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Brain Evolution System

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Isovolumic ventricular relaxation

Although one tends to think of the two ventricles as contracting and relaxing together, there are slight differences in the timing of their contractions and in the opening and closing of the cardiac valves. The left ventricle begins to contract just before the right. Left ventricular pressure therefore increases slightly before right ventricular pressure, and the mitral valve closes before the tricuspid valve. However, because pulmonary artery pressure is much lower than aortic pressure, the pulmonary valve opens first and right ventricular ejection begins before the left. Similarly, the higher aortic pressures result in the aortic valve closing before the pulmonary valve at the end of ventricular systole. At the end of isovolumic relaxation, the lower right ventricular pressures lead to the tricuspid valve opening before the mitral valve.

Relaxation Techniques

Relaxation techniques, such as progressive muscle relaxation and controlled breathing, alter pain perception by triggering a relaxation response (muscle relaxation, reduced heart rate and blood pressure, and improved mood). Several methods of progressive muscle relaxation are used to distract patients from their pain and to reduce pain intensity. Paradoxical reactions can occur in individuals who experience increased distress when attending to bodily sensations. For this subset of patients, distraction or imagery without body scanning is typically more effective.

Macroscopic Kinetics Relaxations Such as Synaptic Currents and Noise

Changes in the occupancy of the open-channel state of the receptor as a function of time (pAR*(t)) in response to a perturbation of the receptor equilibrium can be used to obtain information about the rates of channel gating and the interaction of drugs with ion-channel receptors. The system is said to relax towards a new equilibrium. The time course of the relaxation is used to measure rates from the average behavior of many ion channels in a recording, while noise analysis uses the frequency of the moment-to-moment fluctuations in occupancy of the open-channel state at equilibrium to provide information about the rates in the receptor mechanism. For k states, a relaxation (or noise spectrum) will contain k_j exponential (or Lorentzian) components. Thus, the mechanism in Eq. (6.25) above will have two states in the absence of blocker and so give rise to relaxations (or noise spectra) that can be fitted with single exponential (or Lorentzian) functions. Addition of the blocker creates...

Adequacy of muscle relaxation

Clinical signs of return of muscle tone include retraction of the wound edges during abdominal operations and abdominal muscle, diaphragmatic or facial movement. An increase in airway pressure (with a time- or volume-cycled ventilator) may indicate a return of muscle tone. Quantitative estimation of neuromuscular status may be obtained with a peripheral nerve stimulator (see Ch. 38). Small increments (e.g. 25-35 of the original dose) of muscle relaxant may be given to maintain relaxation alternatively, an i.v. infusion may be a more convenient method of administration, but the use of a peripheral nerve stimulator is mandatory with this technique.

Relaxation Based Treatments

A number of relaxation-based approaches are used to diminish arousal, divert attention from pain, and reduce anxiety (see Table 13.9). Table 13.9 Relaxation training and biofeedback basics Relaxation training includes progressive muscle relaxation, autogenic relaxation, diaphragmatic breathing, guided imagery, and similar techniques intended to reduce autonomic arousal accompanying headache. Biofeedback provides patients with real-time information regarding surface EMG tension, peripheral temperature, skin conductance, the ratio of chest wall to diaphragmatic breathing, heart rate reactivity, and other physiological indices of stress. This is most effective when coupled with relaxation training.

Definition of Relaxation Processes

The term relaxation, as applied in physical chemistry (cf. Section 4.6.8), refers to molecular processes occurring after the imposition of a stress on a system. Thus, one can have a system at equilibrium to which a new constraint is applied (e.g., an electric field switched on suddenly onto a dipole-containing liquid). The system is then constrained to a new position of equilibrium. The time it takes to change position is called the relaxation time. To understand better what is meant by relaxation time, consider a system under the following equilibrium

Effects of Ions on the Relaxation Times of the Solvents in Their Solutions

There are three new effects related to the properties of relaxation time that arise when ions are added to water. First, the solution's relaxation time appears to change. If solvent molecules are far away, say more than 1000 pm distant from an ion, the ion's effect on the relaxation time will be negligible. Conversely, water molecules bound to ions will be what is called dielectrically saturated they will be so tightly held in the ion's local electric field that they will not be affected by the applied electric field used to measure the dielectric constant of the solution. The average relaxation time of all the waters will be increased, because the water molecules attached to the ions now have, in effect, an infinite relaxation time. The second effect is related to the formation of ion pairs. If ion pairs or other ionic aggregates are present, they will introduce a new relaxation time above that exhibited by the pure solvent. Fig. 4.100. Argand diagrams of a completely dissociated...

Detailed Relaxation Instructions

There are three sets of relaxation instructions that follow. The first set has both a tension phase and a relaxation phase. The second uses imagery and the third is a breathing exercise. These types of relaxation are appropriate for adults and children ten years or older. The relaxation instructions should be spoken in a slow, quiet voice. It is best to learn the instructions so that they flow smoothly. It is OK to vary the instructions to suit the patient. The instructions can be tape recorded and then played back at a convenient time. Children and adults can learn relaxation and then apply it when needed.

Make time for playtime arid relaxation

People who have eating disorders don't often know the meaning of being appropriately selfish and tend to put their own needs and wants far down their lists of priorities and to-dos. If you're going to let go of an eating disorder, you must put something else in its place. That is where your hobbies and interests can be effective. Figure out what you like to do (not what you think you should like, or what you think someone else wants you to like) and try to find a balance between work and play. Perfectionism can't be allowed to enter the picture eliminate the word perfect from your vocabulary. The simplest relaxation techniques such as taking a bath, going out for a walk, listening to soothing music, stroking your pet, lighting incense and candles in your room and reading quietly can help, as can more skill-based techniques such as yoga.

Progressive Muscle Relaxation Instructions

Prepare for this strategy by taking off glasses, contact lenses, and or shoes, and loosening any tight clothing. Lie down in a comfortable place, with your arms at your sides. For comfort, you might wish to place pillows under your knees, the small of the back, and your head. (You can also do this in a seated position, with obvious adaptations of the instructions.) Try to stay alert and avoid sleeping as you practice this relaxation skill (unless, of course, you are practicing this in bed as an aid to sleep). Starting with the feet, we will progressively tense and then deeply relax the major muscle groups of the body. Remember to fully concentrate first on the sensation of tension, and then on the contrast, the state of relaxation. Tense relatively hard, but always stop short of discomfort or cramps. 2. When I say tense, I'd like you to point both of your feet and toes at the same time, leaving the legs relaxed. Notice the pulling sensation, or tension, in the calves and the bottoms...

