Relaxation Techniques

Relaxation Audio Sounds Autumn In The Forest

Relaxation Audio Sounds Autumn In The Forest

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Relaxation Techniques

A number of strategies can reduce stress and help patients cope, even without psychotherapy. (Some are reviewed in other chapters of this book.) Progressive muscle relaxation frequently credited to Edmund Jacobson, who published his book Progressive Relaxation in 1929 (7) is one of the most well known and widely taught relaxation techniques. Although relaxing sounds simple and is clearly an idea that has been around for many years, being able to relax, especially when feeling stressed or pressured, is a skill. It is possible to become more proficient at relaxation and more aware of specific muscle groups that may be more tense than they should be by progressively tightening and then relaxing specific muscle groups. Relaxation can only be used to maximum advantages if the patient is able to recognize the signs of stress and tension. Table 3.1 contains the specific muscle groups and the corresponding motor activity necessary to practice progressive relaxation. During this routine, each...

Magnetic Relaxation In Ferrofluids

Ferromagnetic particles suspended in a liquid carrier are generally referred to as ferroflu-ids 19 . The dynamic behavior of these ferrofluids is governed by two very different magnetization relaxation pathways. Either the magnetization can change within each magnetic particle (Neel relaxation) or the whole particle can rotate in the liquid (Brow-nian relaxation). We will first discuss each mechanism individually and then turn to systems with size dispersions, where both relaxation mechanisms can be present simultaneously. 4.3.1 Internal Magnetic Relaxation In the following we will neglect magnetic interactions between magnetic particles, which may arise from dipolar coupling. This assumption is nontrivial, but in the case of biologically functionalized magnetic nanoparticles, the ligand coating helps to separate the individual particles independent of their concentration. The important parameter for assessing the importance of interactions is the ratio of interaction to thermal...

Stress Relaxation Experiments

In a stress relaxation experiment, a constant strain e0 is imposed at t 0 and held constant. Under such conditions, viscoelastic materials display a decrease of stress with time, s(t) (see Figure 9.3b). to this case, the relevant material property is the relaxation modulus E(t) s(t) e0. For linear viscoelastic materials, E(t) is independent of the strainlevel. Wemustbe awarethatmostbiological materials possess highly nonlinear properties. For example, it was found that stress relaxation proceeds more rapidly than creep in medial collateral ligaments, a fact that was found to be consistent with nonlinear theory.19 Another studyonmesenchymal gaptissuealsodescribedthis nonlinear behavior, and such studies may be Note that both creep and relaxation may occur in shear and volumetric (bulk) deformation conditions in this case, the corresponding J(t) and G(t) for shear and 5(t) and A(t) for volumetricdeformations,respectively. Asforcreep,both temperature time and Boltzmann corresponding...

Relaxation Therapy

There are many different types of relaxation techniques which include meditation, mind body interaction, music- or sound-induced relaxation, mental imagery, and biofeedback. Rhythmic, deep, visualized or diaphragmatic breathing may also be used. Most studies of relaxation therapies are of poor quality and provide conflicting results. There is some evidence of short-term benefit in chronic low back pain for combined cognitive therapy and progressive relaxation therapy 28 . Mindfulness based stress reduction, a learned meditation technique that has been applied to many chronic psychological and physical health conditions, appears to be associated with significant and sustained improvements in pain intensity 29 , but has yet to be subjected to adequately sized randomized trials.

Introduction To Bioregenerative Engineering

Regenerative engineering at the molecular level, which may be referred to as molecular regenerative engineering, addresses the promotion and control of molecular and cellular activities (e.g., cell signaling, gene expression, cell division, differentiation, migration, adhesion, secretion, and contraction relaxation) the activation and control of residential stem and progenitor cells the mobilization and recruitment of remote stem and progenitor cells and the formation of functional structures by controlled administration of proteins, genes, antisense oligonucleotides, siRNA, and pharmacological substances. Examples of molecular regenerative engineering include the control of a target signaling pathway, the regulation of specific gene expression, and the enhancement or reduction in the prolifera

Limits of Western Medicine and Research

For children and adults with epilepsy, approaches outside the traditional boundaries may improve seizure control. For example, stress is reported to be a factor that can provoke seizures in a large number of epilepsy patients. Stress can be reduced through a variety of approaches. Many complementary and alternative therapies reviewed in this book specifically address stress reduction. Further, relaxation techniques can provide some sense of control over the disorder. Traditional medicine should consider nonmedical healing and work to identify places where it may be helpful. Although benefits likely extend beyond stress reduction, this is one area that is worthy of further study in the near future.

Quantitative Estimation Of Regional Brain Iron With

Although ferritin in aqueous solution has a strong effect on transverse relaxation times, these changes are much less prominent in tissue. Estimation of transverse relaxation times in patients with PD, using a 1.5-T whole-body imaging system, showed reduced T2 values in substantia nigra, caudate, and putamen in PD patients as compared with healthy controls (40). The decrease was small, however, and because of substantial overlap between groups, the investigators were unable to differentiate individual patients from controls with T2 measurements. Vymazal et al. (41) reported nonsignificant T2 shortening in the substantia nigra in PD consistent with iron accumulation. A more complex relationship between brain iron changes and disease state in PD, however, was suggested by Ryvlin et al. (42). These authors reported decreased T2 in the pars compacta of PD patients, regardless of disease duration, but increased T2 values in the putamen and pallidum in those with duration of illness greater...

B Studies of Glyceryl Trinitrate Biotransformation Using Carbon Monoxide

We carried out studies to determine the mechanism by which GTN is biotransformed to NO or an NO-adduct. One hypothesis that we set out to test and which arose from an earlier study showing GTN biotransformation by deoxyhemoglobin11 was that GTN was biotransformed to NO and or an NO-adduct in vascular smooth muscle cells by a hemoprotein. In order to test this hypothesis, CO, a selective inhibitor of hemoprotein action, was bubbled into a tissue bath containing Krebs' solution in which a rabbit aortic smooth muscle, precontracted with phenylephrine, was mounted.12,13 If a hemoprotein was responsible for biotransformation of GTN to NO and or an NO-adduct, then it was anticipated that CO would inhibit biotransformation of GTN and inhibit GTN-induced vasorelaxation. However, CO was without effect on GTN biotransformation and GTN-induced relaxation, allowing us to conclude that in rabbit aortic strips, GTN biotransformation and GTN-induced relaxation were not dependent upon interaction...

Experimental Techniques to Quantify Interstitial Transport

Been shown to be a more appropriate technique to measure the diffusion coefficient of fluorescently labelled molecules since it strongly reduces the perturbation of the tissue 8 , 9 , 15 , 17 , 18 , 24 , 64 , 67 , 70 , 75 , 76 . The diffusion coefficient can be calculated based on the spatial distribution of fluorescence as the labelled material spreads through the tissue (relaxation of fluorescence gradient) 18 , 24 , 70 , 64 , or by adapting the method of fluorescence recovery after photobleaching (FRAP) based on the recovery of fluorescence pattern in a small region of the tissue (< 40 to) 8 , 9 , 67 , 76 , 75 . The latter method has a high spatial resolution allowing multiple diffusion measurements within the same tissue and also allows discrimination between diffusive and convective transport 17 .

Stress Management And Psychiatric Interventions

Stress management techniques such as relaxation training, cognitive restructuring, and coping skills training may reduce negative mood states in HIV-positive persons by lowering physical tension and increasing self-efficacy (Antoni, 2003a). These affective changes are thought to be accompanied by an improved ability to regulate peripheral catecholamines and cortisol via decreases in ANS activation and improved regulation of the HPA axis, respectively. Neuroendocrine regulation may be associated with a partial normalization of immune system functions, providing more efficient surveillance of pathogens such as latent viruses that may increase HIV replication and enhance vulnerability to opportunistic infections or neoplasias. This normalization of stress-associated immune system decrements may ultimately forestall increases in viral load and the manifestation of clinical symptoms over extended periods. A relatively small number of controlled trials have examined the effects of...

Role of Extracellular Matrix Composition and Assembly

Ta ble 3.2 Interstitial hydraulic conductivity of tumor and normal tissues. Hydraulic conductivity was determined by different methods in confined compression (+), K is evaluated from the time constant for stress relaxation by fitting the data with a poroviscoleastic model 67 in vivo (K is calculated based on pressure gradients measured by micropipet pressure probes during infusion of saline 12 in ex-vivo or in vitro (0*) excised tissue is placed in a flow cell in which a pressure gradient is imposed on the tissue and water flow through the sample measured 55 , 89 .

Self Control Strategies

Patients develop various strategies to stop their seizures or inhibit their spread. Dahl (8) found that the most commonly used methods were restraint of movement (74 ), stimulation of sensory area (77 ), visual stimulation (22 ), auditory stimulation (85 ), olfactory stimulation (32 ), applied relaxation (78 ), and using positive statements (89 ). These strategies are carried out at seizure onset to reduce the likelihood of a seizure and are known as countermeasures. The best way to determine the most effective countermeasure is to use the ABC chart.

