Background: Thoracic sympathetic block surgery is a safe and effective procedure for palmar hyperhydrosis, and this maintains sufficient moisture and prevents compensatory hyperhidrosis. To avoid compensatory hyperhidrosis, the authors performed sympathetic block surgery just above the R4 level to maintain sympathetic tone affecting the caudal area. Material and Method: A total of 71 subjects (45 males and 26 females) were categorized into two groups. Group 1 (31 patients, mean age: 25.5 years) had clips placed both on the upper and lower part of R4 sympathetic ganglion, and group 2 (40 patients, mean age: 25.9 years) underwent clipping of the upper part of R4. Telephone surveys were done to collect data on 8 categories, and the average follow up interval was 24.9 months (group 1) and 18.9 months (group 2). Result: For group 1, 41.9% experienced no sweating and 48.4% re-plied they experienced some sweating depending on the surrounding conditions. Group 2 showed that 60% experienced no sweating and 35% replied they experienced some sweating depending on the surrounding conditions, 58.1% in group 1 experienced sweating right after the surgery, and 40.0% in group 2 experienced the same. Group 1 (38.1%) and group 2 (37.5%) replied they experienced no hand dryness and more patients in group 2 than in group 1 had hand dryness, but without uncomfortable symptoms. 71.0% (group 1) and 62.5% (group 2) replied they had no compensatory hyperhidrosis or related symptoms. One patient in group 1 and two in group 2 reported they regretted undergoing the procedure. The regions of compensatory hyperhidrosis were the back, thigh and chest in group 1 and the group 2 reported the back, chest, and abdomen in the order of frequency. Fewer incidences of the gustatory hyperhidrosis were noted in group 2. Most of the patients were satisfied with their treatment. Conclusion: Clipping the upper part of the R4 ganglion or R4 sympathetic block are both effective for treating palmar hyperhidrosis and these treatments decrease the occurrence or symptoms of compensatory hyperhidrosis. The upper R4 sympathetic block procedure is easier and safer with fewer incidences of gustatory hyperhidrosis and a higher percentage of patient satisfaction.
Cholinergic urticaria with acquired generalized hypohidrosis, and its pathophysiology is not well known. Autoimmunity to sweat glands or to acetylcholine receptors on sweat glands has been mentioned as one of the possible etiologies. Systemic steroid therapy, antihistamines, anticholinergics, and avoidance of the stimulatory situations are recommended for treatment. We experienced a case of cholinergic urticaria with acquired generalized hypohidrosis in a patient who had no other associated disease, and the symptoms eased after repeated bilateral stellate ganglion block. Stellate ganglion block normalized the elevated sympathetic tone and may relieve symptoms in patients with this condition.
Proceedings of the Korean Society for Emotion and Sensibility Conference
/
한국감성과학회 2001년도 추계학술대회 논문집
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pp.91-95
/
2001
In this study, we estimated the behavior of the diversity of physiological responses under varied physical environmental factors by measuring variations of heart rate variability (HRV), an index of activity of cardiac autonomic control. Seven healthy young male adults consented and participated in the study. The environmental conditions consisted of thermal, lighting, and acoustic conditions. Two components of HRV were measured. one was the low frequency (LF) component of HRV, which provided a quantitative index of the sympathetic and parasympathetic (vagal) activities controlling the heart rate (HR). The other component measured was the high frequency (HF) component, which provided an index of the vagal tone. The percent contribution of physical environmental factors to the variations in HRV indices were calculated by ANOVA. The contribution of physical environmental factors to the variations in HR was higher than the contribution of HF and LF. However, the contribution of these factors was lower than the contribution related with individual difference in all indices. This result showed that the individual diversity of physiological responses is not a negligible quantity.
Kim, Hyun-Kyung;Lee, Joon-Suk;Eom, Guk-Hyeon;Lee, Seon-Young;Kim, So-Yeon;Hur, Won-Young;Kim, Jin-Sung;Ryu, Bong-Ha;Yoon, Sang-Hyub
The Journal of Internal Korean Medicine
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제27권2호
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pp.510-520
/
2006
Objectives: The aim of this study was to investigate the correlation between fatigue degree and Comprehensive diagnosis of Qui Xui Shui in patients with functional dyspepsia. There again, we investigated an association between scores obtained from Comprehensive diagnosis of Qui Xui Shui and state of skin sympathetic tone or cardiovascular reactivity. Methods: Subjects were 56 patients with Functional dyspepsia and 8 healthy People. Fatigue degree was assessed by questionnaires consisting of subjective complaints of fatigue. Comprehensive diagnoais of Qui Xue Shui was investigated by questionnaire and physical examination, total score and composition score were calculated from the symptom score. Skin sympathetic tone was measured by Ryodoraku Score(RS) and Cardiovascular Reactivity(CV Reactivity) was checked by Pulse diagnostic apparatus. All patients were divided into two groups by RS $40{\mu}A$(below and above) or by CV Reactivity(decreased and increased or not decreased). Results: There was highly significant correlation between Fatigue Degree and total score and each composition score of Comprehensive diagnosis of Qui Xui Shui. And total score of patients was significantly higher than that of health controls : in the patients, females than males. Significance related with the level of RS $40{\mu}Aor$ the state of CV Reactivity were not remarkable in both patients and health control group. Conclusions: Fatigue degree seems to have a special feature reflecting the state of Comprehensive Diagnosis of Qui Xui Shui in patients with functional dyspepsia.