Signal Detection Relaxation

After a magnetized spin system is perturbed from its equilibrium condition by an RF pulse, it will return to the equilibrium state after a sufficient time once the perturbation is removed. This process is known as free induction decay or relaxation, which was first discovered by Bloch in his seminal work 5 . The recovery of the longitudinal component Mz is called longitudinal or Ti relaxation, whereas the decay of the transverse magnetization Mxy is called transverse or T2 relaxation. The underlying mechanism is quite complicated hence, only the dominant mechanism will be mentioned without going into further details. Accounting for the Tx and T2 relaxations, the Bloch equation describes the magnetization process as follows M and B are the vector forms of magnetization and the magnetic field, respectively, and i, j, and k are unit vectors along x, y, and z, respectively In the Bloch equation, the cross product term, which is the first term on the right-hand side, describes the...

Magnitude of the Relaxation Force and the Relaxation Component of the Drift Velocity

The relaxation force is zero when the centers of charge of the ion and its cloud approximate treatment that the relaxation force is proportional to d, i.e., proportional the cloud. On this basis, the relaxation force FR will be given by the maximum total motion under the external field, i.e., d K .Hence, the relaxation force is In the above treatment of the relaxation field, it has been assumed that the only motion of the central ion destroying the spherical symmetry of the ionic cloud is motion Onsager considered the effect that this erratic character of the leadership would have on the time-averaged shape of the ionic cloud and therefore on the relaxation field. His final result differs from Eq. (4.309) in two respects (1) Instead of the numerical factor ,, there is a factor and (2) a correction factor w 2z2 has to be introduced, the quantity (a being given by Thus, a more rigorous expression for the relaxation force is Substituting the expression (4.313) for the relaxation force in...

Procedure for Calculating the Relaxation Component of the Drift Velocity

It is clear that the relaxation component v of the drift velocity of an ion can be obtained by substituting for the relaxation force FR in The problem therefore is to evaluate the relaxation force. Since the latter arises from the distortion of the ionic cloud, one must derive a relation between the relaxation force and a quantity characterizing the distortion. It will be seen that the straightforward measure of the asymmetry of the cloud is the distance d through which the center of charge of the ion and the center of charge of the cloud are displaced. However, the distortion d of the cloud itself depends on a relaxation process in which the part of the cloud in front of the moving ion is being built up_and the part at the back is decaying. Hence, the distortion d and the relaxation force FR must depend on the time taken by a cloud to relax, or decay. Thus, it is necessary first to calculate how long an atmosphere would take to decay, then to compute the distortion parameter d, and...

Progressive Muscle Relaxation PMR

Progressive muscle relaxation (PMR) is the first form of structured relaxation developed in the West. Its originator, Dr. Edmund Jacob-son, demonstrated that when people consciously relaxed their muscles, they became mentally calmer at the same time. Jacobson found, however, that simply trying to relax is only partially effective. One must paradoxically increase muscle tension for a while in order to help the brain to deeply relax the muscles. Thus, Jacobson developed a procedure to progressively tense the major muscle groups of the body, and then deeply relax those same muscle groups. As one progresses from one muscle group to another, the body becomes more and more relaxed (that is, muscle tension progressively decreases). Perhaps more importantly, the nervous system becomes more and more calm. In controlled research, PMR has been found to reduce blood pressure. It is also a very effective treatment for insomnia.1 PMR is a very active form of relaxation. It requires the expenditure...

Muscle relaxation

In veterinary practice the muscle-relaxant properties of the anaesthetic agents provide adequate relaxation for most procedures. Specific muscle-relaxant drugs cause complete neuro-muscular blockage in skeletal muscle but have no effect on Muscle relaxation is used in the following cases Oesophageal foreign bodies can cause marked spasm of the surrounding muscles and neuromuscular relaxation may aid their removal without recourse to surgery


Relaxation is a behavior that is usually incompatible with the experience of anxiety, distress, or pain. Through relaxation, children can regulate their emotional and physical responses to stressful events by learning to reduce physiological changes associated with stress and pain (e.g., increased heart rate, breathing, temperature, and muscle tension). Commonly used relaxation strategies include deep breathing exercises, guided imagery, and progressive muscle relaxation. Although progressive muscle relaxation and deep breathing are intended to directly influence somatic reactions, imagery-based relaxation aims to induce somatic reactions indirectly by influencing cognitions. In a study aimed at examining the physiological effects of relaxation training in children, Lohaus et al. (2001) found that imagery-based relaxation training led to decreased heart rate and skin conductance levels. Their findings did not indicate a similar physiological pattern for children trained in progressive...

Spin Relaxation

However, the spin system is subject to other interactions, the very interactions that bring about thermal equilibrium. These interactions can be collectively called spinlattice interactions. They comprise radiationless interactions between the spin system and the thermal motion of the lattice or surroundings. The inverse of the rate of spin-lattice induced transitions is described by a characteristic time called the spin-lattice relaxation time and is denoted by the symbol T1. At sufficiently low microwave powers, the spin-lattice relaxation processes are fast enough to maintain a thermal equilibrium population between magnetic energy levels. As the microwave power is increased the net upward rate of microwave-induced spin transitions from the lower to upper states is increased and eventually competes with the spin-lattice induced net downward rate. The spin populations in the two magnetic states become more equal and the ESR signal intensity decreases this is known as power...

My daughter doesnt hug me anymore and she doesnt like it when I hug her Whats happening

The cows seemed to relax when the side panels of the chute were pressed against their bodies. After experiencing a panic attack one day, Grandin put her body into the machine and had her aunt adjust the side panels so that they squeezed her body. She experienced a wave of relaxation that she had never felt before. After this, she constructed her own human squeeze machine.9

Acupressure Fingers Hands and a Whole Lot More

By reading this chapter and following the pictures, you'll feel more confident in the way you perform acupressure, including just the right amount of pressure. Every time you practice, your sensitivity will increase. By asking yourself and others how they feel afterward, you'll continue to guide yourself along in the right direction of healing and centered relaxation. So, no more excuses It's time to give the best acupressure session there is. Let's go for it

Phosphodiesterase inhibitors

Phosphodiesterase inhibitors increase intracellular cAMP concentrations by inhibition of the enzyme responsible for cAMP breakdown (Fig. 7.8). Increased intracellular cAMP concentrations promote the activation of protein kinases, which lead to an increase in intracellular Ca +. In cardiac muscle cells, this causes a positive inotropic effect and also facilitates diastolic relaxation and cardiac tilling (termed 'positive lusitropy'). In vascular smooth muscle, increased cAMP decreases intracellular and causes marked vasodilatation. Several subtypes of phosphodiesterase (PDE) isoenzyme exist in different tissues. Theophylline is a nonspecific PDE inhibitor, but the newer drugs (e.g. amrinone, enox-imone and milrinone) are selective for the PDE type III isoenzyme which occurs in the myocardium, vascular smooth muscle and platelets. PDE III inhibitors are positive inotropes and potent arterial, coronary and venodilators. They decrease preload, afterload, pulmonary vascular resistance and...