A Calcium Dependent Potassium Channels

Wang et al.64 studied the vasorelaxant effects of CO in phenylephrine or U-46619 precontracted rat tail artery. The concentration-dependent relaxation of rat tail artery by CO was only partially inhibited by the sGC inhibitor, methylene blue, in contrast to complete inhibition observed of CO-dependent relaxation of rat aortic strip (RtAS) and rabbit aortic rings (RARs) using the sGC inhibitor, ODQ.55,56 It was thus concluded that, in contrast to RARs and RtAS, an additional cGMP-independent mechanism was involved in CO-dependent relaxation in the rat tail artery. Wang et al.64 also explored the possibility that the cGMP-independent CO-induced relaxation involved K+ channels. They showed that tetraethylammonium

Summary and Future Trends

In b-carotene, the quantum yield of CTI via the T1 state has been determined to be in the order 15-cis (0.98) > 13-cis (0.87) > 9-cis (0.15) > 7-cis (0.12). The quantum yield of isomerization starting from the 15-cis isomer was extremely high so that 15-cis T1 could be detected by neither electronic absorption nor Raman spectrosco-py. The large difference in the quantum yield found between the central-cis and the peripheral-cis isomers supported the idea of the triplet-excited region that is localized in the central part of the conjugated chain. In spheroidene, on the other hand, the quantum yield of triplet-state isomerization was in the order, 15-cis (0.60) > 13-cis (0.52) > 9-cis (0.50) > 13'-cis (0.48). The lower quantum yields of CTI in spheroidene (in contrast to those in b-carotene) may be ascribable to the large peripheral groups hanging on both sides of the conjugated chain that give rise to a larger moment of inertia. The lower quantum yields facilitated the...

Parp Activation And Energy Substrate

FIGURE 3.2 Effect of the functional integrity of PARS on the changes in myocardial contractility in perfused hearts subjected to hypoxia-reoxygenation in vitro. (A) The maximal rates of pressure development (+dP dt, mmHg s, left panels) and the maximal rates of relaxation (-dP dt, mmHg s, right panels) in wild-type and PARS knockout hearts in control conditions (before hypoxia) and after 30 min of hypoxia and 30 min of reperfusion (after hypoxia). (B) The times to peak pressure (TPP, ms mmHg, left panels), and the 1 2 times to relaxation (RT1 2, ms mmHg, right panels) in wild-type and PARS knockout hearts in control conditions (before hypoxia) and after 30 min of hypoxia and 30 min of reperfusion (after hypoxia). Data represent mean SEM values for n 5 hearts in each group. *p < 0.05, **p < 0.01, and ***p < 0.001 represent significant differences between the respective wild-type and PARS deficient groups and p < 0.01 and p < 0.001 represent significant differences between the...

Annexins And Heart Disease

Annexin 6 has been shown in vitro to be a modulator of the sarcoplasmic reticulum Ca2+-release channel, the cardiac L-type channel and the Na+ Ca2+ exchanger (Diaz-Munoz et al., 1990). Cardiomyocytes derived from an annexin 6 null mutant mouse show increased contraction and relaxation amplitudes and reduced 'time to peak relaxation', (Song et al., 2002). Heart-specific annexin 6 overexpression in a mouse resulted in dilation of the heart, acute diffusive myocarditis, moderate to severe fibrosis throughout the heart and frequency-dependent reduced shortening and rates of contraction of isolated cardiomyocytes (Gunteski-Hamblin et al., 1996) consistent with a role in negative inotopic calcium handling.

Studies of Exposure Therapy

A number of programs based on exposure therapy has been used to treat PTSD. Among the variations of exposure therapy, the PE protocol has been the most extensively studied and has been found to be highly effective. Like PE, some other exposure therapy programs include both imaginal confrontation with the traumatic memories and in vivo exposure to trauma reminders (e.g., Marks, Lovell, Noshirvani, Livanou, & Thrasher, 1998), however, some programs rely exclusively on imaginal exposure to the trauma memory (Bryant et al., 2003a Cloitre, Koenen, Cohen, & Han, 2002 Tarrier et al., 1999). Even among programs that include both imaginal and in vivo exposure, there are differences in the specific application of the techniques. For example, PE utilizes both components from the beginning of treatment in contrast, Marks et al. (1998) introduced imaginal exposure in the first half of the program and in vivo exposure in later sessions. Finally, exposure therapy programs differ in the extent...

Variations on a Theme Studies of Other Exposure Protocols

Several recent studies compared exposure therapy protocols other than PE with alternative CBT interventions. Marks et al. (1998) compared exposure, CR, and their combination with a relaxation control group. Like PE, the exposure therapy used in this study included imaginal and in vivo exercises. However, whereas the two modalities are administered simultaneously in PE, the program examined by Marks et al. (1998) presented the modalities sequentially the first five sessions were limited to imaginal exposure and corresponding homework, and the remaining five sessions focused on in-ses-sion, therapist-assisted in vivo exposure and corresponding homework. Immediately after treatment, the exposure, cognitive, and combined interventions were superior to relaxation, and they retained their superiority at follow-up. Comparisons among the three interventions failed to reveal any consistent pattern of superior performance for one treatment over the others. Notably, like the Foa et al. (2002a)...

Concerns About Exposure Therapy

Subsequent research has failed to support the safety concerns about exposure therapy raised by Pitman et al. (1991) and Tarrier et al. (1999). Taylor et al. (2003) investigated symptom worsening following treatment in a study comparing a group treated with imaginal plus in vivo exposure to a group treated with EMDR and a group treated with relaxation training. Rates of symptoms worsening were uniformly low across all three conditions (0 , 7 , and 7 , respectively). Similarly, Gillespie, Duffy, Hackman, and Clark (2002) administered a treatment that combined exposure and CR and found no symptom worsening. Cloitre et al. (2002) investigated the efficacy of a treatment involving sequentially combined skills training in affect and interpersonal regulation (STAIR), based on principles of dia

Studies in MS and Other Conditions

In MS, biofeedback may be beneficial by promoting relaxation. It also may be helpful in treating some types of pain, including tension headaches, migraines, and low back pain. However, the use of biofeedback to treat MS-associated pain has not been formally studied. An interesting issue is whether biofeedback may be used to regulate the immune system and, conceivably, thereby alter immune diseases such as MS. Variable effects of biofeedback-induced relaxation on immune function have been obtained no consistent results have been reported.

Carboxylic ester hydrolases EC 311 and amidases EC 351354

The prominent member of the B-esterases is the acetyl choline esterase responsible for the inactivation of the neurotransmitter acetyl choline. Organophosphates are mechanism-based inhibitors of B-esterases. Their toxic effects are produced by an accumulation of acetyl choline and therefore by an exaggerated cholinergic activity. The inhibitory effect of the organophosphates is due to the fact that the enzyme phosphoserine ester formed between B-esterases and organophosphates hydrolyzes very slowly, if at all, and thus there is virtually no regeneration of the enzyme. The inhibition of another B-esterase, the neuropathy target esterase (NTE) localized in the central nervous system, leads to neurotoxicity called organophosphorus-induced delayed polyneuropathy (OPIDP). The neurotoxicity observed in some gulf war veterans is suspected to have been caused by a combination of the acetylcholine esterase inhibitor pyridostigmine (used as an antidote against anticholinergic chemical weapons)...

Practical Application

AT uses six standard formulas heaviness (muscular relaxation), warmth (vascular dilation), regulation of the heart, regulation of breathing, regulation of the visceral organs, and regulation of the head. Heaviness (muscular relaxation) is the most easily influenced by conscious efforts. The effects of this formula generalize throughout the body, as do the other formulas. The practice must be consistent and always begin with the dominant arm in muscular relaxation. The regulation of breathing acknowledges that breathing is partly autonomous and partly intentional. The rhythm of breathing is integrated into muscular, vascular, and heart relaxation. In the case of AT, intentional modification of breathing is not desirable because it is associated with tension by way of a reflex-type mechanism. As a result, a passive formula is used It breathes me.

Uptake of the Microvascular Filtrate by the Lymphatic Capillaries

The interstitial fluid may be assumed to flow due to a hydrostatic pressure gradient from the interstitial space with a high fluid pressure into the terminal lymphatics with a lower intravascular pressure. The pressure in cardiac terminal lymphatics is not known. The uptake of the interstitial fluid by the terminal lymphatics is readily explained, however, by their structure and the periodic cardiac contraction muscular contraction compresses the terminal lymphatics and pushes the lymph centripetally, whereas closure of the interendothelial clefts of the terminal lymphatics prevents backflow of the lymph into the interstitium during muscular relaxation, the interendothelial clefts are pulled open by the anchoring filaments and interstitial fluid is sucked into the lymphatic capillaries.55 Furthermore, the endothelial cells of the terminal lymphatics in the heart show plasmalemmal vesicles,56 which may additionally contribute to the lymphatic uptake of interstitial fluid and proteins.

Myocardial Contractions

The main force of cardiac lymph propulsion is undoubtedly the myocardial contraction. During systole, the myocardium is squeezed and the lymph is propelled to the superficial lymphatic trunks and forced to flow away from the heart. Accordingly, recent studies have shown a significant decrease in cardiac lymph flow following cardiac arrest during cardiopul-monary bypass.57,58 During cardiac relaxation, the epicardial surface of the heart and the superficial lymphatic trunks are pressed against the pericardium and lymph is propelled away from the heart due to the valves of the lymphatic vessels. The subendo- to subepicardial gradient of intramyocardial pressure, which is present at least during systole, can be assumed also to promote lymph flow within the lymphatic capillary network of the ventricular wall.

