• Clinical and Experimental Pediatrics
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• 제46권6호
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• pp.585-590
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• 2003

목 적 : 심혈관계 자율신경 기능이상은 청소년기 당뇨병 환자의 7.7-28%에서 동반되며, 당뇨병성 자율신경병증은 심장 교감 신경계 이상으로 인한 돌발성 부정맥 및 돌연사를 초래할 수 있는 것으로 보고되었다. 본 연구는 소아 및 청소년기 당뇨병 환자에서 심혈관계 자율신경 기능이상의 빈도 및 이에 영향을 미치는 인자들을 파악하여 당뇨병성 자율신경병증의 조기진단 및 치료에 도움이 되고자 시행하였다. 방 법 : 8-26세의 1형 당뇨병 환자 80명(남자 27명, 여자 53명)과 2형 당뇨병 환자 12명(남자 4명, 여자 8명)을 대상으로, 발살바 동작시 R-R 간격의 변화(발살바 비), 심호흡시 심박수의 변화, 기립시 R-R 간격의 변화(30 : 15 비), 기립성 저혈압의 4가지 항목에 대하여 검사를 시행하여 환자의 연령, 유병기간, 당화혈색소, 소변 알부민 배설량, 신경전달속도 이상 및 당뇨병성 망막증 유무와의 연관성을 분석하였다. 결 과 : 검사 당시 연령 및 평균 유병기간은 1형과 2형 당뇨병 환자간에 의미있는 차이가 없었으나, 당뇨병의 발병연령은 2형에서 더 높았다. 체질량지수는 1형에 비해 2형에서 의미있게 높았으며, 혈압 및 당화혈색소는 두 군간에 차이가 없었다. 1형 당뇨병 환자의 22.5%에서 조기, 8.7%에서 중등도, 1.3%에서 심한 자율신경병증에 해당하였으며, 2형의 경우 16.7%에서는 조기, 8.3%에서 중등도, 8.3%에서 심한 자율신경병증에 해당하였다. 전체적으로, 심혈관계 자율신경 기능 이상은 1형의 32.5%에서, 2형의 33.3% 에서 나타나 빈도에 있어서 두 군간에 차이는 보이지 않았다. 1형에서는 발살바 비와 유병기간 간에 의미있는 상관관계가 있었으며, 2형에서는 발살바 비와 연령, 심호흡시 심박수 변화와 당화혈색소, 그리고 기립성 저혈압과 유병기간 간에 의미있는 상관관계가 관찰되었다. 1형과 2형 당뇨병 환자 전체를 대상으로 시행한 로지스틱 회귀분석상, 연령(OR=1.133(1.003-1.279), P<0.05) 및 유병기간(OR=1.148(1.009-1.307), P<0.05)만이 자율신경 기능 이상의 의미있는 예측인자로 나타났으며, 당화혈색소, 혈압, 소변 알부민 배설량, 신경전달속도 이상 및 당뇨병성 망막증 유무와는 관련이 없었다. 검사항목 중 발살바 비는 31.5%의 환자에서, 심호흡시 심박수의 변화는 41.3%의 환자에서 경계역 또는 이상소견을 보인 반면, 30 : 15 비 및 혈압변화는 각각 14.1%, 9.8%에서 경계역 또는 이상소견을 보였다. 발살바 비(OR=0.001(0.000-0.083), P<0.01)와 심호흡시 심박수의 변화(OR=0.840(0.754-0.934), P<0.01)는 자율신경 기능이상 유무에 의미있게 영향을 미쳤으나, 30 : 15 비 및 기립성 저혈압은 영향을 미치지 못하였다. 결 론 : 심혈관계 자율신경 기능이상은 소아 및 청소년 당뇨병 환자의 32.6%에서 동반되었으며, 중등도 이상의 뚜렷한 자율신경 기능이상도 10.8%에서 관찰되었다. 혈당 조절이 양호한 환자에서도 자율신경계 합병증의 가능성은 배제할 수 없으며 연령 및 유병기간이 증가할수록 그 위험은 더욱 증가하였다. 소아 및 청소년기 당뇨병 환자에서 자율신경 기능검사시, 발살바 비와 심호흡시 심박수의 변화가 가장 유용한 검사 항목으로 사료된다.

