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

• Journal of Korean Medicine Rehabilitation
• /
• v.18 no.2
• /
• pp.131-142
• /
• 2008

Objectives : This study was performed to identify the influence of salivary cortisol and HRV(Heart rate variability) on hypoadrenia predisposing factors and sign. Methods : 30 patients with chronic fatigue symptom belonging to Shen xu(腎虛) were recruited for investigation from March to April 2007. The participants were divided into HS(High score) group(n=15) and LS(Low score) group(n=15) in predisposing factors of adrenal questionnaire. At the same time equal patients separated into OH(+)(Orthostatic hypotension positive) group(n=12) and OH(-)(Orthostatic hypotension negative) group(n=18). Salivary cortisol and HRV made use of evaluating hormonal imbalance and autonomic nervous system of hypoadrenia. Results : Salivary cortisol at P.M.4 in HS group was significantly(p=0.011) lower than LS group. And LF(Low frequency) of OH(+) group was considerably(p=0.014) lower than OH(-) group. Conclusions : Shen xu bian zheng(腎虛辨證), measure of orthostatic hypotension, predisposing factors of adrenal questionnaire, salivary cortisol and HRV deserve clinical application for management of subclinical hypoadrenia.

• Journal of the Korean Society of Radiology
• /
• v.85 no.1
• /
• pp.24-35
• /
• 2024

Spontaneous intracranial hypotension (SIH), which generally presents as orthostatic headache, is increasingly being identified due to improved imaging technologies and heightened awareness. Many prior studies have reported the characteristic brain MRI findings of SIH. However, recently, focus has shifted to spinal MRI, as SIH is believed to be caused by leakage of cerebrospinal fluid from the spinal dural sac. Advanced techniques such as ultrafast CT myelography and digital subtraction myelography have emerged as useful technique to identify the site of cerebrospinal fluid leakage. In this review, we discuss the diagnosis, spinal MRI findings, imaging techniques, and treatment of SIH.

• The Korean Journal of Physiology and Pharmacology
• /
• v.8 no.3
• /
• pp.133-140
• /
• 2004

The purpose of the present study was to elucidate the possible involvement of the medial vestibular nucleus (MVN) and inferior vestibular nucleus (IVN) following acute hypotension in the vestibuloautonomic reflex through vestibulosolitary or vestibuloventrolateral projections. Acute hypotension-induced cFos expression was assessed in combination with retrograde cholera toxin B subunit (CTb) tract tracing. After injection of CTb into the solitary region, CTb-labeled neurons were located prominently around the lateral borders of the caudal MVN and medial border of the IVN. The superior vestibular nucleus also had a scattered distribution of CTb-labeled neurons. After injection of CTb toxin into the unilateral VLM, the distributions of CTb-labeled neurons in the MVN and IVN were similar to that observed after injection into the solitary region, although there were fewer CTb-labeled neurons. In the caudal MVN, about 38% and 13% of CTb-labeled neurons were double-labeled for cFos after injection of CTb into the solitary region and the VLM, respectively. In the IVN, 14% and 7% of CTb-labeled neurons were double-labeled for cFos after injection of CTb into the solitary region and the VLM, respectively. Therefore, the present study suggests that acute arterial hypotension may result in activation of vestibulosolitary pathways that mediate behavioral and visceral reflexes, and vestibuloventrolateral medullary pathways that indirectly mediate vestibulosympathetic responses.

• The Korean Journal of Physiology and Pharmacology
• /
• v.8 no.4
• /
• pp.181-185
• /
• 2004

Extracellular regulated protein kinase1/2 (pERK1/2) is one of the major regulatory factors for transcription of the c-fos oncogene in neurons. The purpose of this study was to evaluate the expression of phosphorylated ERK1/2 within the vestibular nuclei (VN) of rats following acute arterial hypotension. Following the acute arterial hypotension induced by rapid hemorrhage, a significant number of pERK1/2-immunoreactive neurons appeared bilaterally in the caudal aspect of the medial and inferior VN. No labeling of pERK1/2 was observed in the lateral VN. The peak expression of pERK1/2 in these nuclei occurred within 5 min after hemorrhage. However, in bilaterally labyrinthectomized rats, the appearance of pERK1/2-immunoreactive neurons was eliminated in the VN. Western blot confirmed the effect of bilateral labyrinthectomy on pERK1/2 protein expression in the medial vestibular nucleus 5 min after hemorrhage. These results suggest that, following acute hypotension, afferent signals from the peripheral vestibular receptors are required for activation of ERK 1/2 in the VN.