Overview of the vascular effects of co

It is now well known that CO can induce relaxation of vascular tissues with different diameters and from various species (Table 2.1). The affected vascular tissues include aorta,10 tail artery,11 pulmonary artery and vein,12 mesenteric artery,12 renal arteries,13 hepatic arteries,14 ductus arteriosus,3 and femoral arteries.4 Exoge-nously applied CO induced a concentration-dependent relaxation of rat tail artery tissues precontracted with phenylephrine.11 The CO-induced vasorelaxation was not due to antagonism of a-adrenoreceptors since CO also relaxed the vascular tissue precontracted with U-46619 (9,11-dideoxy-11a, 9a-epoxymethano-prostaglandin F2a), which induces vasoconstriction mainly by releasing intracellular calcium. The CO-induced vasorelaxation was sustained, but reversible upon the withdrawal of CO, and independent of the presence of an intact endothelium. The vasorelaxant effects of CO are further exemplified in several specific vascular beds below.

Endocrine Disorders Associated with Myofascial Pain

Hypothyroidism is secondary to a lack of thyroid hormone production levothyroxine (T4) and liothyronine (T3) secondary to a problem with the hypotha-lamic-pituitary-thyroid (HPT) axis. Clinically, the patients are frequently overweight. Their eyelids may be puffy, their voice hoarse. The thyroid gland may be enlarged. Their muscles are stiff, tender, and, on occasion, weak. They may display muscle hypertrophy. TrPs are common. Their primary complaint may be diffuse muscle tenderness. The Achilles reflex may show delayed relaxation. Laboratory testing typically shows low serum thyroxine (T4), free thyroxine index, and a high thyroid-stimulating hormone (TSH) level.

Localizing Nanoparticle Concentrations

Magnetic resonance imaging has been shown to be very well suited for diagnostic cancer imaging as a result of the exceptional anatomical resolution of this modality 29,30 . The basis of molecular MRI is generally based on the assumption that antibodies, peptides, or other targeting molecules, tagged with a magnetic contrast agent, binds to the target and produces a local magnetic field perturbation that results in an increased proton relaxation rate that is detectable by magnetic resonance techniques. Magnetic nanoparticles are a form of magnetic contrast agent in MRI. Para- and superparamagnetic agents such as Gd(III) and various forms of iron oxide in both molecular and nanoparticle form have been used in a broad range of MRI applications to enhance image contrast. This approach is only limited by the inherent sensitivity of MRI, and the specific pulse sequence chosen, to the presence and distribution of the magnetic contrast agent 25,26,31,32 .

Pending and Interdisciplinary Research

The neurochemical and neurophysiologic markers of massage therapy are not well defined. Similarly, the biologic markers of relaxation and restorative sleep are incompletely defined. Understanding changes in the levels of inhibitory neurotransmitters such as GABA may help shed light on both seizure-provoking factors (e.g., sleep deprivation, stress) and seizure-relieving therapies (e.g., massage).

B The Role of Endothelium in the Metabolism and Function of co 1 Expression of HO Isoforms and Production of CO in

Endothelium constitutes a monolayer covering the inner surface of the entire circulatory system. Several vasoconstricting factors and vasorelaxing factors are secreted from the endothelium to finely tune vascular tones. For example, endothelium-derived relaxant factor (NO) and hyperpolarizing factor (EDHF) as well as prostacyclin are responsible for the relaxation of vascular smooth muscles, whereas endothelin induces vasoconstriction by acting on endothelin receptors on SMCs. Whether different isoforms of HO are expressed in vascular endothelial cells and whether CO can be generated from endothelium in a meaningful amount are unclear. Early studies supported the idea that CO production in vascular walls was mainly from vascular SMCs. To a large extent, this still holds true. Interestingly, the acutely regulated release of CO from endothelium was reported in one case. Inhibition of HO activity by tin protoporphyrin IX (SnPPIX) reversed the ACh-induced and NO-independent relaxation of...

Subpulmonary Ventricular Septal Defect

Subpulmonary ventricular septal defects are located high in the ventricular septum and immediately below the pulmonary valve. Myocardial relaxation with cardioplegic arrest allows the upper septum to be retracted inferiorly, so that many subpulmonary defects can be closed completely through the transatrial approach. In many cases, an aortic valve cusp is intimate with the rim of this ventricular defect and care must be used to avoid damage to the valve. If exposure through the atrium is not satisfactory, this approach should be aborted and a high small transverse right ventriculotomy or proximal main pulmonary arteriotomy used for the repair. Working through the proximal ascending aorta with retraction of the aortic valve is an alternative repair exposure.

Photoactive Yellow Protein

By crossing of the transition state barrier, and relaxation from the excited state to the ground state by internal conversion 3 . This intermediate has a red-shifted absorption spectrum and still retains its hydrogen bonds with Tyr42 and Glu46. The C1-C7-C8-C9 dihedral angle (see Fig. 5.1 for numbering) of the Io intermediate has been calculated to be -80 3 , which corresponds with that observed in the crystal structure of a cryogenically trapped early intermediate of the photocycle 4 . It has been suggested that the light energy that drives the photocycle is stored in this highly strained cis conformation 3,5 . Within nanoseconds several relaxation processes of the strained chromophore and the hydrogen bonding network lead to the relaxed, pR, intermediate (also known as Ij or PYPL). Vibrational spectroscopy has been used to show that the hydrogen bond between Glu46 and the anionic chromophore is the same in the dark trans pG state as it is in the cis pR state 6 . Protonation of the...

Uncorrectedsusceptibility corrected T2imsi

Use as an MRI contrast agent because it not only has seven unpaired electrons but the symmetry of its electronic states produces an electron spin relaxation time slow enough to interact significantly with neighboring water protons (4). Relaxivity is impacted by a number of contrast agent properties including hydration number, the distance between the ion and the solvent proton, solvent exchange rate, electronic relaxation time, and rotational correlation time. The hydration number (number of water molecule coordination sites) for Gd chelates is generally > 1 (4). Obtaining the minimal distance between the ion and bound protons (r) is important because the relaxation rate is inversely proportional to r6. The ability of the bound protons to rapidly exchange with free water allows for distribution of the relaxation effects throughout the bulk water (Fig. 8). A longer electronic relaxation time also leads to higher relaxivity. Figure 8 Schematic of water exchange between bound and bulk...

C Effect of co on Nerve Terminals and Neurotransmitters within Vascular Walls

The interaction of CO and the peripheral nerve system may influence vascular contractility in at least two ways. First, chronic CO exposure may affect the development and function of the nerve system.4243 Tetrodotoxin (TTX) inhibited the contraction of rat mesenteric vascular beds evoked by electrical perivascular nervous stimulation. This inhibitory effect of TTX was significantly increased in vascular tissues from prenatal pups after exposing the pregnant mother rats to 150 ppm CO for 5 to 7 days.44 TTX blocks voltage-gated Na+ channels in the nerve endings and inhibits the neurotransmitter release upon the electrical depolarizing stimulation. A reduced TTX effect indicates that chronic CO treatment somehow altered the elec-trophysiological properties of pre-synaptic membranes and facilitated the neurotrans-mitter release. Moreover, in the chronic CO-treated prenatal pups, the ACh-induced relaxation of the mesenteric arterial beds with intact endothelium appeared about 4 days...

Sensing Applications Utilizing Rotational Brownian Motion

Rotational Brownian motion for the signal transduction of biochemical binding events. In one of the earliest measurements, the random rotational motion of a wire in a liquid was detected by light reflected from a mirror attached to the wire 9 . Obviously, the detection of rotational Brownian motion for spherical particles is more complicated and requires an anisotropy to break the spherical symmetry. Examples of symmetry-breaking are permanent electric dipole moments, whose motion can be detected with inelastic light scattering 10 , or anisotropic optical properties, which leave a distinct signature of the rotational motion in dynamical light-scattering experiments 11 . Clearly, a permanent magnetic moment will also break the spherical symmetry its use for the detection of rotational Brownian motion is discussed in Section 4.3.2. An alternative approach for the detection of Brownian relaxation is nuclear magnetic resonance, since the relaxation time for nuclear spins is modified by...

Variability in Ventricular Wall Motion Pattern

There are only weak discriminations between normal and hypokinetic ventricular wall motion unless verified by functional stress tests. If one is familiar with it, the left ventricular pressure-dimension loop may best and easiest inform about the actual functional state of the ventricular wall segment under study.21,22 It is mentioned that there are some peculiarities in the shape of the pressure-length loop which might indicate an acute ischemic insult (Fig. 5.2). Depending on the site and layer where the ultrasonic transducers are implanted, the recorded tracing may show conformational changes of the ventricle which appear as length changes during the isovolumic contraction and relaxation. Pronounced regional wall shortening during isovolumic ventricular relaxation (postsystolic shortening (PSS)) also has been observed in the acutely ischemic myocardium and has been identified to be a predictor of the early and late recovery of function after coronary artery reperfusion.23 In...

