevention and management including designing and implementing approaches to enhance the patients' self-management strategies. Multiple mechanisms are believed to participate in the development and maintenance of IBS symptoms including autonomic nervous system dysregulation, intestinal inflammation, intestinal dysbiosis, dietary intolerances, alterations in emotion regulation, heightened visceral pain sensitivity, hypothalamic-pituitary-adrenal dysregulation, and dysmotility. Because IBS tends to occur in families, genetic factors may also contribute to the pathophysiology. Patients with IBS often report a number of co-morbid disorders and/or symptoms including poor sleep. Conclusion: The key to planning effective management strategies is to understand the heterogeneity of this disorder. Interventions for IBS include non-pharmacological strategies such as cognitive behavior therapy, relaxation strategies, and exclusion diets.

DIAGNOSING CARDIOVASCULAR DISEASE FROM HRV DATA USING FP-BASED BAYESIAN CLASSIFIER

  • Lee, Heon-Gyu;Lee, Bum-Ju;Noh, Ki-Yong;Ryu, Keun-Ho
    • 대한원격탐사학회:학술대회논문집
    • /
    • 대한원격탐사학회 2006년도 Proceedings of ISRS 2006 PORSEC Volume II
    • /
    • pp.868-871
    • /
    • 2006
  • Mortality of domestic people from cardiovascular disease ranked second, which followed that of from cancer last year. Therefore, it is very important and urgent to enhance the reliability of medical examination and treatment for cardiovascular disease. Heart Rate Variability (HRV) is the most commonly used noninvasive methods to evaluate autonomic regulation of heart rate and conditions of a human heart. In this paper, our aim is to extract a quantitative measure for HRV to enhance the reliability of medical examination for cardiovascular disease, and then develop a prediction method for extracting multi-parametric features by analyzing HRV from ECG. In this study, we propose a hybrid Bayesian classifier called FP-based Bayesian. The proposed classifier use frequent patterns for building Bayesian model. Since the volume of patterns produced can be large, we offer a rule cohesion measure that allows a strong push of pruning patterns in the pattern-generating process. We conduct an experiment for the FP-based Bayesian classifier, which utilizes multiple rules and pruning, and biased confidence (or cohesion measure) and dataset consisting of 670 participants distributed into two groups, namely normal and patients with coronary artery disease.

  • PDF

Evidence for adverse effect of perinatal glucocorticoid use on the developing brain

  • Chang, Young Pyo
    • Clinical and Experimental Pediatrics
    • /
    • 제57권3호
    • /
    • pp.101-109
    • /
    • 2014
  • The use of glucocorticoids (GCs) in the perinatal period is suspected of being associated with adverse effects on long-term neurodevelopmental outcomes for preterm infants. Repeated administration of antenatal GCs to mothers at risk of preterm birth may adversely affect fetal growth and head circumference. Fetal exposure to excess GCs during critical periods of brain development may profoundly modify the limbic system (primarily the hippocampus), resulting in long-term effects on cognition, behavior, memory, co-ordination of the autonomic nervous system, and regulation of the endocrine system later in adult life. Postnatal GC treatment for chronic lung disease in premature infants, particularly involving the use of dexamethasone, has been shown to induce neurodevelopmental impairment and increases the risk of cerebral palsy. In contrast to studies involving postnatal dexamethasone, long-term follow-up studies for hydrocortisone therapy have not revealed adverse effects on neurodevelopmental outcomes. In experimental studies on animals, GCs has been shown to impair neurogenesis, and induce neuronal apoptosis in the immature brains of newborn animals. A recent study has demonstrated that dexamethasone-induced hypomyelination may result from the apoptotic degeneration of oligodendrocyte progenitors in the immature brain. Thus, based on clinical and experimental studies, there is enough evidence to advice caution regarding the use of GCs in the perinatal period; and moreover, the potential long-term effects of GCs on brain development need to be determined.

요천수에 투사하는 연수 신경세포들의 분포 (Studies of Origins of Neurons in Medulla that Project to the Lumbosacral Spinal Cord of the Cat)

  • 조성도;고광호;오우택
    • 약학회지
    • /
    • 제35권6호
    • /
    • pp.486-496
    • /
    • 1991
  • Spinal parasympathetic outflows originate in the sacral parasympathetic nuclei. The sacral parasympathetic nuclei receive inputs from the brainstem. Many areas in the medulla appear to influence sympathetic outflow of the spinal cord. Whether neurons in these areas of the medulla may project to the lumbosacral cord to affect the parasympathetic outflow has not been studied clearly. Thus, this study was intended to investigate origins of cells projecting from the medulla to the sacral parasympathetic nuclei of the spinal cord. In 3 cats, horseradish peroxidase (HRP) was injected into the lower lumbar spinal cord. HRP labeled neurons were found mainly in the following areas: nucleus retroambiguus, nucleus tractus solitarius, raphe complex and ventrolateral area of the rostral medulla. Most of these areas are known to be involved in regulation of sympathetic activity, and, thus, these results indicate that these areas are likely to affect the sacral parasympathetic outflow as they do for the sympathetic nerves.

