• Journal of Biomedical Engineering Research
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• v.24 no.4
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• pp.329-337
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• 2003

Blood in congenital or acquired AY fistula(arteriovenous fistula) flows from arteries directly to veins. detouring peripheral micro-circulation. This makes a great effect on the hemodynamics of human cardiovascular system. In this study, a computational method using lumped parameter mode) was proposed to simulate the cardiovascular hemodynamics of patients with acute AV fistula The cardiovascular system model with a fistula compartment in left lower limb was built using 17 standard lumped compartments. Using fourth order Runge-Kutta method. we solved numerically the unsteady linear set of the ordinary differential equations resulting from application of Kirchhoff's law to the lumped parameter hemodynamic model. The baroreceptor reflex system was implemented to explain the auto-regulation effect of the cardiovascular system with acute AV fistula.

• Annals of Clinical Neurophysiology
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• v.12 no.2
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• pp.61-65
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• 2010

Background: Orthostatic hypotension (OH) refers to a fall in systolic blood pressure (BP) of 20 mmHg or more, or in diastolic BP of 10 mm Hg or more within 3 minutes of standing up. The head-up tilt test (HUT) is the most useful, but potentially invasive test for the diagnosis of OH. The purpose of this study was to identify the usefulness of spontaneous baroreflex sensitivity (sBRS). Methods: Ninety one patients with orthostatic intolerance, in whom the HUT data were available, were included in the study. Patients were classified into HUT-positive (group I) and HUT-negative (group II) group. Twenty five healthy volunteers served as normal controls, and were designated as group III. In all subjects, beat-to-beat BP and heart rate were recorded using BeatScope 1.1a. We collected the 50 sBRS data in each patient in a supine position. The average value of one to ten of 50 sBRS data was defined as sBRS10, one to twenty as sBRS20, one to thirty as sBRS 30, one to forty as sBRS 40, and one to fifty as sBRS 50. Differences in sBRS10 and sBRS50 levels were statistically analyzed and compared between groups I, II, and III. Results: No significant difference in the sBRS50 level was found between Groups II and III. sBRS50 was significantly lower in Group I than in Groups II and III (p<0.05), and the same pattern of differences was observed for sBRS40, sBRS30, sBRS20, and sBRS10. Conclusions: Patients with OH showed significantly lower sBRS levels than HUT-negative patients or normal controls. Our study implies that a supine-position sBRS would provide additional diagnostic information for OH.

• Journal of Biomedical Engineering Research
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• v.31 no.5
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• pp.395-400
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• 2010

Hypertension is the chronic disease that the 16% of total population are suffering, and it needs to be studied to find alternative treatment because of the tolerance and side effect of medications that may bother some patients. in this paper, we verified practicality of implantable electrical stimulator that can readily change stimulus magnitude and frequency. And this device is possible to stimulate baroreflex or parasympathetic nerve. Therefore we performed in vitro tests and animal experiment for device's operating conditions. This device consist of implantable electrical stimulator and extracorporeal control/monitoring system. Stimulator was designed to make 1Hz~100Hz pulses and it can change continuous or periodic pulse train type. And this device can control stimulator's function and monitor stimulator's status and patients' blood pressure at exterior of body using ZigBee module as wireless telecommunication. We verified that stimulator have error rate under 5% at 50mm depth of organs and, stimulator makes high-efficiency energy with closer position of two electrodes. Also we can confirm the performance of device that decreasing blood pressure and heart rate of a rat by electrical stimulation.

• The Korean Journal of Physiology and Pharmacology
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• v.18 no.4
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• pp.353-358
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• 2014

Control of blood pressure is maintained by the interaction between the arterial baroreflex and vestibulosympathetic reflex during postural changes. In this study, the contributions of vestibular receptors and baroreceptors to the maintenance of blood pressure following acute hypotension were compared in terms of phosphorylated extracellular regulated protein kinase (pERK) expression in the nucleus tractus solitaries (NTS). Expression of pERK in the NTS was measured in conscious rats that had undergone bilateral labyrinthectomy (BL) and/or sinoaortic denervation (SAD) 5, 10, 20, and 40 min following acute hypotension induced by sodium nitroprusside (SNP) infusion. Expression of pERK increased significantly in the NTS in the control group following SNP infusion, and the expression peaked at 10 min after SNP infusion. The number of pERK positive neurons increased following SNP infusion in BL, SAD, and BL+SAD groups, although the increase was smaller than in control group. The BL group showed a relatively higher reduction in pERK expression than the SAD group, and the pERK expression in the NTS was localized to the caudal portion of the nuclei in the BL and SAD groups. These results suggest that the vestibular receptors may play a key role in maintaining blood pressure following acute hypotension; thus, the vestibular system may contribute to compensate for orthostatic hypotension.