• 대한핵의학회지
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• 제38권5호
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• pp.331-337
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• 2004

Cardiac neurotransmission imaging allows in vivo assessment of presynaptic reuptake, neurotransmitter storage and postsynaptic receptors. Among the various neurotransmitter, I-123 MIBG is most available and relatively well-established. Metaiodobenzylguanidine (MIBG) is an analogue of the false neurotransmitter guanethidine. It is taken up to adrenergic neurons by uptake-1 mechanism as same as norepinephrine. As tagged with I-123, it can be used to image sympathetic function in various organs including heart with planar or SPECT techniques. I-123 MIBG imaging has a unique advantage to evaluate myocardial neuronal activity in which the heart has no significant structural abnormality or even no functional derangement measured with other conventional examination. In patients with cardiomyopathy and heart failure, this imaging has most sensitive technique to predict prognosis and treatment response of betablocker or ACE inhibitor. In diabetic patients, it allow very early detection of autonomic neuropathy. In patients with dangerous arrhythmia such as ventricular tachycardia or fibrillation, MIBG imaging may be only an abnormal result among various exams. In patients with ischemic heart disease, sympathetic derangement may be used as the method of risk stratification. In heart transplanted patients, sympathetic reinnervation is well evaluated. Adriamycin-induced cardiotoxicity is detected earlier than ventricular dysfunction with sympathetic dysfunction. Neurodegenerative disorder such as Parkinson's disease or dementia with Lewy bodies has also cardiac sympathetic dysfunction. Noninvasive assessment of cardiac sympathetic nerve activity with I-123 MIBG imaging nay be improve understanding of the pathophysiology of cardiac disease and make a contribution to predict survival and therapy efficacy.

• 산업융합연구
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• 제21권2호
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• pp.85-92
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• 2023

비정상적인 척추 질환 및 기능은 단순한 근·골격계 문제 외에도 항상성을 방해하고 직·간접적인 생리적 부작용을 일으킬 수 있다. 특히 척추를 통해 나오는 신경이 면역체계를 조절하는 기관에 적절한 신호를 전달하지 못하면 면역 기능의 일부 또는 전부에 문제가 생겨 더 많은 질병에 노출될 수 있다. 이 연구는 기본적인 해부학 및 생리학적 지식에 초점을 맞추고 척추 기능이 잠재적으로 면역 기능을 유지하거나 개선하는 데 도움이 될 수 있는 잠재적 메커니즘을 고찰하고자 한다. 이를 위해 조혈, 스트레스, 호흡, 척추와 신경의 관계, 면역체계와 관련된 척추의 역할을 살펴보고 이러한 역할이 면역기능에 영향을 미칠 수 있음을 확인한다.

• 대한한방내과학회지
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• 제27권4호
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• pp.822-826
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• 2006

Objectives : Essential hyperhidrosis is a socially and occupationally disabling disorder. There are many suggestions that hyperhidrosis is associated with the autonomic nervous system, especiallythe sympathetic system. This study was designed to investigate the autonomic nerve system in patients with essential hyperhidrosis and healthy controls by the frequency domain analysis of heart rate variability (HRV). Methods : 17 head-hyperhidrosis patients in the ambulatory care were investigated. All were inspected at the first medical examination. using the PSA of HRV. HRV was measured for minutes after 5 minutes bed rest. We checked the frequency domain analysis of HRV (i.e. TP, VLF, LF, HF) which were transformed into natural logarithm of patients against the standard measures of the HRV components. Then we compared the values of patients with means of normal Korean subjects. Results : The values of natural logarithmic measure of HRV (LnTP, LnHF, LnLF, LnVLF) of patients With head-hyperhidrosis we examined were $6.85{\pm}1.61$, $4.93{\pm}$2.00, $5.40{\pm}1.83$, and $6.13{\pm}1.37$, respectively. None of these values were higher than means of normal subjects. Conclusions : This study suggests that the function of the autonomic nervous system does not increase in patients with head-hyperhidrosis.