Objectives : This study was performed to evaluate the effect of dry cupping treatment applied to back-shu points on the autonomic nervous system. Methods : Two groups of sympathicotonia and normal with each 30 volunteers were set up for this experiment. The sympathicotonia group was selected by the criterion for sympathicotonia by the questionnaire composed of 11 items. After 10 minutes for environmental adaptation, the first HRV(heart rate variability) test was conducted, and then, dry cupping therapy was applied to back-shu points for 5 minutes to stimulate sympathetic ganglia lying along the spine. The second HRV test was carried out just after the cupping therapy under the same condition and then, the third test was repeated after two hours based on the first test time. Results : 1. In sympathicotonia group, SDNN(standard deviation of all normal R-R intervals), RMSSD(the square root of the mean of the sum of the squares of differences between adjacent normal R-R intervals), Ln(HF)(high frequency power), nmHF(normalized high frequency power) increased and mHR(mean heart rate), nmLF(normalized low frequency power) decreased significantly right after dry cupping therapy which means dry cupping affects on autonomic nervous system. The effect lasts in these items of nmLF, Ln(HF), nmHF, rLHF(rate ratio of LF/HF). 2. In normal group, SDNN, RMSSD increased and mHR decreased significantly right after dry cupping therapy, too. But, Ln(LF)(low frequency power), nmLF, rLHF unexpectedly increased and nmLF, rLHF stay increased up to 2 hours. Conclusions : The results suggest that the dry cupping therapy has effect on the autonomic nervous system. It is effective to stabilize hyper-sympathetic tone of people diagnosed as Sympathicotonia and activate parasympathetic tone.
Park, Woo-Young;Bae, Chun-Sik;Lee, Soo-Han;Park, Woo-Dae
Journal of Veterinary Clinics
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제26권3호
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pp.212-219
/
2009
Anticholinergics, which are commonly given as a pre-anesthetic medication to prevent adverse effects in canine anesthesia, can cause cardiac adverse effects. To determine the effects of atropine and glycopyrrolate on the balance of sympathetic nervous tone and parasympathetic nervous tone of the heart during ketamine anesthesia in beagle dogs, heart rate variability(HRV), duration of anesthesia and behavioral changes were evaluated. There were no significant temporal domain differences between atropine and glycopyrrolate. Concerning the frequency domain component, atropine and glycopyrrolate effects were significantly lower(P<0.05) than the control saline-treated group. However, the root mean square of the interval differences between consecutive R peaks(RMSSD) and the standard deviation of Poincare plot perpendicular to the line-of-identity(SD1) in atropine were significantly decreased(P<0.05) from the baseline value, and the low frequency/high frequency ratio(LF:HF ratio) in glycopyrrolate was significantly increased from baseline value(P<0.05). The change of SD1 agreed with that of the high frequency(HF) in the frequency domain component and also with those of respiratory rate and $SpO_2-R$. Our results prove that glycopyrrolate is more suitable as a pre-anesthetic anticholinergic in ketamine anesthesia of dogs with respect to safety and duration of action.
Objectives : Acupuncture restores the flow of vital energy in the body by stimulating the organ-specific meridians and enhances cardiac vagal activity and suppresses sympathetic activity. The purpose of this review is to summarize and evaluate the acupuncture studies on autonomic nervous system (ANS). Methods : We conducted a PubMed search to obtain a fair sample of acupuncture studies related ANS published in English in 2007. Each article was reviewed for study objectives and outcomes, as well as acupuncture points, experimental and control interventions. Results : We reviewed a total of 15 studies published from 1997 to 2007. In normal states, acupuncture enhanced either vagal or sympathetic tone depending on the stimulated acupuncture point sites. On the other hand, most of studies demonstrated that acupuncture restored the autonomic dysfunctions in various kinds of stressful states. Conclusions : We reviewed studies that contributed to an understanding of the autonomic mechanisms of acupuncture with the hope that this review will be of benefit to the future studies. Although the relationship between acupuncture and ANS response is still uncertain, acupuncture would be a noteworthy modality for modulating autonomic dysfunction.