Coronary Circulation Big Picture

Coronary vessels are classified as an end circulation that is, they may not anastomose with each other. Therefore, blockage of any of these vessels is detrimental because once a coronary artery is blocked cardiac tissue supplied by that vessel is damaged. Blood flow in the coronary arteries is maximal during diastole (ventricular relaxation) and minimal during systole (ventricular contraction) because of the compression of the blood vessels in the myocardium during systole. All coronary arteries branch from either the left or the right coronary arteries.

Psychotic Syndromes

In patients with chronic mild or moderately severe anxiety, benzodiazepines, used sparingly for a few weeks to several months, can be helpful. When chronic treatment is necessary, buspirone, tricyclic antidepressants, and MAO inhibitors may be utilized in selected patients, particularly those with concomitant depression. Beta-blockers may also be useful in certain cases. Referral to a neuropsychologist or psychotherapist for training in self-reliance and relaxation techniques including biofeedback, meditation, and self-hypnosis should also be considered. The treatment of obsessive compulsive disorders should involve both pharmacological and psychological measures. Medications can significantly reduce the symptoms in over 50 percent of patients. Clomipramine is generally considered the drug of first choice, but other drugs with serotonergic properties such as fluoxetine, paroxetine, and clonazepam can be used.

Therapeutic Interventions

Help the client to develop a list of the things he she can do to reduce the negative effects of ADD (e.g., reduce extraneous stimulation, make lists and reminders, take medication, utilize relaxation techniques, talk to someone, go to AA NA meetings, engage in physical exercise). 20. Teach the client relapse prevention techniques of going to meetings, talking to someone, calling a sponsor, utilizing relaxation skills, engaging in physical exercise, and turning worries over to a higher power. 21. Using relaxation techniques (e.g., progressive relaxation, guided imagery, biofeedback), teach the client how to relax assign him her to relax twice a day for 10 to 20 minutes. 22. Encourage the client to implement relaxation skills as a coping and focusing mechanism when feeling tense and frustrated by a learning situation or when tempted to relapse into addictive behavior.

Ventricular Fibrillation Experimental Evidence and Basic Concepts 1880s1920s

The first important research that treated VF with deeper insight into its pathophysiology was the work by John A. MacWilliam, a physiologist at Aberdeen University, who had, like every other physiologist, studied at Ludwig's laboratory. He was there at the same time as Walter Gaskel and Henry Bowditch of Harvard. In 1887-1889 MacWilliam published results of his experiments on ventricular fibrillation. He was convinced that the arrhythmia occurred independently of any mechanical relation of the ventricles to the rest of the heart, and of any nervous relation of the ventricles to the rest of the heart or to the extra-cardiac nerves. He demonstrated that fibrillary movements of the heart were the result of the lack of harmony in the contraction and relaxation of the minute muscular fibers that compose the myocardium, thus supporting the myogenic character of VF.34 The general appearance of VF was well known, but MacWilliam's accurate and colorful description claimed both a new clinical...

Behavioral Interventions

With brain tumor to function at the highest level possible for the longest time possible and has been shown to be cost effective.15 There are a number of behavioral strategies that can also enhance functional outcome in brain tumor patients. There is a growing literature about the positive effects of exercise on cancer-related symptoms.4 Behavioral interventions such as relaxation therapy and self-hypnosis may be very useful as well. Such strategies can alleviate symptoms such as pain, nausea, and fatigue and help patients relax and focus when they feel overwhelmed. Life-style alterations may also be useful. For instance a person with increased distractibility may be able to maintain employment given reasonable accommodations, such as flexibility of deadlines and a quieter work environment. Students may be able to continue in school if allowed to tape lectures and to take tests without time constraints.

Dynamical Picture of Molecular Ensembles

The mechanisms by which molecules change their energy are intermolecular collisions and the absorption and spontaneous or stimulated emission of photons. This involves that molecules coexist and are in dynamic equilibrium with a spectrum of photons continuously created and annihilated. Intermolecular collisions and absorption emission of photons are also the mechanisms by which systems out of equilibrium reach the thermal, mechanical, composition, and chemical equilibrium through the superposition of several relaxation processes. However, it must be stressed that this is a simplified picture because it does not consider that the occurrence of intermolecular interactions prevents the assignment of well-defined energy packets to each molecule.

Posterior Resin Composite Restorations

A major disadvantage of composite resin is the polymerization shrinkage these materials undergo following light curing. The extent of polymerization shrinkage is greater with microfilled resins, but due to plastic flow relaxation some of the polymerization shrinkage stress is dissipated and not transferred to the adhesive bond. The likelihood of gap formation and failure of the adhesive bond is dependent upon the C or configuration-factor (i.e., the ratio of bonded to unbonded surface in a restoration). An increase in the C factor results in a greater contraction stress because the possibility of plastic

Liquid Crystalline Polymers and Polymer Blends via Hbonding

The addition of 2.6 wt C60 enhanced the tendency to form interpolymer complexes due to its strong hydrophobic interaction. The dynamic mechanical behavior was studied, as well as the blend homogeneity via solid state NMR spectroscopy 50 . They found that the mixing was complete even at a scale of 1-3 nm, as verified by comparing the proton spin lattice relaxation times in the rotating frame. Other studies using ESR methods on the blend miscibility of poly(styrene-co-methacrylic acid) poly(butylmethacrylate) were performed by Qiu et al. 51 , revealing the maximum miscibility at about 29 mol of carboxylic acid. Another method probing the heterogeneity in blends consisting of poly(vinyl relied on dielectric relaxation spectroscopy 52 , revealing a larger dynamic heterogeneity in the copolymers in relation to the blends with the pure homopolymers. Jiang et al. 53 compared the ionic interaction with the hydrogen-bonding interaction in mediating polymer miscibility. They...

Normal Right Atrial Pressure Pulse Contours

Atrial contraction is followed not only by atrial relaxation but also by ventricular contraction. Both events follow each other in succession during normal atrioventricular (A-V) electrical conduction (during normal PR relationship). Both events lead to a fall in atrial pressure. The fall caused by atrial relaxation completes the a wave and is termed During ventricular contraction, which follows atrial contraction, the ventricular pressure rises, and once it exceeds the pressure in the atrium, the tricuspid valve becomes closed. As ventricular systole continues, RV pressure rises, and once it exceeds the pulmonary diastolic pressure, the pulmonary valve opens and ejection of blood into the pulmonary artery occurs. During this phase of ventricular systole, however, the atrial pressure continues to fall. This fall in atrial pressure is termed the x' descent. This should be distinguished from the x descent caused by atrial relaxation (26). The x' descent, on the other hand, is caused by...