  • PDF

불면환자 175명의 심박변이도, 체성분 분석 및 동반증상의 특징에 관한 연구 (Study on the Characteristics of Heart Rate Variability, Body component analysis and accompanying symptoms in 175 Insomnia Patients)

  • 하지원;김보경
    • 동의신경정신과학회지
    • /
    • 제21권4호
    • /
    • pp.21-39
    • /
    • 2010
  • Objectives : This study was to investigate the characteristics of the heart rate variability(HRV), types of insomnia and accompanying symptoms of 175 insomnia patients. Methods : For this study we carried out HRV, Inbody of 175 patients with insomnia who have come to Dongeui oriental hospital of Dongeui university from the period of Janaury 2008 to September 2010. We studied the association of the insomnia patients' age and gender with HRV, accompanying symptoms and the types of insomnia. The information of the accompanying symptoms and types of insomnia was based on each patients' progress note. Results : l. There was no significant differences in the characteristics of HRV between male and female. 2. The most frequent symptom shown among the insmonia patents' was headache(41.14%). 3. Comparing the symptoms between the gender, female patients had more dry mouth, alternative periodic chill and fever, and hot flush symptoms than the male patients. 4. Comparing the symptoms between the age groups(divided in two), the lower age group (20~59) had more dizziness and constipation symptoms than the higher age group (over 60). 5. Comparing the types of insomma between the age group, the higher age group (over 60) had more termination insomnia. 6. The types of insomnia of the entire insomnia patients were onset insomnia (73.1%), maintenance insomnia(20.6%), termination insomma(l7.1 %), shallow sleep (52.6%), listed by order of frequency. 7. The patients who takes hypnotics had more anorexia symptoms than the patients who doesn't take hypnotics. 8. There was no visible differences of the average fractal portrait between male and female. The age group of 20~30yrs. had the highest average fractal portrait, and the age group of 30~59yrs. the second highest, and the age group over 60yrs. the lowest. 9. The average of the regulation reserves of the autonomic nervous system(B2) - was lower than the regulation level of the ANS at the present (Bl). 10. When compared the priority of the function of the ANS, it showed that the proportion of HF($38.61{\pm}29.19%$)was the most, and than VLF($30.65{\pm}23.36%$), LF($20.04{\pm}19.13%$) the least. 11. The average of the compensation level of the central nervous system at present(Cl) - was lower than the compensation reserves of the CNS(C2). 12. The average of the control reserves of the cerebrum(D2) - was lower than the control level of the cerebrum at the present (Dl). 13. There was no visible differences between different sexes and ages in pulse rate. 14. The abdomen fat ratio above the line of the insomnia patients was 77.97% in male and 93.1% in female. Both sexes showed that insomnia patients had more abdomen fat that the standard, and female patients had more abd. fat than male patients. Conclusions : This study shows that the HRV of insomnia patients had no significant differences between gender. Fractal portrait, HF, LF and VLF of the insomnia patients are in inverse proportion to the age. The study of the Body Component Analysis showed that female had more abdomen fat than male, and both gender showed more abdomen fat than the standard. When looked into the accompanying symptoms of the insomnia patients, the symptoms show differences according to gender, age and hypnotics taking, as shown as below. In the entire patients, Headache was the most accompanying symptom. Female had more dry mouth, alternative periodic chill and fever, and hot flush symptoms than male. Higher age groups had more dizziness and constipation as accompanying symptoms than lower age groups. Patients who takes hypnotics had more anorexia than those who dont.