The vasorelaxant effects of endogenous co

FIGURE 2.1 Mechanism of CO-induced vascular smooth muscle relaxation. Three major hypotheses for CO-induced SMCs relaxation cGMP accumulation, large conductance potassium channel activation, and inhibition of the cytochrome P450-monooxygenase system are illustrated. Whether the endothelium-produced CO can diffuse into the underlying SMCs is unclear. Whether this pathway is applicable to adult vascular beds is unclear. The expression and the presence of functional HO-1 are unclear. FIGURE 2.1 Mechanism of CO-induced vascular smooth muscle relaxation. Three major hypotheses for CO-induced SMCs relaxation cGMP accumulation, large conductance potassium channel activation, and inhibition of the cytochrome P450-monooxygenase system are illustrated. Whether the endothelium-produced CO can diffuse into the underlying SMCs is unclear. Whether this pathway is applicable to adult vascular beds is unclear. The expression and the presence of functional HO-1 are unclear. The vascular effect of...

Diagnosis of Graves Disease

The diagnosis of Graves' disease, aside from a history of thyroid problems, uses measures of visual acuity, pupillary light responses, and ocular motility. The configuration and movement of the lid margins should be carefully studied. The slit-lamp examination should include the measure of intraocular pressure by applanation tonometry both in downgaze and in the primary position. Because of the foreshortened rectus muscle's traction on the globe, attempts to force the eye into the primary position often result in a marked, though transient, elevation of the intraocular pressure. Visual field testing and a sonographic determination of rectus muscle thickness by A-scan complete the workup. Echographic confirmation of rectus muscle thickening in the midportions of muscle belly, but with no thickening at the tendinous insertions, is characteristic of Graves' disease and differentiates it from orbital myositis, in which the inflammatory swelling extends all the way to the point of...

Effects of Meditation

In an elegant study, Telles and colleagues (10) proved a similar point by studying the effectiveness of yoga relaxation techniques. They compared oxygen consumption with respiratory and heart rates during cyclic activation by using a yoga posture alternating with Shavasana (the corpse posture), and by using Shavasana alone. To their surprise, they found more reduction in oxygen consumption during cyclic activation than during the lying down posture. Throughout history, many similar techniques or practices have been used to achieve an altered state of consciousness. The recently documented physiologic effects of these various practices reflect the commonality of the experiences and of the relaxation response. Beary and Benson (11) point out four common elements integral to these varied practices that are necessary to evoke the relaxation response Do not worry about whether you are successful in achieving a deep level of relaxation. Maintain a passive attitude and permit relaxation to...

Autonomic Nerve System

In the peripheral nervous system, NO functions as a neurotransmitter. The most prominent evidence come from studies on the autonomic nerve system, including the digestive system. nNOS is selectively localized in the myenteric plexus and NOS inhibitors selectively block nonadrenergic- and noncholinergic (NANC)-mediated relaxation of the gastrointestinal tract (2), indicating that NO is the NANC neurotransmitter (40). This is further supported by studies using mice with targeted disruption of the nNOS gene (41). These mice are normal in most respects despite their lack of NOS catalytic activity in the brain and loss of NOS immunostaining in the central and peripheral nervous systems. No morphological abnormalities were observed in the brain or in most peripheral tissue at the gross and microscopic level. However, these mice have the markedly enlarged stomachs and histological examination reveals hypertrophy of the inner circular muscle layer. NO is thought to mediate relaxation of the...

AStimulation of cGMP Pathway

Like NO, CO is a potent stimulator of sGC.19,31 CO binds to the heme regulatory subunit of sGC and activates the enzyme.74 The activation of sGC results in an increase in cGMP level. In vascular smooth muscle, increased cGMP production subsequently induces relaxation by lowering intracellular calcium concentration and or decreasing the sensitivity of the contractile system to free calcium. The mechanism producing the stimulating effect of CO on the sGC system is discussed in detail in Chapter 4.

AIIMS Study on Drug Resistant Epilepsy

Researchers told patients in the meditation intervention group that the purpose of meditation was to attain as high as possible a degree of physical relaxation and to improve their concentration, which was defined as nonanalytic attending to some passive act. The method of meditation was word repetition they were instructed to repeat a specific word while sitting in a comfortable posture. The patients practiced this for 20 minutes every day. They selected the word from a list of common words used in meditation practice and words of similar length, including both meaningful (conventionally used) and meaningless syllables (listed later on). This was done to avoid religious and cultural connotations. After 6 months of observation, we brought an additional 11 patients into the meditation training, including five with generalized tonic-clonic seizures, three with complex partial seizures, and three with simple partial seizures. We studied the effects of meditation on the parameters...

In Silico Dynamic Studies of Cis Trans Isomerization in Organic and Biological Systems

The reaction path of photochemical reactions is determined primarily by the topology of the excited singlet surfaces Sx (x 1, 2, ), along with the topology of the ground state S0 if no intersystem crossing to a triplet surface occurs. The most important characteristics of these potential energy surfaces (PESs) are the locations of minima, points of contact (e.g. conical intersections between S0 and S1), barriers and singlet-triplet intersection points. The shapes of the PESs are intimately tied to changes in the electronic wave function in relation to molecular geometry. Different approaches can help in the understanding of photoisomeriza-tion processes. Qualitative approaches are based on correlation diagrams expressed either in the valence bond (VB) or in the molecular orbital (MO) framework 1,2 . Although essential for the understanding of the nature and the symmetry of the electronic wave functions associated with the respective molecular geometries in the various electronic...

BModulation of k Channels by co

Earlier studies at the vascular tissue level indicated the involvement of K+ channel activation in the CO effect. The muscle-relaxing effect of CO was relatively weaker in high concentrations of KCl-precontracted than in agonist-precontracted tissues.76 The CO-induced relaxation of rat tail artery was also significantly reduced by tetraethylammonium (TEA, 30 mM), a K+ channel blocker.73 Charybdotoxin (ChTX), a large conductance KCa channel blocker, inhibited the vascular effect of CO as TEA did, whereas apamin, a small conductance KCa inhibitor, had no effect. These results clearly indicate that the activation of large conductance KCa channels constitutes an important mechanism for CO-induced vasorelaxation. Furthermore, CO-induced vasorelaxation was completely abolished by co-application of either TEA and methylene blue (MB) or ChTX and Rp-8-Br-cGMPS.73 Leffler et al.27 showed that topically applied CO dose-dependently dilated piglet pial arterioles in vivo over the range 10-11 to...

C Inhibition of Cytochrome p450 by co

Cytochrome P450-linked mono-oxygenase is responsible for the generation of vas-oconstricting substances, such as an arachidonic metabolite3,80 or ET-1.81 A decreased formation of these vasoconstrictors would lead to vascular relaxation.48 CO and cytochrome P450 function are closely related. CO is an inhibitor of cytochrome P45082 and the levels of cytochrome P450 are controlled by the availability of cellular heme53 which can be catalyzed to CO and biliverdin. Therefore, it has been hypothesized that the vascular effect of CO may result from the inhibition of a cytochrome P450-dependent mono-oxygenase. In rat thymocytes, capacitance-induced calcium entry was prevented by some known cytochrome P450 inhibitors as well as a 3-min treatment with CO, whereas elevation of cGMP or cAMP level had little or no effect.83 These results suggest that a cytochrome P450-based mechanism may be involved in the effect of CO. In the lamb ductus arteriosus, exogenously applied CO and most of the known...

Electrical Stimulation

Electrical Stimulation (E-Stim) is frequently used to relieve muscle spasm and pain of MTrPs both pre- and post-TPI. Transcutaneous electrical nerve stimulation (TENS) is felt, at low frequencies (60-90 Hz), to work via the gate control theory in the spinal cord. At the very low levels (1-4Hz) galvanic or tetanizing current can work well to induce muscle relaxation. At both of these levels, endogenous opiates are stimulated. High-frequency TENS (up to 1000-2000 Hz) appears to have a more serotonergic system effect. Ultra-high frequency (15,000 Hz) TENS, which in the past was known as cortical electrical stimulation (CES), has been found to change the neurochemi-cal milieu of the brain (27).

Mechanisms of Meditation

Meditation induces relaxation and attentional changes. Whether attentional changes and changes in relaxation during meditation influence these areas in the brain remains to be tested. Perhaps through these changes, meditation may normalize the activity of thalamocortical circuits and produce a normal pattern of EEG frequencies. Some also propose that meditation may boost some naturally occurring endogenous antiepileptic chemical substances in the brain. Results from our study appear to be mediated through nonautonomic and nonstress mechanisms, as evidenced by specific EEG changes. Another Indian study claimed a reduction in stress after Sahaja Yoga intervention in epileptics (32).

PGs and Mechanical Strain

Figure 2 Stress-length curves during stepwise relaxation of parenchymal strips in vitro, showing increased compliance of the lung tissue in parenchymal strips from decorin-deficient mice. Compliance of the tissues (Ctis) was measured from the slope of the tangent to the curve between 300 and 500 mg mm2. L500 is the length of the strip above lo at 500 mg mm2. Dcn+ +, wild type Dcn , decorin deficient. *, p < 0.05 vs Dcn+ + **, p < 0.01 vs Dcn+ +. Reproduced by permission from Ref. (39). Figure 2 Stress-length curves during stepwise relaxation of parenchymal strips in vitro, showing increased compliance of the lung tissue in parenchymal strips from decorin-deficient mice. Compliance of the tissues (Ctis) was measured from the slope of the tangent to the curve between 300 and 500 mg mm2. L500 is the length of the strip above lo at 500 mg mm2. Dcn+ +, wild type Dcn , decorin deficient. *, p < 0.05 vs Dcn+ + **, p < 0.01 vs Dcn+ +. Reproduced by permission from Ref. (39).