Jugular Venous Inflow Velocity Patterns And The Relationship To The Right Atrial Pressure Pulse

Although the venous inflow in the jugulars is continuous, the jugular venous flow velocity, which is similar to flow velocity in the superior vena cava, in normal subjects is biphasic, with one peak in systole corresponding to the x' descent of the RA pressure pulse and a second peak in diastole corresponding to the y descent (allowing, however, for transmission delay) (Fig. 2A,B). The systolic flow (Sf) peak is normally more dominant compared to the diastolic flow (Df) peak, just as the x' descent is more dominant compared to the y descent in the normals (40). Venous inflow during atrial relaxation under normal conditions can only be seen on Doppler tracings ofjugular venous flow as a notch on the upstroke of the Sf velocity corresponding to the x descent whereas the peak of the Sf always corresponds to the x' descent (Fig. 2C). Separate atrial relaxation flow as such can be demonstrated, however, during periods of A-V dissociation and when the PR interval is long (35,36,39,40). Fig....

General Considerations

Studies have shown that the frequency of use of complementary or alternative medical therapy in the United States is far greater than previously reported. These therapies include relaxation techniques, imagery, chiropractic, massage, spiritual healing, herbal medicine, acupuncture, homeopathy, folk remedies, and prayer, to name a few. It has been estimated that 42 of the American population uses at least one of these and other alternative healing methods to satisfy their medical needs. The most common users of complementary and alternative therapy are the more affluent people, women, those better educated, individuals born after 1950, and those who are concerned about emotional stress and the environment. The most common therapies were relaxation techniques (18 ), massage (12 ), herbal medicine (10 ), and megavitamin therapy (9 ). The perceived efficacy of these therapies ranged from 76 (hypnosis) to 98 (energy healing). The number of visits to providers of this health care is greater...

Why Muscle Relaxant Drugs Are Used

Prior to the use of muscle-relaxant drugs, the only method available to the anesthesiologist to assure the patient would not move during surgery was by the administration of very deep levels of ether anesthesia. As anesthesia was deepened with ether, the patient's muscles would relax, but this relaxation came at a heavy price to the patient Deep ether anesthesia would produce dangerous levels of cardiac and respiratory depression. Cardiovascular collapse and respiratory arrest with ether anesthesia were not uncommon before the introduction of curare. With the availability of muscle-relaxant drugs today, the anesthesiologist does not have to subject you to dangerously deep levels of general anesthesia to achieve akinesia and adequate muscle relaxation for surgery.

Polymers Connected with Trivalent Hydrogen Bonds

Revealing similar association constants of the hydrogen-bonding interactions of the polymers as compared to small molecular weight compounds. In the solid state, sheet-type structures are formed as studied by solid-state NMR spectroscopy, TEM- and thermal measurements. DSC methods clearly revealed the presence of two separate phases, whereas solid-state 13C-MAS-NMR demonstrated the different chain mobility of the PEK- and PIB chains via relaxation measurements.

Investigating Your Blood Pressure Numbers

Diastolic pressure is the bottom, smaller number. This represents the pressure in your arteries while your heart is relaxing between beats. During this relaxation period, your heart is filling up with blood for the next squeeze. Although both numbers are critically important, your doctor might be more concerned with an elevated diastolic number because this indicates that there is increased pressure on the artery walls even when your heart is resting.

Signals Activated by AR Subtypes

The multiplicity of AR subtypes suggests that they may activate many different, redundant, or potentially conflicting signaling pathways, resulting in a multitude of different functional responses. This is in fact the case because AR activation causes effects ranging from contraction or relaxation of vascular smooth muscle contraction of cardiac muscle decreased motility of intestinal smooth muscle release of energy stores from liver, fat, and skeletal muscle and many others. Many of these different effects are simply caused by the presence or absence of particular AR subtypes in a particular tissue and are thus to be expected. For example, bronchial smooth muscle contains primarily P2-ARs, which cause relaxation most vascular smooth muscles contain primarily a1-ARs, which cause contraction.

Dielectric Constant of Solutions

The main purpose of this section is to give the basis of how measurements of the dielectric constants of ionic solutions can give information on solvation, particularly primary hydration numbers. However, dielectric measurements as a function of frequency also give information on the dynamic behavior of water by allowing us to determine the relaxation time of water in ionic solutions and expressing the changes in terms of the number of water molecules bound to the ion. Dielectric measurements of ionic solutions are also important for another topic that will be dealt with in Section 2.22, namely, electrostriction, the study of the compressive effect of the very strong electric fields produced by ions on the surrounding medium. When one looks into the effect of ions on the frequency at which water undergoes relaxation (i.e., when water no longer reacts to an applied field), it is found that the cation has a greater effect than the anion. The reason is shown in Fig. 2.28. For the cation,...

How Does One Measure the Dielectric Constant of Ionic Solutions

Two approaches can be used to avoid this difficulty. In the one, which is best used for frequencies well below the relaxation frequency of water, one measures the force between two plates that have the conducting liquid between them. This force is independent of the conductance of the liquid or the direction of the field. If d is the distance between the plates, it is easy to show that the force is If it is desired to measure the dielectric constant at high frequencies (e.g., 10 -10 Hz), a different technique is necessary, partly because one may be working in the range of the relaxation time of water. The measurement of this, and the degree to which it is affected by the presence of ions, provides yet another way of finding how many molecules of water are bound to cation and to anion. The technique involves the use of a wave guide consisting of a coaxial liquid-filled cell, containing a probe that is moved about until the interference signal between it and an alternator is found to be...

What Are The Other Elements Of Treatment Besides Medical Therapy

The psychosocial aspects of epilepsy are an important component of the disorder. Patients often have major concerns about health, independence, personal growth, relationships, well-being, and security. These issues are discussed more fully in Chapter 5 and can be appreciated and addressed only if the physician attempts to uncover the psychologic and social problems that adversely affect the patient's quality of life. This process begins with taking a complete psychosocial history, including information about any previous psychiatric illnesses or treatments, education, employment, driving, insurance, interpersonal relationships, and attitude toward having epilepsy. A number of questionnaires developed for this purpose supplement the psychosocial history and provide a quantifiable means of assessing and following patients as pharmacotherapeutic and psychosocial interventions are implemented.3 Uncovering a source of psychosocial stress may lead to an effective strategy for reducing the...