콜린성 및 아드레날린성 신경전달물질에 의한 이스라엘잉어 복대동맥의 혈관긴장도 조절기능 (Vasomotor Regulation of the Israeli Carp (Cyprinus carpio) Ventral Aorta by Cholinergic and Adrenergic Neurotransmitters)

  • 박관하
    • 한국어류학회지
    • /
    • 제12권1호
    • /
    • pp.38-45
    • /
    • 2000
  • 어종에 따라 혈관의 긴장도 조절은 다양한 신경전달물질에 의하여 조절되고 있다. 그러나 아직 대부분의 어종에서 자율신경계 신경전달물질 및 혈관긴장도 조절인자들의 기능에 대하여 명확하게 규명되어 있지 않다. 본 연구는 아직 연구되지 않은 분야인 이스라엘잉어에서의 자율신경계 신경전달물질들의 혈관긴장도 조절에서의 역할을 규명하고자 적출복대동맥을 이용하여 시험하였다. 이 적출혈관에서 아세틸콜린 (ACh)은 정상혈관과 미리 일정수준 수축시킨 혈관 모두에서 수축을 유발하였으며 수축작용은 무스카린성 길항제인 아트로핀에 의해 거의 완벽하게 차단되었다. 여러 가지 아드레날린성 수용체를 동시에 흥분시키는 내인성 물질인 에피네프린 (Epi)은 혈관의 조건에 상관없이 이완반응을 유발하였다. 그러나 유사한 내인성물질인 노르에피네프린 (NE)은 정상혈관에서는 미약한 수축율, 미리수축된 혈관에서는 이완작용을 유발하였다. 한편 ${\alpha}_1$ 아드레날린성 수용체 흥분제인 페닐에프린은 수축을, $\beta$수용체 홍분제인 이소프로테레놀은 이완을 각각 유발하였으며 ${\alpha}_2$수용체 흥분제인 클로니딘은 아무런 반응을 유발하지 않았다. Epi, NE 및 이소프로테레놀에 의해 유발된 혈관이완 반응은 $\beta$ 아드레날린성 수용체 길항제인 프로프라놀롤에 의해 유의하게 억제되었다. 따라서 살아있는 상태의 이스라엘 잉어에서는 ACh는 주로 무스카린성 수용체 활성화에 의한 혈관을 수축하는 기능을, Epi과 NE는 $\beta$수용체 흥분에 의한 이완작용을 각각 발휘하는 것으로 판단된다.

  • PDF

내수용 감각과 촉각처리 및 심박변이도 간의 관계 (Relationship Between Interoceptive Awareness, Tactile Processing, and Heart Rate Variability)

  • 김지희;김은영
    • 대한감각통합치료학회지
    • /
    • 제22권1호
    • /
    • pp.15-24
    • /
    • 2024
  • 목적 : 본 연구의 목적은 내수용 감각(interoception)과 감각처리, 그리고 자율신경계의 균형을 반영하는 심박변이도와의 관계를 알아보는 것이다. 연구방법 : 젊은 성인을 대상으로 청소년/성인 감각프로파일(Adolescent/Adult Sensory Profile; AASP)과 다차원 내수용 자각 척도(Multidimensional Assessment of Interoceptive Awareness; MAIA)를 사용하여 감각처리와 내수용 감각을 평가하였다. 심박은 안정상태 심전도로 기록되었고, 심전도에서 심박표준편차(Standard Deviation of Normal to Normal interval; SDNN)를 추출하였다. AASP 감각영역과 MAIA 하위척도 간 상관을 분석하였고, 높은 SDNN과 낮은 SDNN 집단 간의 감각처리 및 내수용 감각의 차이를 비교하였다. 결과 : AASP 촉각 영역이 MAIA 하위척도와 상대적으로 강한 상관을 나타내었다. AASP 촉각 영역의 점수가 높을수록 MAIA 걱정하지 않음과 주의 조절 점수가 낮은 반면, 정서자각 점수는 높았다. 높은 SDNN 집단은 낮은 SDNN 집단과 비교하였을 때 내수용 감각이 높은 경향성을 나타냈다. 결론 : 본 연구는 촉각 처리와 내수용 감각의 관련성을 확인하였으며, 심박변이도가 높은 그룹은 내수용 자각이 높은 경향성이 있음을 제시하였다. 본 연구는 최근 작업치료와 감각통합에서 강조되는 내수용 감각에 대한 정보를 제공하고, 감각통합의 신경과학적 기전에 대한 이해를 심화시킨다.