• 사상체질의학회지
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• 제16권3호
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• pp.76-84
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• 2004

1. Objectives This paper is intended to find out Sasang Constitutional difference on Autonomous Function after Acupuncture stimulation in healthy subjects. 2. Methods of Research Nineteen healthy volunteers(Soyangin 6, Taeumin 7, Soeumin 6) had acupunctured perpendicularly into the Hapkok point(LI4) and the Taechung point(Liv3). Heart Rate Variability, Mean Heart Rate and Blood Pressure were checked 4 times(before and after Acupuncture stimulation) to evaluate Autonomous Function. 3. Results & Conclusions The conclusions were as follows 1. There was no statistically significant Sasang Constitutional difference on sympathetic activity and parasympathetic activity before Acupuncture stimulation. 2. Acupuncture stimulation caused a statistically significant increase in the parasympathetic activity in the whole subject. 3. After Acupuncture stimulation, there was a statistically significant increase in the parasympathetic activity in Soeumin and a tendency of increase in the parasympathetic activity in Soyangin. But there was a tendency of increase in the Sympathetic activity in Taeumin.

• 동의생리병리학회지
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• 제26권5호
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• pp.797-802
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• 2012

Alcoholic polyneuropathy is a disorder of the peripheral nervous system that interferes with sensory, motor, and autonomic nerve function. This study was to report the effect of Oriental medical treatment on a patient with alcoholic polyneuropathy. Conservative Oriental medical treatment was done to a man of 84 years who was diagnosed as a alcoholic polyneuropathy and suffered from both distal dominant leg weakness & symmetrical paresthesia and ataxic gait. The changes of symptoms, reflexes and sensory test were checked by Toronto Clinical Neuropathy Scoring System(TCNSS). Reflexes, motor and sensory impairments were improved after the Oriental medical treatment. I reported good effects of Oriental medical treatment on alcoholic polyneuropathy. Oriental medical treatment can be helpful to improve the symptoms of alcoholic polyneuropathy.

• 대한한의학회지
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• 제28권1호통권69호
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• pp.126-136
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• 2007

Objectives : Bell's palsy in an acute peripheral facial nerve paralysis that usually affects only one side of the face. The seventh cranial nerve carries predominantly motor fibers, but also supplies some autonomic innervation, sensation to park of the ear, and taste to the anterior two thirds of the tongue. The aim of this study is to provide evidence of differences between facial skin temperature of the paralyzed side and normal side in Bell's palsy patients. Methods : the author studied 68 patients with Bell's palsy whose facial nerve function had been documented by the House-Brackmann grading system. We measured skin temperature of the forehead, zygoma, lower lip, temple and lower jaw area of the paralyzed side and those of the normal side. Results : there were significant facial skin temperature differences between the forehead area of paralyzed side and that of normal side of GrII(P<0.05) and III(P<0.05). The result also showed that the facial skin temperature difference according to the aflection period vanished when air temperature was calibrated (F=1.700, P=0.178). Conclusions : Thermography is a useful diagnostic tool in Bell's palsy if the air temperature is low enough to cool the facial skin temperature and the forehead area is evaluated as the sampling zone.

• 동의생리병리학회지
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• 제25권2호
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• pp.217-226
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• 2011