Mechanisms in CBF Control

Recent interest has focused on the role of nitric oxide (NO) in the control of cerebral haemodynamics. NO is synthesized in the brain from the amino acid L-arginine by the constitutive form of enzyme nitric oxide synthase (NOS). This form of the enzyme is calmodulin dependent and requires Ca++ and tetrahydrobiopterin for its activity and differs from the inducible form of the enzyme which is present in mononuclear blood cells and is activated by cytokines. Under basal conditions, endothelial cells synthesize NO which diffuses into the muscular layer and, via a cGMP-mediated mechanism, produces relaxation of vessels. There is strong evidence to suggest that NO exerts a tonic dilatory influence on cerebral vessels. It is important to emphasize that data on NO obtained

Nursing interventions

Music has been used as a distraction therapy to help reduce a patient's perception of pain in the immediate postoperative period (Taylor etal, 1998). Relaxation has been successfully used as a technique to reduce pain in cancer patients (Sloman et al., 1994) and in older men undergoing hip replacement (Parsons, 1994). Other strategies may be used to assist in pain relief. Measures such as turning, lifting or massage may be very comforting. Simple aids such as a bed cradle to reduce the weight of the bedclothes can be very effective.

Clinical Assessment Of The Jugular Venous Pulse

In most normal adults what one will see is simply one large downward movement or descent, which will be synchronous with the pulse. This jugular contour of the normal adult can be simply described as showing single X descent. It immediately implies a normal contour. In young subjects one may see a major descent in systole with the pulse and a much smaller descent slightly after the pulse, indicating the pattern of the X descent followed by a small y descent. This contour can be described as a dominant X descent. This description implies the presence of a small y descent. Occasionally there may be a slight hesitation in the systolic descent because of the presence of an X descent (caused by atrial relaxation) quickly followed by the X descent, which is of course caused by the descent of the base. The combined movement will still be synchronous with the pulse, indicating a normal contour.

Maintenance of anaesthesia

Inhalational anaesthesia with spontaneous ventilation is appropriate for superficial operations where profound muscle relaxation is not required. The patient is allowed to breathe spontaneously and a volatile anaesthetic agent such as halothane, enflurane, isoflurane or sevoflurane is used with carrier gases nitrous oxide and oxygen. Most anaesthetic machines will not deliver less than 30 oxygen and have an interlocking device to ensure this. These volatile agents are delivered from vaporisers, which are specially calibrated containers that will deliver a constant percentage of agent irrespective of the gas

Epigenetic Factors Regulating Ventricular Development

Schematic of epigenetic events regulating chromatin structure and transcription. Acetylation of specific lysine residues in tails of histone H3 or H4 by histone acetyl-trans-ferases (HATs) results in relaxation of chromatin structure, making target DNA more accessible to DNA-binding transcription factors. The reverse reaction is catalyzed by histone deacetylases (HDACs) and results in condensation of chromatin into a transcriptionally silent state. Deacetylated residues can be methylated by histone methyl-transferases (HMTs), causing a more permanent state of transcriptional silencing. Acetylated (Ac) or methylated (Me) residues are recognized by bromodomain (BD)- or chromodomain (CD)-containing proteins, respectively. Figure 3. Schematic of epigenetic events regulating chromatin structure and transcription. Acetylation of specific lysine residues in tails of histone H3 or H4 by histone acetyl-trans-ferases (HATs) results in relaxation of chromatin structure, making target...

Magnetic Resonance Imaging

Since its inception in 1973, magnetic resonance imaging (MRI) has been a revolutionary development in its scope and utility. The range of parameters that may be mapped using nuclear magnetic resonance has continued to increase and currently spans such phenomena as proton density measurement, nuclear magnetic relaxation times T1 (longitudinal relaxation time) and T2 (transverse relaxation time), flow in large vessels, diffusion, perfusion, temperature, blood volume, and blood oxygenation. All of the above-mentioned parameters have applications of clinical relevance, and many of them are in routine use. Clinical MRI is likely to move on from its current role simply as a structural technique for visualizing pathology, since researchers have now developed methods used to measure dynamic or functional aspects of human physiology. One of the significant applications of dynamic functional MRI is in the visualization of localized neuronal activity, inferred through its physiological...

Blood Volume Imaging Technique

For some years now, bolus injections of chelated contrast agents, in particular gadolinium diethylenetriamine pentaacetic acid, have been used to assess regional cerebral blood volume, and, when the mean transit time of the contrast agent through the brain is known, cerebral blood flow. The high paramagnetic nature of these contrast agents alters the relaxation processes of water molecules in their surrounding. Changes are evident as a shortening in the relaxation times, and it is this shortening that is used to obtain a qualitative map of regional cerebral blood volume. The major disadvantages of this technique are the necessity of repeated bolus injections of a contrast agent, the potential for subject motion between injections to mask any regional cerebral blood flow (rCBF) changes, and the limited number of neurological states that can be studied in a single session.

Lipid Peroxidation and Free Radical Formation

Endothelial nitric oxide (NO) is normally associated with relaxation of vascular endothelium and in this setting may aid recovery from acute ischaemic insults. However, generation of neuronal NO, often triggered by EAAs, may result in cellular injury. One of the mechanisms of such injury involves the combination of NO with hydroxyl radicals to generate the highly reactive peroxynitrite species, which can result in molecular oxidant injury.

What youll choose to change will depend on your unique set of circumstances your goals the time frame you set for

A number of tools can help you get comfortable with this initial process of recovery, some of which you may already know about, such as journal writing, taking relaxation breaks, and cultivating relationships with people you trust and enjoy. Other steps will probably be new to you, such as taking dictation from yourself by answering deeply personal questions noting, challenging and changing your negative self-talk and negative triggers and defusing your eating environment one step at a time to help you begin thinking about food and eating in non-eating-disordered ways. Eventually, you'll change how you respond to and communicate with people so the eating disorder won't have to do that for you. In addition, your world view that thinness determines your personal worth will shift, and you'll rebuild self-esteem on a more secure foundation.

Benzene Tricarboxamide BTC

Some related CTC derivatives (Fig. 3b) also form viscoelastic solutions in several non-polar solvents 35 , but the rheological signature is different from the case of BTC the frequency dependence of the storage and loss moduli cannot be described by a single relaxation time 36 . Two relaxation times are necessary to adequately fit the data, so that the authors propose a model where the supramolecular polymer would present alternative sequences of rigid rod-like parts and more flexible parts. The increased rigidity of CTC compared to BTC is attributed to its particular hydrogen bonding pattern because of the lack of n-stacking interaction and the lack of conjugation between the amides and the cyclohexane ring, the hydrogen bonds are believed to be parallel to the column axis (Fig. 3b). This hypothesis is supported by X-ray crystallography of a model compound 37 . The straight hydrogen bonding pattern of CTC may then lead to fewer defects (and thus more rigidity) than the helical...

