• Clinical and Experimental Pediatrics
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• v.59 no.sup1
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• pp.149-151
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• 2016

Chiari malformations are a congenital anomaly of the hindbrain. The most common, Chiari malformation type I (CM-I), is characterized by herniation of the cerebellar tonsils extending at least 3 mm below the plane of the foramen magnum. Consequently, CM-I is associated with hydrocephalus and symptoms involving compression of the cervicomedullary junction by ectopic tonsils. Several studies have reported the clinical symptoms associated with CM-I, including suboccipital headache, weakness in the upper extremities, facial numbness, loss of temperature sensation, ataxia, diplopia, dysarthria, dysphagia, vomiting, vertigo, nystagmus, and tinnitus. Syncope is one of the rarest presentations in patients with CM-I. There are many hypotheses regarding the causes of syncope in patients with CM-I; however, the mechanisms are not clearly understood. Although surgical decompression for CM-I in patients with syncope has yielded good clinical results in some studies, such cases are rarely reported. We report a case of orthostatic syncope in a patient with CM-I who was treated with surgical intervention.

• Journal of Biomedical Engineering Research
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• v.18 no.1
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• pp.37-44
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• 1997

In this paper, the power spectral analysis of heart rate variability(HRV) was performed to evaluate effects of orthostatic stress with head-up tiIt on autonomic nervous system(ANS) for 25 healthy male subjects(age : 24 $\pm$ 5 yr.) and a new method was proposed to assess the autonomic balance. The ECG and respiration signals were recorded at tiIt angles of $0^{\circ}$, $45^{\circ}$, $90^{\circ}$and $0^{\circ}$ successively for 10 minutes per each stage under the condition of frequency controlled respiration(0.25Hz). Heat rate(HR) gradually increased ils the angle increased Similarly, according to the increment of angle, normalized low frequency component(0.05-0.15Hz) gradually increased, whereas normalized high frequency component (0.20-0.30Hz) was reduce4 From these results it is speculated that orthostatic stress head-up tiLt, results in the prevalence of sympathetic tone in autonomic balance with the increment of sympathetic tone and the decrement of parasympathetic tone, which seems to meanthat autonomic nervous system plays a major role in compensating for disturbances of cardiovascular system due to it.

• Journal of Sasang Constitutional Medicine
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• v.28 no.2
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• pp.193-204
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• 2016

Objectives This case study is about a Taeeumin patient with advanced Parkinson's disease identified as Dry-heat (Joyeol) pattern. In this study, we report significant improvement of non-motor and motor symptoms after treatment with Cheongsimyeonja-tang.Methods The patient was identified as Taeeumin Dry-heat (Joyeol) pattern and treated with Cheongsimyeonja-tang and acupuncture. The Unified Parkinson Disease Rating Scale (UPDRS) was used to assess the overall functions of the patient. And the global assessment scale (GAS) was used to assess the improvements of dizziness, bradykinesia and tremor after the treatment.Result and Conclusion The UPDRS total score decreased from 138 points to 86 points after 5 weeks treatment. And symptoms of dizziness caused by hypotension, bradykinesia, and tremor showed significant improvement in GAS after the treatment. Furthermore, sleep disturbance and constipation were reported to be improved after the treatment. In conclusion, this study shows that Sasang constitutional medicine can be effective treatment for Taeeumin patient with advanced Parkinson's disease having orthostatic hypotension.

• Annals of Clinical Neurophysiology
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• v.21 no.1
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• pp.30-35
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• 2019

Background: Postural tachycardia syndrome (POTS) refers to the presence of orthostatic intolerance symptoms associated with a heart rate increment of greater than 30 beats/min, usually up to 120 beats/min, on head-up tilt test. Symptoms related to POTS are usually light-headedness, palpitations and tremor, but syncope can also occur. The pathophysiology of POTS is heterogeneous and its prognosis is uncertain. Methods: We prospectively evaluated patients who met the criteria for POTS, at baseline and follow-up, using composite autonomic symptom scores and autonomic tests to assess the autonomic function. We compared the clinical and autonomic test results between baseline and follow-up. Results: Sixty-eight patients met the inclusion criteria for POTS and forty-five patients were ultimately followed up for at least 1 year after baseline. The patients were predominantly young females (84%), with a mean age of 21 years. Most patients showed improved orthostatic symptoms and more than a quarter of patients had no longer met the criteria for POTS at follow-up. Conclusions: Most patients had a benign outcome in that they could resume their daily activities without great limitations. Our results demonstrated a relatively favorable prognosis in most patients with POTS.

• The Korean Journal of Pain
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• v.26 no.4
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• pp.406-406
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• 2013

• Proceedings of the KIEE Conference
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• 2002.07d
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• pp.2693-2695
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• 2002

In this paper, the power spectral analysis of heart rate variability(HRV) was performed to evaluate effects of orthostatic stress with head-up tilt on autonomic nervous system(ANS) for 20 healthy male subjects(age : 245 yr.) and a new method was proposed to assess the autonomic balance. The ECG signals wore recorded for 3 minutes in both the supine and 70 head-up tilt positions, and then the HRV signals underwent power spectrum analysis at each position. The results of this study suggest that cardiac autonomic functions, such as sympathetic tone in autonomic balance with the increment of sympathetic tone and the decrement of parasympathetic tone which occur during head-up tilt position, arc not sufficient to overcome tile orthostatic stress arising in Cerebral Palsy.