침의 치료기전에 대한 신경기반 및 신경기능 가설 -침자극과 관계된 신경기반 및 체액성 반응, 신경적 반응, 면역반응- (Neural Substrates and Functional Hypothesis of Acupuncture Mechanisms - Neural substrates and humoral-, neural-, and immune-responses related to acupuncture stimulation-)

  • 조장희;황선출;;손영돈;강창기;박태석;배선준;성강경
    • Journal of Acupuncture Research
    • /
    • 제20권5호
    • /
    • pp.172-186
    • /
    • 2003
  • Acupuncture therapy has demonstrated efficacy in several clinical areas, and of these areas the understanding of pain has progressed immensely in the last two decades. The underlying mechanisms of acupuncture in general and the analgesic effect in particular are still not clearly delineated. The leading hypothesis include the effects of local stimulation, neuronal gating, release of endogenous opiates, and the placebo effect. Accumulating evidence suggests that the central nervous system(CNS) is essential for the processing of these effects, via its modulation of the autonomic nervous system, neuro-immune system, and hormonal regulation. These processes tap into basic survival mechanisms. As such, understanding the effects of acupuncture within a neuroscience-based framework becomes vital. We propose a model which incorporates the stress-induced hypothalamus-pituitary-adrenal axis(HPA-axis) model of Akil et al., the cholinergic anti-inflamatory observations of Tracey et al., and Petrovic et al.

  • PDF

Reduced Heart Rate Variability in Somatic Symptom Disorder: Associations with Alexithymia

  • Lee, Jae Hoon;Jang, Ye Eun;Park, Hye Youn
    • 정신신체의학
    • /
    • 제28권1호
    • /
    • pp.89-97
    • /
    • 2020
  • Objectives : We investigated heart rate variability (HRV) patterns in patients with somatic symptom disorder (SSD) and the relationships of these patterns with alexithymia. Methods : In total, 42 patients with SSD and 33 healthy controls were enrolled in this study. Demographic, psychological, and HRV data were assessed at baseline, and 24 patients with SSD were reassessed after 6 months of treatment. The psychological data included somatic symptoms and levels of depression, anxiety, and alexithymia as indicated by the somatic symptom subscale of the Symptom Checklist 90-Revision (SCL-12), Beck Depression Inventory-II (BDI-II), Beck Anxiety Inventory (BAI), and the Toronto Alexithymia Scale 20 (TAS-20), respectively. Results : Patients with SSD had a lower standard deviation of normal-to-normal R-R intervals (SDNN) and lower proportions of adjacent R-R intervals greater than 50 milliseconds (pNN50) compared with controls. These HRV parameters were negatively correlated with alexithymia severity. After treatment, patients exhibited significantly decreased levels of somatic symptoms and reduced anxiety and depression, but there were no significant differences in the HRV parameters. In patients with alexithymia, a high baseline SDNN and pNN50 were associated with a decrease in somatic symptoms. Conclusions : Patients with SSD have different HRV patterns, and several HRV parameters are associated with alexithymia severity. These findings suggest that ANS regulation is involved in the pathophysiology of SSD, mediated by alexithymia. Furthermore, these results suggest that certain HRV parameters may be associated with clinical outcomes of SSD.

Modulation of $GABA_A$ Receptor by Protein Kinase C in Autonomic Major Pelvic Ganglion Neurons

  • ;;;공인덕
    • 대한의생명과학회지
    • /
    • 제14권2호
    • /
    • pp.69-76
    • /
    • 2008
  • ${\gamma}$-aminobutyric acid (GABA) is the major inhibitory neurotransmitter in the central nervous system, and its actions are mediated by subtypes of GABA receptors named as $GABA_A$, $GABA_B,\;and\;GABA_C,\;GABA_A$, receptor consisting of ${\alpha},\;{\beta},\;{\gamma}\;and\;{\delta}$ subunits is a heterooligomeric ligand-gated chloride channel. This study was performed to investigate regulation of $GABA_A$ receptor by protein kinase C(PKC). Ion currents were recorded using gramicidine-perforated patch and whole cell patch clamp. mRNA encoding the subunits of PKC expressed in major pelvic ganglion (MPG) neurons was detected by using RT-PCR. The GABA-induced inward current was increased by PKC activators and decreased by PKC inhibitors, respectively. These effects were not associated with intracellular $Ca^{2+}$ and GAG (1-oleoyl-2-acetyl-sn-glycerol), a membrane permeable diacylglycerol (DAG) analogue. These results mean that the subfamily of PKC participating in activation of $GABA_A$ receptor would be an atypical PKC (aPKC). Among theses, ${\xi}$ isoform of aPKC was detected by RT-PCR. Taking together, we suggest that excitable $GABA_A$ receptor in sympathetic MPG neuron seemed to be regulated by aPKC, particular in ${\xi}$ isoform. The regulatory roles of PKC on excitatory $GABA_A$ receptors in sympathetic neurons of MPG may be an important factor to control the functional activity of various pelvic organs such as bowel movement, micturition and erection.

  • PDF