How Do Lifestyle And Living Conditions Affect Seizure Control

For many people with epilepsy, it is possible to identify factors that may provoke seizures. In one study, patients reported that forgetting to take medication (84 ), emotional state (58 ), sleep loss (56 ), menses (54 ), physiologic state (32 ), specific sensory stimuli (21 ), alcohol consumption (20 ), and illness (11 ) were the most common factors that exacerbated their epilepsy.24 For some persons, relaxation therapy or avoidance of stressors can help reduce seizure frequency, but

What is acupressure When is it useful in treating LBP

Acupressure is the application of thumb or finger pressure to traditional acupuncture points. When applied to a myofascial trigger point, it is called ischemic compression. Acupressure techniques are reported to achieve a therapeutic effect by producing ischemia, muscle relaxation, and reactive hyperemia. When trigger points are identified in back musculature, acupressure techniques may produce rapid muscle relaxation and pain relief. One advantage of acupressure is the ease of application. The patient can use a tennis ball, cane, or other object to provide appropriate pressure independently. Alternatively, a family member or friend can be trained to provide acupressure treatment.

The Jehovahs Witnesses Society

Jehovah's Witnesses (JW) belong to the religious organization, the Watch Tower Bible and Tract Society. They number an estimated 6 million world-wide, of whom 145 000 live in the UK1. In Australia, a 2001 population survey showed that the 81 000 JW represented 0.4 of the population2. JW refuse blood transfusion with the 'primary components' of blood (see below for definition) and are prepared to die rather than be transfused. Until 2000, the church would have expelled any member who had been transfused with any prohibited component of blood. Such an individual would have been ostracized and shunned by the members of the church and their family, leading to social isolation. In 2000, rejection by the church was abandoned and it was left to the individual to revoke his own membership from the Society. Although this change in policy was seen as a relaxation of the JW policy on blood transfusion, the JW Society felt that no JW would wish to dissociate them-selves3. In practical terms, this...

Individual Psychotherapy

Psychoeducation, progressive muscle relaxation, systematic desensitization, and cognitive strategies to correct automatic thoughts (Looper and Kirmayer 2002). Symptom-focused strategies appear to have greater benefits than general stress management. Two randomly controlled studies of CBT with patients with hypochondriasis have shown that deliberate focus on physical symptoms, graded exposure to address avoidance behaviors, and response prevention for bodily checking may help to improve global problem severity as well as reduce anxiety and mood symptoms (Clark et al. 1998 Warwick et al. 1996). CBT involving psychoeducation on the roles of attention, attribution, and stress as well as relaxation training has been found to be effective in reducing illness fears and attitudes, somatic symptoms, and dysfunctional beliefs of patients with hypochondriasis (Avia et al. 1996 Barsky et al. 1988a). CBT has been used successfully in the treatment of recurrent abdominal pain (Sanders et al. 1989,...

Behavior Modification

Behavior modification programs may also play a key role as part of the treatment program for somato-form disorders. Operant conditioning is used to increase the reinforcement the child receives for healthy behavior and to reduce reinforcement received for somatization (Campo and Fritsch 1994). The child should receive reinforcement for reduced complaints about symptoms and for healthy behavior, such as participation in pleasant activities when the child is symptom free. Behavior modification programs with incentives for greater functioning and decreased attention to illness behavior and symptoms may play an important role in helping break cycles of secondary gain and reinforcement. Behavioral techniques such as contingent reinforcement and relaxation appear helpful in reducing secondary gain, alleviating headache pain, and treating conversion disorders (Brugman and Newman 1993 Dickes 1974 Larsson et al. 1987 Manne et al. 1990 Speed 1996 Treischmann et al. 1970).

Research Evidence to Date

Not everyone is drawn to biofeedback or comfortable with using equipment. Researchers say that at least half of those who do use biofeedback for headache relief realize 50 to 80 improvement. It should be noted, however, that approximately the same proportion of patients show improvement when treated by relaxation without feedback. Biofeedback is useful also to prevent and reduce migraine headaches in some people. There are still questions about the effectiveness of hand warming as a primary biofeedback therapy for migraine headaches, as clinicians cannot predict accurately who will benefit and who will not.

Adrenergic Receptors in Pulmonary Medicine

All three subtypes of a1-adrenergic receptors (particularly the a1A-subtype) and all three subtypes of -adrenergic receptors are expressed in human lung at the mRNA level, but no major role in the regulation of human airway function has been described (49-53). Among the P-adrenergic receptors, P1- and P2-adrenergic receptors coexist in the human lung the P3-subtype appears to be absent (53). P2-Adrenergic receptors are more abundant than P1-adrenergic receptors in all pulmonary cell types (except in pulmonary blood vessels) and are apparently the only subtype on airway smooth muscle cells (53). Accordingly, relaxation of airway smooth muscle is a prototypical function of P2-adrenergic receptors, and P2-selective agonists have been used for many years as bronchodilator drugs in asthma, chronic obstructive pulmonary disease, and other pulmonary conditions. Short-acting P-adrenergic agonists, such as salbutamol or terbutaline, are well established as acute bronchodilators, whereas...

Lability now often called emotionalism

The patient should not have to use a huge amount of physical effort - the effort should be on the part of the therapist, with relaxed reciprocation from the patient. Intervention should involve successful activity, be challenging but not impossible and not cause stress. Working with therapists involves both physical and mental effort on the patient's part, and it can be more effective to change the task than stop and rest when a patient appears tired. Carr and Shepherd (1987) report studies in normal subjects that show muscle work performed after a diverting activity was greater than that performed after a rest - and they report one study with a small group of stroke patients that appeared to support this. As an alternative to activity or rest, suitable relaxation techniques can be taught to the patient.

What Practitioners Say It Does

At the very least, proponents say, hypnosis brings about a state of increased relaxation. Claims about its efficacy expand from there. It can serve some as a remedy for addiction, including drug, alcohol, and tobacco dependency. It helps some people maintain diets, relieve stress, and reduce anxiety. It can effectively relieve or eliminate chronic migraines, arthritis, and even warts, which appear to respond to various types of mental suggestion.

Guided Imagery and Hypnotherapy

Imagery can focus attention away from symptoms, alter sensory experiences, reduce distress, induce relaxation, reframe symptom experiences, facilitate dissociation from pain, and enhance feelings of mastery and self-control. These techniques can also be used to problem-solve (e.g., to imagine being calm during a test) and to feel a sense of accomplishment. This intervention is best for children of school age or older. Gut-directed hypnotherapy, which includes gut-specific treatments and suggestions, was developed for individuals with irritable bowel syndrome and digestive disorders (Vlieger et al. 2007).