• Journal of the Korean neurological association
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• v.36 no.4
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• pp.280-288
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• 2018

Vertigo/dizziness is a common complaint in patients who are seeking a primary health clinic. Vertigo is traditionally attributed to damage of the vestibular system. Many peripheral and central vestibular disorders are usually presented with vertigo. However, patients with benign paroxysmal positional vertigo (BPPV), a leading cause of vertigo, may present with postural lightheadedness, near faint, imbalance rather than true vertigo. On the contrary, patients with orthostatic hypotension may present with true spinning vertigo, not dizziness. Persistent postural perceptual dizziness, a second most common cause of dizziness (after BPPV), is mainly occurred after organic vestibular disorders such as BPPV or vestibular neuritis, and classified as a chronic functional vestibular disorder. This article describes non-vestibular disorders presenting dizziness and/or vertigos, which conditions may be misdiagnosed as structural vestibular disorders.

• Annals of Clinical Neurophysiology
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• v.23 no.2
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• pp.126-129
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• 2021

We present a patient with a primitive neuroectodermal tumor arising from the right atrium who experienced multiple syncope episodes daily, which had first appeared 1 month after surgery. The symptoms continued to worsen over the course of chemotherapy, and the autonomic function test (AFT) was performed after the 14th chemotherapy cycle. The AFT revealed orthostatic hypotension and reduced baroreflex-dependent sympathetic reactivity. Physical counterpressure techniques were applied with a visual biofeedback intervention, and were found to be effective in reducing the syncope episodes.

• The Korean Journal of Physiology
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• v.30 no.2
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• pp.237-247
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• 1996

This study was carried out to determine the effect of $-6^{\circ}$ head-down bedrest on the cardiovascular and hormonal responses to orthostasis and to evaluate the mechanism of orthostatic intolerance. Ten healthy young men were changed the body position from $-6^{\circ}$ head-down or supine bedrest for 2 hr to $70^{\circ}$ head-up tilt for 20 min. During the bedrest, there were no differences in hemodynamic and hormonal changes between the head-down and the supine positions. However, the tendency of decreased end-diastolic volume and increased cardiac contractility during the later period of 2 hr showed that the cardiovascular adaptation could be accelerated within a relatively short period in the head-down bedrest. During the head-up tilt, presyncopal signs were developed in five subjects of the supine bedrest, and one of the same subjects of the head-down bedrest. In the tolerant subjects, the increase in cardiac contractility and plasma epinephrine level during the bend-up tilt was greater following the head-down bedrest than that following the supine bedrest to compensate for reduced venous return. The intolerant subjects showed the greater decrease in end-diastolic and stroke volume, and the greater increase in heart rate during the head-up tilt than the tolerant subjects. Cardiac contractility and plasma epinephrine level were remarkably increased. However, arterial pressure was not maintained at the level for the appropriate compensation of the reduced venous return. It seems that the tolerance to orthostasis is more effective after the short-term head-down bedrest than after the supine bedrest, and the secretion of epinephrine induces the higher cardiac performance as a compensatory mechanism fur the reduced venous return during the orthostasis following the head-down bedrest than the supine bedrest.

• Genomics & Informatics
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• v.11 no.3
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• pp.129-134
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• 2013

Orthostatic hypotension (OH) is defined by a 20-mm Hg difference of systolic blood pressure (dtSBP) and/or a 10-mm Hg difference of diastolic blood pressure (dtDBP) between supine and standing, and OH is associated with a failure of the cardiovascular reflex to maintain blood pressure on standing from a supine position. To understand the underlying genetic factors for OH traits (OH, dtSBP, and dtDBP), genome-wide association studies (GWASs) using 333,651 single nucleotide polymorphisms (SNPs) were conducted separately for two population-based cohorts, Ansung (n = 3,173) and Ansan (n = 3,255). We identified 8 SNPs (5 SNPs for dtSBP and 3 SNPs for dtDBP) that were repeatedly associated in both the Ansung and Ansan cohorts and had p-values of < $1{\times}10^{-5}$ in the meta-analysis. Unfortunately, the SNPs of the OH case control GWAS did not pass our p-value criteria. Four of 8 SNPs were located in the intergenic region of chromosome 2, and the nearest gene (CTNNA2) was located at 1 Mb of distance. CTNNA2 is a linker between cadherin adhesion receptors and the actin cytoskeleton and is essential for stabilizing dendritic spines in rodent hippocampal neurons. Although there is no report about the function in blood pressure regulation, hippocampal neurons interact primarily with the autonomic nervous system and might be related to OH. The remaining SNPs, rs7098785 of dtSBP trait and rs6892553, rs16887217, and rs4959677 of dtDBP trait were located in the PIK3AP1 intron, ACTBL2-3' flanking, STAR intron, and intergenic region, respectively, but there was no clear functional link to blood pressure regulation.