The aim of this study is to identify central neural pathway of neurons following the projection to the large intestine and Hapgok(LI4) which is Won acupoint of the large intestine meridian of hand-yangmyeong. In this experiment, Bartha's strain of pseudorabies virus was used to trace central localization of neurons related with large intestine and acupoint(LI4) which has been known to be able to regulate intestinal function. The animals were divided into 3 groups: group 1, injected into the large intestine; group 2, injected into the acupoint(LI4); group 3, injected into the acupoint(LI4) after severing the radial, ulnar, median nerve. After four days survival of rats, PRV labeled neurons were identified in the spinal cord and brain by immunohistochemical method. First-order PRV labeled neurons following the projection to large intestine, acupoint(LI4) and acupoint(LI4) after cutting nerve were found in the cervical, thoracic, lumbar and sacral spinal cord. Commonly labeled neurons were labeled in the lumbosacral spinal cord and thoracic spinal cord. They were found in lamina V- X, intermediomedial nucleus and dorsal column area. The area of sensory neurons projecting was L5-S2 spinal ganglia and T12-L1 spinal ganglia, respectively. In the brainstem, the neurons were labeled most evidently and consistently in the nucleus tractus solitarius, area postrema, dorsal motor nucleus of vagus nerve, reticular nucleus, raphe nuclei(obscurus, magnus and pallidus), C3 adrenalin cells, parapyramidal area(lateral paragigantocellular nucleus), locus coeruleus, subcoeruleus nucleus, A5 cell group, periaqueductal gray matter. In the diencephalon, PRV labeled neurons were marked mostly in the arcuate nucleus and median eminence. These results suggest that overlapped CNS locations are related with autonomic nuclei which regulate the functions of large intestine-related organs and it was revealed by tracing PRV labeled neurons projecting large intestine and related acupoint(LI4).

• 대한한방부인과학회지
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• 제29권3호
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• pp.1-9
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• 2016

Objectives: Cold Hypersensitivity of Hands and Feet (CHHF) has been diagnosed objectively by Digital Infrared Thermal Imaging (DITI) and has been known to be associated with autonomic nervous system (ANS), which can be assessed by Heart Rate Variability (HRV). This study evaluated the correlation between severity of CHHF and HRV variables.Methods: We studied 155 non-menopausal women with CHHF who visited Kyung Hee University Hospital at Gangdong from 01 October 2013 to 30 April 2016. We measured DITI and HRV of each patient. We used DITI to calculate the severity of CHHF with thermal difference between upper arm (L4, 俠白穴) and palm (P8, 勞宮穴) of both hands and anterior thigh (ST32, 伏兎穴) and dorsum of foot (LI3, 太衝穴) of both feet. The correlation between severity of CHHF and HRV variables were analyzed.Results: In time domain analysis, there was significantly positive correlation between the severity of CHHF and both SDNN and RMSSD. In frequency domain analysis, there was significantly positive correlation between the severity of CHHF and TP, HF and HF Norm while there was significantly negative correlation between the severity of CHHF and LF Norm as well as between the severity of cold hypersensitivity of both hands and LF/HF ratio.Conclusions: The more severe CHHF is, the more increased the function of parasympathetic nerve system (PNS) and relatively decreased the function of sympathetic nerve system (SNS) is. Also, it has known that cold hypersensitivity could be caused by deficiency syndrome and qi deficiency has the same ANS tendency as CHHF. Therefore, in practical fields, this result can be helpful in planning treatment and deciding prognosis in respect of deficiency syndrome.

• 대한한방부인과학회지
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• 제19권3호
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• pp.191-201
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• 2006

Purpose : Skin Resistance Variability(SRV) is a kind of biofunctional signal, and it can show the function of autonomic nervous system, especially in the sympathetic nerve. The objective of this study is to find out the differences of SRV of reproductive women with aging. Method : We measured SRV(by CP-6000A) of 151 women who visited Gynecologic Clinic. And the results were classified according to age, by five groups. After detection of SRV, we performed correlation analysis and ANOVA by SPSS 12.0. Results : 1. The SRV was measured twice. It resulted in seven areas. In 1, 2, 3 areas, the second results were higher than first results in every groups. In 4, 5, 6, 7 areas, the first results were higher than second results in every groups. 2. The SRV of lower part (4, 5, 6, 7 area) on the body was higher than that of higher part (1, 2, 3 area). 3. The SRV in the youngest group was higher than the oldest group in 1, 2, 3 area of second trial. Conclusion : With relations to the standardization and objectification of oriental medicine, we expect that these results contribute to gynecologic clinic in the department of diagnosis of functional abnormality of hypothalamus-hypophysis-ovarian axis (H-P-O axis).