Journal of the Korean Association of Oral and Maxillofacial Surgeons
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제30권6호
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pp.488-496
/
2004
Oral & Maxillofacial surgery can lead to complications that result in abnormal sensation or movement. Inferior alveolar nerve(IAN) injury can result in dysesthesia, paresthsia of the lower lip and chin, so patients presenting with IAN damage suffer from sensory loss. But diagnosis of the nerve injury is largely limited to the subjective statements made by the patient. Distribution of sympathetic nerves parallels the distribution of the somatosensory nerves. Loss of sensory tone causes a concomitant loss of sympathetic activity, resulting in vasodilation of the cutaneous blood vessels that demonstrates greater heat loss. Digital infrared thermographic imaging(DITI) detects infra-red radiation given off by body. DITI can detect minute difference in temperature from different parts of the body and translates the amount of heat into quantitative data. The area of different temperature correlated with pain or disease can be visualized by corresponding color. The objective of this study was to determine the efficacy of DITI in objectively assessing IAN injury. The 19 normal subjects and the 14 patients underwent DITI scan. The normal subjects received unilateral IAN block anesthesia with 2 ml of 2% lidocaine (IAN bolck group) to evaluate temporary alteration in nerve function. Patient group were patients with unilateral IAN damage (dysesthesia or paresthesia) after surgical treatment(Mn. 3rd molar Extraction, etc.). The surgical procedure performed within 6 months of test. The results were as follows. 1. No significant differences in temperature were found between left and right sides of the lower lip and chin in the control group. 2. Significant temperature differences were found between the anesthetized and non-anesthetized sides of the lower lip and chin in the IAN block group. 3. Significant temperature differences were found between the involved and uninvolved sides of the lower lip and chin areas of the experimental group. The results of the study show that DITI can be an useful and effective means of objectively assessing and visualizing IAN damage.
The Journal of the Society of Korean Medicine Diagnostics
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제15권2호
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pp.127-140
/
2011
Objectives: Acupuncture has been shown to relieve pain and modulate biological function by stimulating the organ-specific meridians and enhances parasympathetic activity and suppresses sympathetic activity. The aim of this review is to summarize and understand the effects of acupuncture on autonomic nervous system. Methods: We reviewed a total of 29 studies published from 2000 to 2010 searched by PueMed and various domestic oriental medicine journals to obtain acupuncture studies related with ANS. Each article was classified by ANS measurement index and reviewed for study objectives, outcomes, acupuncture points, experimental and control interventions. Results: In the study of acupuncture about EEG, HRV, SCR, the experiment results are not the same by acupoints. Although same acupoint the results differ by subject's condition. But the study showed some clear tendency. In brief, in normal states acupuncture enhanced either vagal or sympathetic tone depending on the stimulated acupuncture point sites. On the other hand, most of studies demonstrated that acupuncture restored the autonomic dysfunctions in various kinds of tired or stressful states. Conclusions: We reviewed studies that contributed to an understanding of the effects and mechanisms of acupuncture on autonomic nervous system. Although the relationship between acupuncture and ANS response is still uncertain, acupuncture could be a excellent treatment method for modulating autonomic dysfunction.
In this study attempts were made to observe the effects of guanabenz on renal function in dog, which manifests the antihypertensive action by inhibition of sympathetic tone through stimulating the presynaptic adrenoceptor (${\alpha}_2-adrenoceptor$). Guanabenz, when injected at a dose of $30.0{\mu}g/kg$, or infused at a dose of $3.0{\mu}g/kg/min$ intravenously, produced diuretic action with increased amounts of $Na^+\;and\;K^+$ in urine, and with decreased reabsorption rates of $Na^+\;and\;K^+$ in renal tubules. It was also observed that the rates of osmolar and free water clearances were increased, but the glomerular filtration rate and renal plasma flow were not changed. Guanabenz injected at a dose of $3.0{\mu}g/kg$ into a carotid artery or infused intravenously at a dose of $3.0{\mu}g/kg/min$ in a state of water diuresis elicited the diuretic action of the similar aspect as a case of guanabenz given intravenously. The diuretic action produced by guanabenz was completly blocked by pretreatment of i.v. prazosin, ${\alpha}_1-adrenoblocking$ agent, or of i.v. yohimbine, ${\alpha}_2-adrenergic$ blocking agent. Prazosin, when given into a renal artery, inhibited the diuretic action by i.v. guanabenz in only injected kidney, whereas in case of yohimbine the action was inhibited in both kidney. Guanabenz infused at a dose of $1.0{\mu}g/kg/min$ into a renal artery exhibited no significant changes of renal function in both kidney. In denervation experiments, guanabenz given intravenously produced typical diuretic action in innervated kidney, whereas in denervated kidney, it did not affect the action at initial period but exhibited the action with increase of only free water clearance at later period. These results suggest that guanabenz produced diuretic action in dog by inhibition of electrolyte reabsorption rates in renal tabules, mainly proximal tubule and of ADH release, which is mediated by stimulating of central sympathetic ${\alpha}_2-receptor$.
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