• The Korean Journal of Pharmacology
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• v.25 no.1
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• pp.1-11
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• 1989

In this study, it was aimed to investigate the role of serotonergic neurotransmission in nucleus tractus solitarius (NTS) for the central regulation of blood pressure and heart rate and its involvement in baroreceptor reflex activation in rats. A microinjection of 5-hydroxytryptamine (5-HT) into the NTS produced decreases in blood pressure and heart rate. Maximal decreases were $34.4{\pm}1.6$ mmHg and $41.7{\pm}10.2$ beats per min by 300 pmol of 5-HT. Microinjections of ${\alpha}-methylnor-adrenaline$ $({\alpha}-MNE)$ and clonidine manifested similar decreases in blood pressure and heart rate. The hypotensive and bradycardial effects of 5-HT were blocked by previous applications of 5-HT antagonists, ritanserin, methysergide and ketanserin into the NTS, respectively. By pretreatment with reserpine and 6-hydroxydopamine (6-OHDA, i.c.v.), both hypotensive and bradycardial effects of 5-HT were significantly attenuated. Pretreatment with 5, 7-dihydroxytryptamine (5,7-DHT, i.c.v.) enhanced the hypotensive and bradycardial effects of 5-HT. Similarly, following pretreatment with 6-OHDA, the effects of clonidine were increased. Pretreatment either with 5,7-DHT or 6-OHDA significantly attenuated the sensitivity of baroreflex produced either by phenylephrine or by sodium nitroprusside. When either 5,7-DHT or 6-OHDA was injected into the NTS $(5,7-DHT;\;8{\mu}g\;6-OHDA;\;10{\mu}g)$, both of the baroreflex sensitivities were impaired. In the immunohistochemical study, the injection of 6-OHDA into the the NTS led to reduction of axon terminal varicosity, however, the injection did not reduce the numbers of catecholaminergic cell bodies. Likewise, when 5,7-DHT was injected into the NTS, the varicosity of serotonergic axon terminals was markedly reduced. Based on these results, it is suggested that (1) stimulation of serotonergic receptors in the NTS leads to decreases in blood pressure and heart rate as observed with the stimulation of catecholaminergic system, (2) both serotonergic and catecholaminergic receptors may be located postsynaptically, and (3) the serotonergic neurons as well as catecholaminergic neurons may have a close relevance for the activation of baroreflex.

• 한국전산유체공학회:학술대회논문집
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• 2000.10a
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• pp.123-128
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• 2000

Orthostatic stress in human cardiovascular system following spaceflight remains a critical problem in the current lifercience space program. The study presented in this paper is part of an ongoing effort to use mathematical models to investigate the effects of gravitational stresses on the cardiovascular system of normals and microgravity adapted individuals. We employ a twelve compartment lumped parameter representation of the hemodynamic system coupled to set-point models of the arterial baroreflex and the cardiopulmonary reflex to investigate the transient response of heart rate to orthostatic stress. We simulate current hypotheses concerning the mechanisms underlying postspaceflight orthostatic intolerance over a range of physiologically reasonable values and compare the simulations to astronaut stand-test data pre-and postflight.

• 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.

• Annals of Clinical Neurophysiology
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• v.25 no.2
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• pp.66-77
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• 2023

Orthostatic hypotension is a sustained and pathological drop in blood pressure upon standing. Orthostatic hypotension can be due to non-neurogenic conditions or autonomic disorders. Impaired baroreflex-mediated vasoconstriction and insufficient release of norepinephrine play key roles in the pathophysiology of neurogenic orthostatic hypotension. Its common symptoms mainly related to inadequate cerebral blood flow include dizziness, lightheadedness, and syncope. It is crucial to differentiate neurogenic orthostatic hypotension from non-neurogenic orthostatic hypotension. For the management of neurogenic orthostatic hypotension, physicians should implement non-pharmacological methods and, if possible, reverse combined non-neurological conditions. Depending on severity of symptoms, pharmacological intervention may be tried after or with non-pharmacological methods. Its management should be individualized based on intensity of symptoms, comorbid conditions, drug side effects, and etiology. In this review, we discuss the definition, pathophysiology, clinical approach, and management of neurogenic orthostatic hypotension.

• International Journal of Vascular Biomedical Engineering
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• v.2 no.2
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• pp.16-26
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• 2004

The object of this study is to develop a mathematical model of the hemodialysis system including the mechanism of solute kinetics, water exchange and also cardiovascular dynamics. The cardiovascular system model used in this study simulates the short-term transient and steady-state hemodynamic responses such as hypotension and disequilibrium syndrome (which are main complications to hemodialysis patients) during hemodialysis. It consists of a 12 lumped-parameter representation of the cardiovascular circulation connected to set-point models of the arterial baroreflexes, a kinetic model (hemodialysis system model) with 3 compartmental body fluids and 2 compartmental solutes. We formulate mathematically this model in terms of an electric analog model. All resistors and most capacitors are assumed to be linear. The control mechanisms are mediated by the information detected from arterial pressoreceptors, and they work on systemic arterial resistance, heart rate, and systemic venous unstressed volume. The hemodialysis model includes the dynamics of urea, creatinine, sodium and potassium in the intracellular and extracellular pools as well as fluid balance equations for the intracellular, interstitial, and plasma volumes. Model parameters are largely based on literature values. We have presented the results on the simulations performed by changing some model parameters with respect to their basal values. In each case, the percentage changes of each compartmental pressure, heart rate (HR), total systemic resistance (TSR), ventricular compliance, zero pressure filling volume and solute concentration profiles are represented during hemodialysis.

• Korean Journal of Psychosomatic Medicine
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• v.14 no.1
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• pp.33-38
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• 2006

Biofeedback training to increase the amplitude of respiratory sinus arrhythmia(RSA) maximally increases the amplitude of heart rate variability(HRV) only in respiratory rate at approximately 0.1Hz. To perform this task, people slow their breathing to this rate to point where resonance occur between respiratory sinus arrhythmia(RSA) and oscillation that naturally occur at this rate, probably triggered in part by baroreflex activity. The biofeedback technique allows each individual to breathe at a rate that is specifically adapted to the rhythms of his or her own body. A manual is presented for carrying out this method.