• Journal of Korean Academy of Fundamentals of Nursing
• /
• v.2 no.2
• /
• pp.239-251
• /
• 1995

The prevalence of postural hypotension among over 65 year old men is 10-30%. The postural hypotension commonly causes the discomfort such as dizziness, irritability or fainting spell, and for the result it diminishes the quality of the life of aged. Therefore the assessment and intervention of postural hypotension during changing position is very important. The purpose of this study is to investigate the effect of changing position from supine to standing upright, from supine through left lateral to standing upright, from supine through sitting to standing upright of aged. The results obtained are as follows : 1. The average systolic blood pressure of normotension group is $132.68{\pm}16.04mmHg$ at supine position. The average diastolic blood pressure of normotension group is $80.72{\pm}9.82mmHg$ at supine position. The average systolic blood pressure of hypertension group is $153.92{\pm}20.12mmHg$ at supine position. The average diastolic blood pressure of hypertension group is $93.74{\pm}15.53mmHg$ at supine position. 2. There is no significant difference of blood pressure after three different procedures as mentioned above from supine to standing upright. 3. The prevalence of postural hypotension at standing upright is 13.5% which is 18.8% of the hypertension group and 9.4% of the normotension group. There is statistical difference of the prevalence of postural hypotension between hypertension group and normotension group.

• Journal of The Korean Dental Society of Anesthesiology
• /
• v.12 no.3
• /
• pp.151-155
• /
• 2012

A vasovagal reaction is defined as the 'development of hypotension and bradycardia associated with the typical clinical manifestations of pallor, sweating and weakness'. The most profound degree of vasovagal reaction results in fainting or syncope. Incidence of vasovagal reactions in the local anesthetic department of a dental hospital is around 2%. The pathophysiology of the hypotension/bradycardia reflex responsible for vasovagal syncope is not completely understood. Central as well as peripheral mechanisms have been implicated in its pathogenesis: however their relative contribution is not fully elucidated. Recently, trigeminocardiac reflex, previously known as oculocardiac reflex, may serve as syncope. The management of vasovagal syncope is evolving. Non-pharmacological treatment options are a fundamental first step of all treatment pathways. In this article, we would like to review new mechanism of vasovagal syncope and hope to be of help to manage the syncopal patients.

• Journal of Dental Anesthesia and Pain Medicine
• /
• v.20 no.2
• /
• pp.89-93
• /
• 2020

We experienced an unusual case of accelerated junctional rhythm with severe hypotension after infiltration of lidocaine containing epinephrine during dental surgery under general anesthesia. The patient's electrocardiogram exhibited retrograde P-waves following the QRS complex, which could be misinterpreted as ST-segment depression. As a temporary measure, administration of ephedrine restored the patient's blood pressure to normal levels. The importance of this case lies in its demonstration of an unexpected and serious side effect of commonly used epinephrine infiltration. This case also highlights the need for accurate interpretation of the electrocardiogram and comprehensive understanding of best practices for patient management.

• The Korean Journal of Pain
• /
• v.10 no.1
• /
• pp.109-112
• /
• 1997

Spontaneous intracranial hypotension(SIH) is a rare syndrome of spontaneously occurring postural headache associated with low CSF pressure. It usually occur without evidence of any preceeding events such as lumbar puncture, back trauma, operative procedure, or medical illness. This syndrome usually resolves spontaneously or with strict bed rest. When the headache persists or is incapacitating, more aggressive treatment may be necessary. Autologous epidural blood patch is highly effective in the management of SIH. We experienced a case of SIH with downward displacement of brain in MRI and successfully treated with epidural blood patch.

• The Korean Journal of Pain
• /
• v.23 no.1
• /
• pp.46-50
• /
• 2010

Spontaneous intracranial hypotension (SIH) is considered to be a very rare disorder. It is characterized by an orthostatic headache that is aggravated with the patient in the upright position and it is relieved by the patient assuming the supine position. SIH is caused by a spontaneous spinal cerebrospinal fluid leakage without the patient having undergone trauma, surgery or dural puncture or having any other significant medical history. An autologous epidural blood patch (EBP) is effective in relieving SIH. We report here on a case of SIH with cerebrospinal fluid leakage at the upper cervical vertebral level and the middle thoracic vertebral level. The points of leakage were identified by radionuclide cisternography, and this patient was successfully managed by injecting an EBP at each level of leakage.