Psychological Treatment

CBT involves restructuring of a patient's maladaptive beliefs regarding his her ability to cope with the pain or control it and the reduction of pain behaviors building healthy behavioral patterns and relaxation training are also parts of this treatment strategy (41,42).

Complementary and Alternative Approaches

According to a recent national survey, 50 or more of patients who report severe depression have used complementary and alternative therapies in an attempt to alleviate symptoms (Kessler et al. 2001). These approaches include cognitive techniques such as relaxation and biofeedback, oral medications such as herbal medicine and homeopathy, physical treatments such as massage and chiropractic, and other approaches such as spiritual healing and dietary modification. Most persons using these approaches also seek treatment professionally (e.g., by a psychiatrist, psychologist, or general physician), which provides an opportunity to assess for possible adverse effects of combining alternative therapies with pharmacotherapies (e.g., mild serotonin syndrome from mixing St. John's wort and SSRIs). Clinicians need to inquire about the use of complementary and alternative approaches, become familiar with current data on efficacy, and inform patients of any potential known risks. A recent...

Structure in an Aqueous Solution

Nuclear magnetic resonance (NMR) spectroscopy has been used to study the structure of inulin in aqueous solutions. In addition, the use of low-angle laser light scattering, dynamic light scattering, and small-angle x-ray scattering following size exclusion chromatography has yielded information on the molecular weight distribution, hydrodynamic radii, and geometry of Jerusalem artichoke inulin (Eigner et al., 1988). Inulin was found to have a rod-like shape with maximum dimensions of 5.1 x 1.6 nm (length x mean diameter). 13C relaxation rate measurements indicate that the fructofuranoside units are not part of the polysaccharide backbone therefore, the structure is like a polyethylene glycol polymer with furanosides attached (Figure 5.1). This greatly increases the flexibility of the chains, which is reflected by a segmental motion that is two to three times faster than amylose (Tylianakis et al., 1995).

NaK ATPase as the Target of CO

Investigations started several decades ago and intensified in the last 10 years demonstrated that CO is an important endogenous gaseous vasoactive factor. CO acts on vascular SMCs to induce relaxation and shares many similar mechanisms with NO. However, depending on the types of vascular tissues and species, vascular responses to CO vary for still unknown reasons. The up-regulation of the CO-generating enzyme HO-1 is achieved by the surge of many endogenous factors, and the down-regulation of HO becomes successful with the use of pharmacological agents, such as metalloporphyrin compounds or steroids.94 Among the mechanisms underlying the vascular effects of CO, the activation of cGMP, the opening of KCa channels, and the modulation of cytochrome P450 have attracted the most attention. Whether CO also acts on other cellular and molecular targets is still being investigated.

Mitotic Versus Postmitotic Compartments

Paro and coworkers (65) constructed a Drosophila strain carrying a Pc-G response element-linked reporter gene. In temperature shift experiments, they reported loss of silencing over time during adulthood (i.e., an age-related loss) at this recombinant locus. How might relaxation or initiation of heritable silencing be established in the absence of DNA replication A speculative but potentially important possibility is that chromatin domains could be remodeled by repeated cycles of DNA damage and repair. Studies on budding yeast provide a precedent for this idea. In that organism (as in mammalian cells), double-stranded DNA breaks lead to activation of one or more nonhomologous end-joining (NHEJ) pathways. Ku proteins are thought to bind to, and facilitate, end joining, at least in part through mobilization from telomeric binding sites. Notably, SIR proteins are recruited to double-stranded DNA breaks in much the same manner (11,66). The product of the SIR3 gene, in particular, has been...

Diseases of the Adrenal Gland

Of effector cells, a and p receptors (al and a2, pi, p2, and p3). In particular, al receptors mediate vasoconstriction, intestinal relaxation, uterine contraction, and papillary dilatation p 1 mediate increases of heart rate and lipolysis, p2 induce smooth muscle relaxation and increase glycogenol-ysis in skeletal muscle, while p3 increases brown-fat thermogenesis and lipolysis 26 .

What Is The Evidence For Cbts Effectiveness

A potential limitation of these studies is that the inclusion of all recently distressed trauma survivors raises the possibility that treatment effects may overlap with natural recovery in the initial months after trauma exposure. In an attempt to overcome this problem, other studies have focused on people who meet criteria for ASD because of evidence that most people who do display ASD are at high risk for subsequent PTSD (Bryant, 2003). In an initial study of ASD participants, Bryant and colleagues randomly allocated motor vehicle accident or nonsexual assault survivors with ASD to either CBT or SC (Bryant, Harvey, Dang, Sackville, & Basten, 1998b). Both interventions consisted of five 1.5-hour weekly individual therapy sessions. CBT included education about posttraumatic reactions, relaxation training, cognitive restructuring, and imaginal and in vivo exposure to the traumatic event. The SC condition included trauma education and more general problem-solving skills training in...

Treatment of insomnia

Insomnia may be distinguished in two different states. The first is a state of transient insomnia due to an acute event, while the second is the state of chronic insomnia. What is required in the first case is a treatment lasting for a few days only, i.e., for the period of the underlying event that caused insomnia. Such a case requires a medicine able to induce sleep immediately, while its effect quickly diminishes, so that the individual does not experience after effects when awakened. In the case of chronic insomnia, i.e. , when a person cannot relax in order to fall asleep, the therapeutic effort should be aimed at the reduction of chronic stress. The objective is to reduce the level of arousal when going to bed. Thus, the treatment may be more on a psychological basis, employing psychotherapeutic techniques, so that the patient can control the levels of his or her stress. In fact, all psychotherapeutic techniques, ranging from those of a psychoanalytical nature to those of...

Principles Of Analytical Pyrolysis

Analytical pyrolysis techniques, in which organic matter samples are thermally degraded in the absence of oxygen to form smaller more recognizable compounds, were developed during the 1960s and 1970s.20 During pyrolysis, the organic matter sample absorbs thermal energy and this energy becomes distributed throughout the molecular structure. This gives rise to the excitation of chemical bond vibrational modes. Relaxation of these same bond vibrational modes causes cleavage, both heterolytic and homolytic, of weaker bonds. In this way, bond scission leads to high yields of pyrolysis products. In most pyrolysis reactions the bonds of strongly electron-withdrawing

Magnetic Resonance Imaging

In contrast to optical imaging, MRI has the advantages of a very high spatial resolution (25-100 im) and the ability to measure more than one physiological parameter at once using different radiofrequency pulse sequences (23). These features make MR very attractive for imaging reporter gene expression. The imaging signal is generated as a result of spin relaxation effects, which can be altered by atoms with high magnetic moments (e.g., gadolinium and iron). One particularly useful MR imaging signal amplification system is

Anxiety Management Skills

It can be useful to provide anxiety management strategies early in therapy because (1) they can give patients a degree of control over their distress, and (2) these techniques are relatively simple to use. Be aware that most patients experience considerable distress during the initial sessions because they are confronting and expressing upsetting memories. The utility of reducing arousal in the acute posttrauma phase is also indicated by evidence that acute arousal is associated with chronic PTSD (Shalev et al., 1998). Giving the patient some tools to assist mastery over the acute anxiety can provide both a sense of relief and a motivation to comply with more demanding therapy tasks. Anxiety management often involves progressive muscle relaxation (Ost, 1987) and breathing retraining, which aims to achieve 10 breaths a minute. Although these techniques are simple, therapists need to be aware that focusing on bodily sensation or on breathing can trigger reminders of the trauma. First,...

Conclusions and future directions

Different types of K+ channels influence the contractility of vascular SMCs differentially. The voltage sensors of KV channels, buried inside the plasma membranes, react to the membrane potential change, altering the conformation and the gating of KV channel proteins. The calcium sensors of KCa channels detect the changes in free calcium concentration of the microzone on the intracellular side of the membrane. Consequently, KCa channels will open or close. The KATP channel complex also has its ATP sensor located on the intracellular side. Cellular metabolism leads to the fluctuation of ATP level, which in turn controls the gating of KATP channels. The trigger for the opening of different K+ channels varies, but opening of K+ channels leads to the same outcome, i.e., relaxation of vascular SMCs. The presence of multiple subfamilies of K+ channels in vascular SMCs provides fine-tuned mechanisms for the modulation of vascular tone in the face of different stimuli and under different...

Youth Smoking Cessation

Sussman, Dent, and Lichtman (2000) designed an innovative school quit-smoking program that featured interactive activities, such as games and talk shows, alternative medicine techniques (i.e., yoga, relaxation, and meditation), and behavioral strategies for smoking cessation. Two hundred and fifty-nine students enrolled in the program at 12 schools and another 76 students served as standard care controls (smoking status surveyed at baseline and at 3 months). Objective measures of cigarette smoking were used. Elective class credit and class release time were offered for participation in the program.

Conclusion of the Class

The conclusion of each class should offer a complementing or contrasting item to the main topic of the exercise class. In this way a quiet movement such as stretching or massage (with brightly coloured spiky plastic massage balls) can be experienced as soothing. In contrast, exercise classes that have focused a lot on high concentration or relaxation may profit from a finale that is a bit more movement intensive, such as a group dance or a little game such as ball over the line (i. e. throwing a ball over the rope).

