• Journal of Korean Academy of Nursing
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• v.43 no.5
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• pp.579-586
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• 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.

• Proceedings of the KSRS Conference
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• v.2
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• pp.868-871
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• 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.

• Clinical and Experimental Pediatrics
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• v.57 no.3
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• pp.101-109
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• 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.

• YAKHAK HOEJI
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• v.35 no.6
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• pp.486-496
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• 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.

• Journal of Oriental Neuropsychiatry
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• v.21 no.4
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• pp.21-39
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• 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.

• Korean Journal of Ichthyology
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• v.12 no.1
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• pp.38-45
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• 2000

Depending on the fish species the vascular tone is distinctively regulated by numerous vasoactive substances. In most fish species the regulatory role of autonomic neurotransmitters and other vasoactive substances are not well defined. This research was designed to delineate the regulatory role of various endogenous autonomic neurotransmitters known to be important in mammalian vascular systems on isolated Israeli carp ventral aorta. Acetylcholine(ACh) contracted the aorta regardless of the pre-existing level of vascular tone, and the contraction was almost completely abolished by a cholinergic-muscarinic antagonist atropine. Endogenous, multiple receptor ($\alpha$ and $\beta$)-acting adrenergic agonist epinephrine (Epi) relaxed the vessel in the presence and absence of the pre-existing tones. Another endogenous multiple receptoracting agonist norepinephrine (NE) weakly contracted the aorta in non-preconstrcted state, but the response was reversed to relaxation when preconstricted. Isoproterenol, ${\alpha}\;{\beta}$ adrenergic receptor agonist, was a potent vasodilator whereas an ${\alpha}_1$ agonist phenyephrine was a contractor. The ${\alpha}_2$ adrenergic receptor agonist clonidine has not any significant effect in altering the vascular tone. The vasorelaxing action of Epi, NE and isoproterenol was significantly attenuated by $\beta$ receptor antagonist propranolol. These results imply that ACh may primarily play a contractor role via muscarinic receptor activation while adrenergic agonists, Epi and NE, are relaxants through activation of $\beta$ adrenergic receptors in vivo.

• Journal of Acupuncture Research
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• v.20 no.5
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• pp.172-186
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• 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.

• Korean Journal of Psychosomatic Medicine
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• v.28 no.1
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• pp.89-97
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• 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.

• Biomedical Science Letters
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• v.14 no.2
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• pp.69-76
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• 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.

• The Korean Journal of Physiology and Pharmacology
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• v.6 no.3
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• pp.149-154
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• 2002

The blood pressure (BP) is regulated by the nervous system and humoral factors, such as renin- angiotensin system, vasopressin and others. In the present study, we examined the central effects of glutamate and GABA on the cardiovascular regulation by injection of these substances into the lateral ventricle and also investigated the relationship between these central effects and the action of angiotensin II (Ang). Male Sprague Dawley rats, $350{\sim}400$ g, were anesthetized with urethane and instrumented with an arterial catheter for direct measurement of BP and heart rate (HR), and an guide cannula in the lateral ventricle for drug injection. A glass microelectode was inserted into the rostral ventrolateral medulla (RVLM) for recording single unit spikes. Barosensitive neurons were identified by changes of single unit spikes in RVLM following intravenous injection of nitroprusside and phenylephrine. The effects of GABA and glutamate injected into the lateral ventricle were studied in single neuronal activity of the RVLM in addition to changes in BP and heart rate, and compared the results before and after treatment with intravenous losartan, nonpeptide Ang II-type 1 receptor antagonist (1 mg/100 g BW). Intracerebroventricular administration of GABA decreased systolic blood pressure (SBP) and HR, but increased the firing rates in the RVLM. However, intracerebroventricular glutamate injection produced effects opposite to GABA. After pretreatment of intravenous losartan, the central effects of GABA on BP and firing rate in the RVLM were significantly attenuated and that of glutamate showed a tendency of attenuation. These results suggested that central GABA and glutamate regulated BP and firing rates in RVLM were inversely related to BP change. The central effects of GABA or glutamate on the autonomic nervous function were modulated by humoral factor, Ang II, by maintaining BP.