What It Can Do for You

Hypnosis has significant and meaningful documented benefits. It usually produces a state of profound relaxation. It can refocus attention away from adverse stimuli, including pain, and increase the unconscious mind's receptivity to suggestion. In turn, this can bring about physiologic changes such as decreased pulse rate, temperature reduction or increase, and reduced blood flow to specified areas of the body. Hypnosis also is useful against addiction, anxiety, depression, pain and phobias.

Traumatic gas gangrene

Shock associated with gas gangrene may be attributable, in part, to direct and indirect effects of toxins. a-Toxin directly suppresses myocardial contractility in vivo16 and may contribute to profound hypotension via a sudden reduction in cardiac output.17 In experimental models, 0-toxin causes 'warm shock' which is defined as a markedly reduced systemic vascular resistance combined with a markedly increased cardiac output.16'17 It is clear that 0-toxin accomplishes this indirectly by inducing endogenous mediators, such as the lipid autocoids, prostacyclin, or platelet-activating factor,18 that cause relaxation of blood vessel wall musculature. Reduced vascular tone develops rapidly and, in order to maintain adequate tissue perfusion, a compensatory host response is required that either increases cardiac output or rapidly expands the intravascular blood volume. Patients with Gram-negative sepsis compensate for hypotension by markedly increasing cardiac output, but this adaptive...

Alternative and Experimental Therapies

Alternative medicine covers a broad spectrum of therapies, ranging from special diets, vitamin and mineral supplements, and herbal therapies to hyperthermia, ultrasound, light therapy, gene therapy, magnets, acupuncture, moxibustion, yoga, massage therapy, relaxation exercises, and prayer. There is some evidence that specific dietary factors may be useful in preventing or slowing the growth of prostate cancer these factors, along with vitamins and minerals, are discussed in Chapter 13. The present chapter will focus on herbal therapies as well as other experimental therapies being studied for the possible treatment of newly diagnosed prostate cancer. Drugs and other experimental treatments for recurrent prostate cancer are examined in Chapter 11.

When Discoveries Are Made

Equally important to understanding discovery is that insights seem to occur more often when scientists are not directly working on a problem than when they are. Thus, several studies have shown that only about a third of scientific problems are solved by a direct, brute force approach. An equal number are solved when scientists give upon on the original problem and begin working on a related problem. The remaining third of the problems get solved during leisure-time activities, which range from going on vacation to taking a shower to dreaming the answer in one's sleep. Some investigators, such as Linus Pauling have even gone so far as to claim to be able to 'program' their minds to make use of this leisure time. Pauling said that when he worked on a problem that he could not solve directly, he would turn to something else during his work hours, and think very hard about the unsolved problem every night before he went to sleep. After a few weeks, he would forget to think about the...

Beliefs on Which It Is Based

The major foundation for meditation's popularity, especially as a benefit to personal health, is the belief that the mind can cause changes in the body. Many cultures, particularly those in Asia where meditative strategies have long been included in health regimens, have relied on this idea for millennia. A more recent underlying belief is the idea that stress itself has harmful effects on the body. Because meditation emphasizes mental training and relaxation and imparts a sense of control, it is considered a potent agent against stress and anxiety. That is part of the reason that meditation has gained widespread acceptance as a valid, beneficial medical therapy.

Brain Machine Interfaces

The idling activity over primary sensorimo-tor cortex includes a variety of 8-12 Hz mu and 18-26 Hz beta rhythms. Movement and preparation for movement decreases these rhythms, called event-related desynchronization, especially contralaterally. Relaxation after a movement increases the rhythm, called event-related synchronization. With considerable training, subjects can learn to increase the amplitude of mu over the left vertex by, for example, imagining movement of the right hand, and decrease the amplitude by, for example, imagining movement of the left foot. The basis for these changes appears to be the enhanced attention given to the focus coupled to inhibition of attention to other stimuli (surround inhibition), modulated by thalamocorti-cal and different portions of reticular nucleus cells that correspond to distinct sensory modules, such as the hand and foot.40a Normal and quadriplegic subjects who were trained to vary the amplitude or synchronization of their mu

Theres Meditation and Then Theres Transcendental Meditation

During meditation's 1960s rise in popularity in the West, a version called transcendental meditation (TM) was founded by Maharishi Mahesh Yogi, a physics scholar from lndia. TM is based on ancient Indian practices, is it similar to other forms of meditation such as Zen, yoga, progressive relaxation, and other means of eliciting deep relaxation. Meditation is a vital component of transcendental meditation activity. Meditation reduced blood pressure better than did progressive muscle relaxation or instruction about healthy living habits in one study. Frequent regular meditation may reduce anxiety, depression, and pain among patients with cancer as well.

Facing Food Fears A Food Hierarchy

Relaxation exercises are also an effective way to handle food fears, especially right before you eat. Visualize (imagine) yourself in a pleasurable and happy situation. Feel the sensations that go along with your imagery. Try to savor whatever positive sensations emerge and let them calm you. Or, try listening to soothing music before a meal. Take a leisurely bath. Go for a walk (but not a power-walk to burn calories, nor a run). Call a friend. Snuggle with your pet. Read a good book.

Cognitive Affective Models

In a recent meta-analysis of 25 years of mood-creativity research, Baas, DeDreu, and Nijstad concluded that a number of variables are involved in this complex area of mood and creativity. Specific mood types (not just positive and negative) and aspects of those moods must be considered. They concluded that positive moods do produce more creativity than neutral moods. But this is true for positive moods like happiness that are activating and associated with approach motivation. It is not true for positive but deactivating mood states like relaxation. They point out that an interesting practical implication of this finding is that relaxing in a bathtub or on the beach may not be conducive to creative thinking. How the task is framed is also important. Positive moods lead to more creativity when the task is framed as enjoyable and intrinsically rewarding and to less creativity when the task is framed as serious and extrinsically rewarding. As for negative affect, in general, deactivating...

Calcium Channel Blockers

Calcium antagonists (Ch. 7) act selectively on calcium channels in the cellular membrane of cardiac and vascular smooth muscle cells. Free calcium within the vascular smooth muscle enhances vascular tone and contributes to vasoconstriction. Calcium antagonists reduce the transmembrane calcium influx in these cells and via this mechanism are responsible for relaxation of the vascular smooth muscle and subsequent vasodilatation.

Role of physical activity

The mechanisms that are responsible for the blood pressure lowering effect of exercise training are not definitively known, but the possible mechanisms include attenuation of adrenergic sympathetic activity, increased cellular insulin sensitivity and decreased level of circulating insulin, decreased peripheral resistance, increased baroreflex sensitivity, changes in the renin-angiotensin aldosterone system and reduction in body fat. Improved relaxation and decreased tension and anxiety are examples of indirect mechanisms.