Amide Relevant Conformations in Proteins

Either cis to trans or trans to cis isomerization. However, in a proline-free variant of the a-amylase inhibitor tendamistat, for a small fraction of refolding molecules the relaxation time, which was 400 ms, could be assigned to CTIs of secondary amide peptide bonds 27 . Obviously, this type of isomerization during refolding must be universal in unfolded proteins. Many folding intermediates typically exist under strongly native refolding conditions with the native state containing cis prolyl bonds. For example, the refolding reaction of GdmCl-denatured RNase T1, which is a single domain protein of 104 amino acid residues encompassing two trans and two cis prolyl bonds, is properly described by a kinetic model containing four unfolded species (2n with n for the number of cis prolyl bonds) and three folding intermediates, all of which contain one non-native prolyl bond at least. For the three intermediates with non-native prolyl bonds relaxation rates of formation and decay ranging...

Adult Smoking Cessation

Proaches to smoking cessation (Fagerstrom, 1988 Hymowitz, 1999). Multi-component behavioral programs, whether in group, individual, or self-help formats, typically include a number of strategies (self-monitoring, stimulus-control procedures, behavioral contracting, alternative behaviors, aversive conditioning, relaxation training, diet and exercise, self-management skill training for relapse prevention, etc.) to motivate smokers, to help them gain control over smoking, and to eliminate smoking systematically from their behavioral repertoire. Once smokers stop smoking, many of the very same behavioral skills that helped them quit smoking are used to help them prevent relapse. Schwartz (1987) reported that 1-year quit rates for multicomponent behavioral group quit-smoking programs average 40 . Initial end-of-treatment quit rates may be considerably higher. Hall, Tunstall, Rugg, Jones, and Benowitz (1985) studied the effects nicotine gum and intensive behavioral treatment. They assigned...

Human Cardiovascular Gene Therapy Current Status

Treatment of heart failure is another scenario for gene therapy, where it is close to entering clinical trials (10). Molecular targets for restitution of contractile function in the failing heart include interventions in calcium homeostasis e.g., overexpression of sarcoplasmic reticulum Ca-ATPase (SERCA) to increase contraction and relaxation velocity, or inhibition of phospholamban to increase SERCA levels (11,12) , in p-adrenergic signal transduction e.g., p-receptor overexpression to increase contractility, or inhibition of p-adrenoceptor kinases to reduce receptor desensitization (13) and in the cascade of apoptotic cell death e.g., overexpression of the anti-apoptotic factor Bcl-2 (14) .

Absorption of Vibrational States of Biological Components

In recent years, there has been further discussion of the role that might be played by resonant absorption of EM energy by the vibrational states of biological components such as microtubules 9 . Foster and Baish 53 noted that the main contribution to the width of a vibrational state in a biological component is likely to arise from the viscosity of the fluid in which it is immersed. To estimate this effect, Foster and Baish 53 calculated the relaxation time of longitudinal oscillations of a cylinder immersed in water. For a cylinder with a diameter equal to that of a microtubule, the relaxation rate and hence the line width was around 1000 times larger than the frequency even at 10 MHz and would be even greater at higher frequencies. Similar results were obtained by Adair 54 . In addition, Adair 54 calculated the energy transferred to a vibrational state of a biological component from an EM field. The interaction is weak and is forbidden by momentum conservation in the absence of...

Ronald T Brown Summary

This chapter reviews literature pertaining to the management of pain within the school setting. Etiological issues underlying obstacles to school attendance are reviewed, including issues pertaining to make-up work, concerns among many children pertaining to use of the bathroom at school, diet and eating habits at school, relationship with a teacher or peer, fear of pain episodes at school, learning problems, test or performance anxiety, separation anxiety, and familial reinforcement of sick behavior. Interventions to increase school attendance are reviewed these also include a careful assessment of the child and the family system, the use of behavioral interventions, as well as other treatment approaches, including the use of relaxation therapy and problem-solving therapy. Finally, specific directions for future research efforts and training also are provided.

Valvular Heart Disease

Aortic stenosis is associated with LV hypertrophy and LV relaxation abnormalities and may, in some cases, eventually progress to LV systolic dysfunction. The progression of aortic stenosis is routinely monitored by serial Doppler echocardiographic examinations, permitting noninvasive estimates ofthe transvalvular gradient and aortic valve orifice area. The relation among natriuretic peptide plasma levels, disease severity, and symptoms has been examined in patients with aortic stenosis (182-184). BNP and NT-proBNP plasma levels were higher in symptomatic than in asymptomatic patients, even after adjustment for aortic valve area and ventricular function (184). NT-proBNP was found to be a sensitive marker of even mild LV hypertrophy (183) and to correlate significantly with the trans-valvular pressure gradient (182).

Regulation of Appetite in the Elderly

During a meal, the fundus distends to accommodate food, a process termed adaptive relaxation. Food is then passed to the antrum after mixing with stomach secretions. Antral distension is the major signal for termination of a meal 1 . With aging, there appears to be impaired gastric fundal accommodation 6 due to impaired adaptive relaxation, which is caused by a decline in the local release of nitric oxide. Older mice have decreased nitric oxide synthase activity in their fundus 7 . The decline in adaptive relaxation that occurs with aging leads to more rapid antral filling. In addition, some studies suggested that large- Nitric Oxide, Adaptive Relaxation, and Appetite

Physiological Effects

Cannabis intoxication commonly heightens the user's sensitivity to external stimuli, thus making colors seem brighter and smells more pungent. It also distorts, sometimes severely, the user's sense of time. The term temporal disintegration (Mathew, Wilson, Humphreys, Lowe, & Weithe, 1993) has been coined to describe this slowing of subjective time after use of marijuana. In addition, at least in low doses, marijuana causes mild euphoria and feelings of relaxation. It is also know to increase appetite. There is some controversy over whether individuals intoxicated with cannabis pose a hazard, as they seem to be attracted to thrill-seeking behavior and are usually subdued. Some people have argued that individuals who smoke marijuana are less likely to drive fast however, reaction time to complex and unforeseen situations is slowed, and muscle strength and hand-eye coordination is decreased. Because it delays reaction time, alters time perception, and for many other reasons, marijuana...

Fear of Pain Episodes at School

A primary goal in working with these children is to assist them in learning that they can cope with their pain (4). Walker recommended that children's initial return to school be brief, perhaps only 1-2 hours day. Most children will be able to attend school and even manage their pain for brief periods. The brief school attendance will assist children in building confidence so they may later be able to survive a pain episode at school. The child's health care provider and caregivers should have a plan in place in case the child experiences pain while at school. It is typically best if the child is allowed to lie down and rest until well enough to return to class or until it is time to leave school for the day. A child may also work with a school counselor to learn relaxation or distraction techniques (4,14). Walker cautioned it is often counterproductive for children to call home or be allowed to leave school early when a pain episode occurs as this reinforces complaining and passive...

Active versus Passive Treatment

This literature is consistent in the message that passive therapies are inadequate for pain management, and that multimodal (multidisciplinary) treatment is effective active treatment. But if inactivity is ineffective for pain management, what about relaxation therapies or hypnosis As we will see below, the activity is in the patient's active application of these techniques to his her pain and stress problems, and that practice in the clinic and not at home leads to poor results.

Modulation of Pain by the Autonomic Nervous System

Perception of intestinal stimulation (61). Using brief distending stimuli in the intestine, the effect of sympathetic activation by LBNP on sympathetically mediated intestinal relaxation and on vagally mediated gastric relaxation was measured by corresponding barostats. The effect of LBNP on perception of duodenal distension was also compared to the perception of somatic stimulation. It was found that sympathetic activation significantly heightened perception of intestinal distension without modifying perception of somatic stimuli (perception scores increased by 41 and 2 , respectively). Also, the reflex responses to duodenal distension significantly increased during sympathetic activation both in the stomach and in the intestine (relaxation increased by 91 and 69 , respectively, with p < 0.05 for both).

Various Behavioral and Cognitive Behavioral Treatments

A review 20 of clinical studies published from 1960 to 1985, concerning relief of pain using relaxation, biofeedback, hypnosis, placebo, TENS, and no treatment found that only biofeedback and relaxation achieved improvements greater than what was reported with no treatment . A review 21 of back pain in primary care found that the CBT improved depression, anxiety, and somatic symptoms at six months and those who continued relaxation practice improved more than those who did not. From these older studies, despite their lower quality, the consistent message is that patients who continue to practise what they learn are more likely to benefit from CBT, and that different behavioral techniques -cognitive behavioral, relaxation, and biofeedback-assisted relaxation, may all be effective for pain relief, improvement in mood, and coping skills.

Magnetic Resonance Imaging MRI and spectroscopy

Of this macroscopic magnetisation, in a process called excitation. After switching off the RF waves, magnetisation returns to the thermal equilibrium in a time and direction dependent manner. This process is called relaxation and the changing macroscopic magnetisation induces an electrical signal in the receiver coil. Signal intensity in MRI is dependent not only on the proton density in the volume of interest, but also on the interaction between tissue protons and externally applied RF waves during the excitation, and on the interaction between nuclei within the tissue during the relaxation. The different physical properties of protons within water and fatty acid molecules result in strong differences in the time and phase dependent behaviours of these nuclei during the relaxation, producing a relaxation and phase dependent contrast for magnetic resonance imaging. T -relaxation based contrast can be used for volumetric measurements of subcutaneous and intra-abdominal fat...

Practical Information

Meditation may be done independently by following techniques described in books such as The Relaxation Response. Classes in meditation techniques often are available through hospitals, health clubs, and community centers. Individual classes are typically 30 to 90 minutes in length and cost 60 to 150 per session. Group sessions are 60 minutes and cost 15 to 35. If meditation is pursued, it is important to keep in mind that it often does not have immediate effects. It may take several weeks or months of practice to achieve significant relaxation.

Modulation of Brain Responses by Pharmacological Treatments

Associated with significant activation of the pACC, right insula, and right PFC. Amitriptyline treatment was not associated with either a significant subjective symptom improvement or changes in brain activation during the relaxing music condition. However, decreased activation in the pACC and the left posterior parietal cortex was observed during distension when associated with the auditory stressor. Even though adequately powered, this study had several shortcomings that may have affected the outcome. Patients had significant psychological comorbidities, making it difficult to determine if the effect of the drug was on IBS symptoms or anxiety. Given the well-known side effects of amitriptyline, it would seem that the study was inadequately blinded, and that exposure to drug during the initial session significantly affected the placebo response during the second session. Finally, the finding of pACC during the relaxation condition is different from generally observed activation of...

Psychosocial Treatments

Published studies of behavioral approaches to tic suppression are few but show some promise. The behavioral technique shown to be most effective is habit reversal training. For Tourette's disorder, habit reversal training is the use of a competing muscle contraction or behavioral response that opposes the tic movement. This method is usually combined with relaxation training, self-monitoring, awareness training, and positive reinforcement. In the few published studies of habit reversal training, there were marked overall reductions in tic frequency. Treatment averaged 20 training sessions during an 8- to 11-month period. Marked tic reduction was noted at 3 to 4 months. Interestingly, urges or sensations experienced before the tic movements also decreased with behavioral treatment.

Cognitive Behavioral Therapy

The CBT program includes some or all of the following modalities relaxation training, cognitive restructuring, meditation, aerobic exercise, stretching, pacing of activities, and patient and family education. The majority of published studies showed CBT to have some benefit (178-182). Some of the studies took place in interdisciplinary pain programs (183,184). Finally, improvement was noted after periods of six months (183) to 30 months (181).

Studies of MS and Other Conditions

Variable results have been obtained in studies of the effects of prayer on other medical conditions. Anxiety and depression, which may occur with MS, may be reduced in those who pray. For anxiety, a therapeutic effect of prayer could be due to the fact that prayer, like meditation, elicits relaxation (see the chapter on Meditation).

Practical description

Acetylcholine is the most commonly used vasodilator for assessing endothelium-dependent vasodilation. It is believed that the vasodilatory effect of acetylcholine is to bind to the muscarine receptor and activate endothelial NO-synthase, resulting in vascular relaxation. Although acetylcholine-induced vasodilation is mainly caused by endothelial cell NO release, potassium-ATP channels also play a role in acetylcholine induced vasodilation (Higashi & Yoshizumi 2003).

Treatment Approaches to Meet the Developmental challenges of adolescents and Young adults

The psychosocial needs of adolescents with cancer can be met through a variety of support programs focusing on school reintegration, learning coping methods such as relaxation and hypnosis techniques, and participating in peer-based programs. Such programs should be offered routinely rather than in a response to a crisis. While there is a need for crisis-initiated interventions, such programs are a last resort and tend to foster stigmatization, alter effective treatment, and discourage self-help 45 .

Systolic vs Diastolic Heart Failure

HF can result from any cardiac disorder that impairs the heart's ability to fill and or relax or empty, and the syndrome of HF consists of two entities, namely, systolic and diastolic dysfunction. Both can lead to HF and ultimately death. Inability to fill and relax the left ventricle is diastolic dysfunction, defined as an elevated end-diastolic pressure in a normal-sized ventricle. Difficulty emptying the left ventricle is systolic dysfunction, represented by a reduced ejection fraction. Almost one third of all HF patients have normal systolic function but abnormal left ventricular diastolic function. Diastolic ventricular relaxation is an energy-requiring process and not just simple passive elastic recoil. Normal ventricular filling is a prerequisite for normal ventricular emptying. It is important to differentiate between systolic and diastolic dysfunction because treatment is different for systolic and diastolic dysfunction. Frequently both systolic and diastolic dysfunction are...

Distension of Hollow Viscera

Using fixed-pressure distensions, the result is quite different if the gut contracts, both intraluminal volume and perception decrease (12). Hence, using these methods, perception of gut distension depends on the muscular activity of the gut, and varies upon contraction and relaxation. To overcome these problems, a new methodological approach, the tensostat, has been developed (13). The tensostat is a computerized air pump that applies fixed tension levels on the gut wall. Based on intraluminal pressure and intraluminal volume, the system calculates wall tension, by applying Laplace's law (either for the sphere or for the cylinder) and drives in the pump to maintain the desired tension level on the gut wall. Applying fixed-tension distensions, if the gut contracts, intraluminal volume decreases and intraluminal pressure increases, but perception remains unaffected. These data indicate that perception of gut distension in healthy subjects depends on stimulation of...

In Cardiomyocytes Of The Failing Heart

In ventricular dysfunction, ventricular hypertrophy, and other cardiac pathologies with chronic hemodynamic pressure or volume overload, cardiomyocytes undergo pheno-typic modifications and reexpress several fetal genes (Table 2), which may be energy-sparing (9,12,13). In contrast to the growing fetal heart, the fetal expression pattern of sarcomeric proteins (e.g., myosin, troponin T) and the proteins of the calcium-handling machinery in cardiomyocytes of failing hearts leads to impairment of myocardial contraction and relaxation as well as cardiac dilation. The myosin heavy and light chain isoform shift leads to a reduced myosin ATPase activity. Calcium plays a central role in the regulation of myocardial contraction and relaxation. A reduced activity or expression of sarcoplasmic SERCA-2a, which mediates diastolic calcium reuptake by the sarco-plasmic reticulum, the calcium-release channel, and voltage-dependent calcium channel as well as an increased activity of the plasmalemmal...

Mri Of Atherosclerosis Multi Contrast MRI of Atherosclerosis

The appearance of a thrombus or intraplaque hemorrhage, on MRI, largely depends on the state of hemoglobin contained in the hemorrhage or retained in the thrombus. Depending on the stage of the hemorrhage thrombus it may contain different oxidative and byproduct forms of hemoglobin such as hemosiderin, ferritin, oxyhemoglobin, deoxyhemoglobin, or met-hemoglobin. The different oxidative and byproduct forms of hemoglobin have particular magnetic resonance relaxation parameters that give them different signal intensities due to differences in their T1 and T2 (51-55). The progression of hemorrhage and subsequent thrombus and its appearance on MRI has been

Cognitive Behavioral and Nonpharmacological Treatments

Tity is considered unimportant, patients are less likely to manifest overt resistance. Rather than emphasize powerlessness, this approach assumes that people have within themselves the capacity to change. Although the efficacy of MET MI for cocaine abusers has yet to be proven, it would appear that its unique focus on readiness should, at minimum, help patients to engage in other forms of therapy. In addition, a few studies have begun to support the use of MET MI for treatment of cocaine abuse and dependence. In a small study examining 27 female workers with concurrent cocaine or heroin dependence, MI significantly reduced the women's cocaine use (Yahne, Miller, Irvin-Vitela, & Tonigan, 2002). Similarly, compared to patients who only underwent a detoxification program, patients who also received MI were more likely to be abstinent from cocaine following detoxification and demonstrated higher abstinence rates throughout the following relapse prevention treatment. In addition, MI was...

Overview Review of the Literature

Secondly, as children with higher levels of distress, anxiety, depression, and negative life events are more likely to be at increased risk of long-term pain and disability 26, 27 . psychological treatments are also a key component of the bio-psychosocial model. These treatments include modalities such as biofeedback, relaxation training, and cognitive therapies and are often incorporated in order to target the effects of chronic pain on an individual 28 . These targets may include a child . s mood, fear of pain, fear of activity, acceptance of pain, and any thought process that might contribute to the disabling effects of pain on the child. Cognitive .behavioral treatment programs that focus on pain education, learning pain management strategies that help to reduce problematic behavioral patterns such as activity cycling and activity avoidance, and reducing pain-related distress, fear, anxiety, and depression have been found to be effective 29 .

Lower Urinary Tract Symptoms and Sexual Dysfunction

Sexual dysfunction is poorly understood, although a number of common components have been identified such as upregulation of -adrenoceptor activity, alteration in a1-adrenoceptor subtypes, decreased NO bioactivity, and sex hormone imbalance. -Adrenoceptors are involved in the maintenance of smooth muscle contraction and relaxation in penile tissue. It has been suggested that any impairment of these receptors and their regulators such as the Rho Rho-kinase pathway will contribute to smooth muscle dysfunction, which is evident in both LUTS and erectile dysfunction. Endothelium dysfunction as a result of ROS-induced NO breakdown can also contribute to LUTS and erectile dysfunction. Testosterone alterations are well established as a cause of BPH and LUTS, and it is likely that any androgen imbalances may also lead to erectile dysfunction. For more information on sexual dysfunction, see Chapter 6.23.

Interaction of Sensory and Reflex Dysfunctions

Normally, ingestion of a meal induces a relaxation of the proximal stomach to accommodate the meal volume, and the magnitude of the relaxation is regulated by a complex net of reflexes (61,62). Hence, this partial relaxation prevents wall tension increments and symptoms, but still the residual contraction of the proximal stomach gently forces gastric content distally into the antrum and initiates gastric emptying. As the relaxatory input decreases, the proximal stomach regains tone and emptying progresses. A gastric hyporeactivity to relaxatory reflexes would predictably result in a defective volume accommodation of the proximal stomach and antral overload. In patients with functional dyspepsia, gastric tone and compliance are normal during fasting (47,48,63,64). However, the reactivity of the stomach to regulatory reflexes is abnormal, and the proximal stomach does not relax properly in response to reflexes arising from the antrum and the small intestine (14,48,65). Consequently,...

Other Magnetic Resonance Methods

By varying the image acquisition parameters, TR (pulse repetition time) and TE (echo time), it is possible to construct images of the proton relaxation times T1 and T2. The development of methods for echo planar imaging makes it possible to collect images with a large number of TR and or TE values quite rapidly and, thereby, to estimate localized T1 and T2 values very reliably. This relaxation time mapping is sometimes referred to as relaxometry. Changes in relaxation times may reflect anomalous cerebral development, as recently demonstrated in schizophrenia (Andreasen et al., 1991 Williamson et al., 1992 Yurgelun-Todd et al., 1995). Alternatively, alterations in cerebral perfusion may lead to small changes in T2 which can be detected using echo planar imaging (Teicher et al., 2000). In the area of substance abuse, relaxation time measurements have also been used to assess brain hydration. In general, as brain water content decreases, relaxation times become shorter. Within the brain,...

Histone Deacetylase Inhibitors

Histone deacetylases (HDAC) catalyse the deacetylation of lysine residues at the amino termini of core nucleosomal histones (42). This process is associated with chromatin relaxation and uncoiling, which permits the transcription of various genes including the key cyclin-dependent kinase inhibitor, p21 (42). By inhibiting HDAC, histone deacetylase inhibitors (HDI) cause hyperacetylation of histones. Hyperacetylation of histone H3 leads to transcriptional up regulation of p21, cell cycle arrest and apoptosis in tumor cells (42,43). The HDI acid SAHA induced p21 expression in one of the two CML cell lines and induced expression of p27, a key cell cycle regulator, in both of them (42). SAHA treatment was also associated with down regulation of p210Bcr-Abl protein. Combination treatment of CML cell lines with SAHA and imatinib resulted in a greater level of apoptosis than was achieved with either agent alone (42,44). This combination also produced synergis-tic induction of apoptosis in...

Mechanisms Of Diabetic Peripheral Neuropathy

Insulin is not responsible for glucose uptake in the peripheral nerves. For this reason, high glucose levels in the blood cause high nerve glucose concentrations. The polyol pathway, via reactions catalyzed by aldose reductase, converts glucose to sorbitol. Nerve fructose levels are also increased. Excess fructose and sorbitol induce a decrement in the expression of the sodium myoinositol cotransporter, which causes decreased myoinositol levels. This, in turn, creates decreased levels of Na K ATPase activity. Aldose reductase, when activated, depletes its cofactor nicotinamide adenine dinucleotide phosphate (NADPH), which causes decreased levels of nitric oxide and glutathione, which work to stop oxidative injury. The lack of nitric oxide stops vascular relaxation, which helps in the induction of chronic ischemia (60-65).

Structures of CS Proteoglycans

The mobility of the various components of cartilage may be investigated by 13C NMR relaxation times. Comparison of isolated chondroitin and its monosaccharides with whole cartilage samples has shown that the carbohydrate component of cartilage retains mobility, whereas the protein components remain relatively rigid (Huster et al., 2002 Naji et al., 2000).

Callitrichine and ateline ecology

The absence of female kin bonding emphasised in phylogenetic analyses of callitrichines and atelines is only partially consistent with ecological predictions. Vulnerability to predation may account for the cohesive groups of the small-bodied callitrichines (Caine, 1993), while the relaxation of predation pressures may account for the tendencies of the large-bodied atelines to adjust their grouping patterns in response to the size of food patches. The fruit, invertebrate prey, and plant exudates eaten by calli-thrines include defensible resources that could lead to female kin bonding unless, as van Schaik (1989, p. 212) has noted, 'female dispersal is enforced by some other factor'. The social and hormonal mechanisms that can inhibit reproduction in subordinate callitrichines may exemplify one such 'other factor'. Both the individualistic (non-kin) hierarchies among some female Saguinus and the nepotistic (kin) hierarchies among female Callithrix (Garber, 1994) are consistent with the...

Mechanisms of Renal Dysfunction

Calmodulin displaces caveolin-1, activating eNOS and leading to production of NO, which diffuses to vascular smooth muscle and causes relaxation by activating guanylate cyclase, to increase cyclic guanosine monophosphate (cGMP) levels which in turn produce a vasodilatory response.25

Management of Renal Dysfunction

Aside from the classic treatment of hypertension, an emerging approach to renal dysfunction is the treatment of the components that trigger endothelial dysfunction, e.g., NO bioavailability and oxidative stress. For example, oral treatment with L-arginine, the precursor of NO, reduces blood pressure and improves endothelial dysfunction in hypertensive patients.60 Statins and lipid-lowering drugs improve endothelial dysfunction in hypertensive animal models by enhancing NO levels.61 Antioxidants also can improve endothelial dysfunction in hypertensive animal models. For example, the SOD mimetic tempol decreases hypertension and oxidation stress and improves endothelium-dependent relaxation and kidney damage in hypertensive animal models such as AT-II-infused mice and Dahl salt-sensitive rats.62

Physiological Effects of BNP

BNP is a potent natriuretic, diuretic, and vasorelaxant peptide. It coordinates fluid and electrolyte homeostasis through its activity in the central nervous system (CNS) and peripheral tissue. BNP promotes vascular relaxation and lowers blood pressure, particularly in states of hypervolemia. It inhibits sympathetic tone, the renin-angioten-sin axis, and synthesis of vasoconstrictor molecules such as catecholamines, angiotensin II, aldosterone, and endothelin-1 (28). An improvement in central hemodynamics, including the cardiac index, in patients with chronic heart failure is achieved through suppression of myocyte proliferation, cardiac growth, and compensatory hypertrophy of the heart (28). Its renal effects include increasing the glomerular filtration rate and enhancing sodium excretion. BNP does not cross the blood-brain barrier, yet it reaches areas of CNS that are not protected by the barrier. Its action in the CNS complements that in the periphery. BNP reinforces the diuretic...

Aids Palliative Care And Death And Dying

Different methods of comfort care such as pastoral care, hypnosis, music, relaxation, meditation, writing, and art can be incorporated with much success, and these methods need to be integrated and offered to persons during the entire course of their illness on a routine basis (Cohen, 1999). Depression, anxiety, pain, and other mental health disorders need to be addressed with both psychotherapy and pharmaco-therapy using multiple models, including crisis, individual, group, and family therapy, over the entire spectrum of illness. Integration of spiritual care has been shown to provide comfort and solace to persons suffering with cancer (Saunders, 1988 Jacox et al., 1994). Attempts to provide these interventions across the spectrum of HIV illness will improve the seamless attention given to the associated suffering and distress.

Algorithms for Combinatorial Search and Optimization

Combinatorial search and optimization methods are well developed and suited to the incorporation of problem-related knowledge in order to find solutions quickly. There are two types of general methods for solving combinatorial problems depending on the strategy used (1) divide-and-conquer methods and (2) relaxation methods. In divide-and-conquer methods, problems are solved by answering subproblems and building up the solution. For example, in the traveling salesman problem, a route for the complete journey could be constructed by adding cities one at a time and taking into account the lengths of these intermediate routes. Well-known search techniques in this class, used in de novo design methods, include the depth-first, branch-and-bound, and A* searches.56 In contrast, in relaxation methods, an initial solution would be proposed and used as a baseline for improvements. In the traveling salesman problem, all cities could be initially visited in a random order to decrease the length...

BNP and Diastolic Dysfunction

The European Society of Cardiology recently published its recommendations regarding the diagnosis of isolated diastolic heart failure, which included the presence of symptoms, presence of normal or mildly reduced systolic function, and evidence of abnormal LV relaxation and filling, diastolic distensibility, and diastolic stiffness (62). Redfield et al. studied 657 subjects with normal systolic function and found that BNP concentrations were higher than those with isolated diastolic dysfunction (62). Recently, Lubien et al. studied 294 patients referred for echocardiography to evaluate ventricular function were studied (63). Patients with abnormal systolic function were excluded. BNP concentrations were blinded from cardiologists making the assessment of LV function. Patients with a restrictive filling pattern (n 37) had higher BNP concentrations (428 pg mL) than patients with impaired relaxation (230 pg mL). The area under the ROC curve for BNP to detect diastolic dysfunction by...