Interventions for Dysarthria and Aphasia

Therapies aim to improve the patient's speech intelligibility, volume, and fluidity by means of exercises for affected structures. Patients may be trained to slow their articulation, use shorter sentences, maximize breath support, extend the jaw's motion, and purposefully place the tongue or exaggerate articulatory movements. A modest Valsalva exercise may increase adduction of the vocal folds. By increasing vocal cord adduction and respiratory support for speech, patients with extrapyramidal disorders often improve their intelligibility (Lee Silverman Voice Treatment).134 Relaxation techniques may lessen the strained vocal quality in patients with a pseudobulbar palsy. Behavioral retraining methods include pacing vocalizations by an external cue, using delayed auditory feedback by speaking into an echoic device, and use of a Speech Enhancer (Electronic Speech Enhancement, St. Louis) that amplifies the voice and clarifies dysarthric speech.

Insight Problem Solving Revisited

According to Knoblich et al.'s (1999) representational change theory, insight problems are highly likely to evoke initial representations in which solvers place inappropriate constraints on their solution attempts. Impasses are resolved by revising one's representation of the problem. They tested this theory using Roman numeral matchstick arithmetic problems in which solvers must move one stick to a new location to change a false numeric statement (e.g., VI VIII + III) into a statement that is true. According to Knoblich et al.'s theory, rerepresentation may happen through either of two mechanisms - constraint relaxation or chunk decomposition. Constraint relaxation involves deactivating some knowledge element that has constrained the operators being considered, thereby allowing application of new operators For example, changing II + to III requires relaxation of the value constraint (numeric values do not change except by applying an operation that produces a compensating change in...

The beastly boss game

In this exercise, from Epstein's The Big Book of Stress Relief Games, people learn the value of performing relaxation exercises when they're under stress. People divide into pairs and role play situations in which a Beastly Boss makes unreasonable demands of an Exemplary Employee. In some role plays, the employee subtly performs simple breathing exercises in order to stay relaxed. Without such exercises, the conversations often escalate with the exercises, they do not. Exercises of this sort can be used to teach both managers and employees the value of stress-management training.

Opening Snap in the Absence of Mitral stenosis

Fig. 27. (A) Diagram showing simultaneous left ventricular (LV) and left atrial (LA) pressures in mild, moderate, and severe degrees of mitral stenosis. The more severe the stenosis, the higher will be the left atrial pressure. The opening snap (OS) occurs at the end of the isovolumic relaxation phase of the left ventricle when the left ventricular pressure falls just below the left atrial pressure. The OS will therefore tend to occur earlier with higher LA pressure and later with lower LA pressure. Thus, the S2-OS interval is short with severe mitral stenosis and long with mild mitral stenosis. (B) Visual representation of the excursion of the mitral leaflets in mitral stenosis of different degrees of severity a, normal b, mild c, moderate d, severe. With milder stenosis the column of blood has to travel further before deceleration against the valve, thereby making a late OS. Fig. 27. (A) Diagram showing simultaneous left ventricular (LV) and left atrial (LA) pressures in mild,...

Timing ofthe OS and the S2OS Interval

The OS will be expected to occur at the end ofthe isovolumic phase of relaxation. The latter has an average duration of at least 60 ms. The S2-OS interval then must be expected to be at least 50 ms or longer. In general the OS may occur anywhere between 50 and 110 ms after S2. The OS has been reported to follow A2 by a delay ranging from 30 to 150 ms (56). The interval will depend on the level ofthe aortic pressure, the rate ofisovolumic relaxation, and the left atrial v wave pressure peak. Of these three, the most important determinant is the level of the peak left atrial pressure. Thus, if the left atrial v wave is higher, then the OS will occur earlier than when the left atrial v wave is lower (Fig. 27A). Because besides the left atrial pressure, the aortic pressure and the rate of isovolumic relaxation control the S2-OS interval, this interval may not always accurately predict the severity of mitral stenosis, especially in elderly patients and in the presence of hypertension. This...

Nonpharmacologic Therapy Lifestyle Modifications

Sildenafil (Viagra), tadalafil (Cialis), and vardenafil (Levitra) act by selectively inhibiting phosphodiesterase (PDE) type 5, an enzyme that breaks down cGMP. By inhibiting the breakdown of cGMP, smooth muscle relaxation is induced, leading to an erection (Fig. 51-1). However, the PDE inhibitors are only effective in the presence Alprostadil is a prostaglandin Ei analog that induces an erection by stimulating adenyl cyclase, which leads to an increase in smooth muscle relaxation, rapid arterial inflow, and increased penile rigidity. Alprostadil is available as an intracavernosal injection (Caverject or Edex) or a transurethral suppository (MUSE, medicated urethral system for erection), but the injectable form is more effective (Fig. 51-3). Both forms of al-

Ability or performance

There was a small improvement in the range of lumbar motion following treatment, but this only correlated weakly with improved pain and disability. Isometric strength and EMG activity increased after treatment, though the correlation between them was weak. Fifty-five percent of patients had loss of the normal flexion-relaxation response at baseline, but this did not improve following Adams M A, Bogduk N, Burton K, Dolan P 2002 The biomechanics of back pain. Churchill Livingstone, Edinburgh Ahern D K, Follick M J, Council J R et al 1988 Comparison of lumbar intervertebral EMG patterns in chronic low back pain patients and non-pain controls. Pain 34 153-160 Ahern D K, Hannon D J, Goreczny A et al 1990 Correlation of chronic low back pain behaviour and muscle function examination of the flexion-relaxation response. Spine 15 92-95 Arendt-Nielsen L, Graven-Nielsen T, Drewes A M 1998 Referred pain and hyperalgesia related to muscle and visceral pain. International Association for the Study...

Early Rapid Filling Phase

The rapid filling phase of diastole is part of this active phase of relaxation. The S3, when present, occurs at the end of this period. The rate of expansion of the ventricle during this phase is conditioned by the prevailing load or wall stress, increasing with the increasing wall stress. The latter can be defined by Lame's modification of the Laplace relationship, where the wall stress or the wall tension is directly proportional to the pressure and the dimension or the radius and inversely related to the wall thickness. This phase begins at the onset of mitral and tricuspid valve opening. The peak pressure head driving the filling of the ventricle is the peak v wave pressure in the atrium because the ventricular pressure is close to zero at the beginning of this phase. During this phase of filling, the ventricle receives volume and expands, and its walls continue to thin. This means that there is an increasing wall stress from the beginning of this phase (at the mitral opening) to...

Mechanism ofFormation ofS3

The energy achieved by the moving column of blood during the active rapid filling phase of diastole is related to the rate of relaxation, the velocity, and the volume of blood entering the ventricle and the pressure head provided by the v wave peak in the atrium. When the momentum achieved by the moving column of blood is significant and the transition from the early rapid filling phase to the slow filling phase more abrupt because of decreased ventricular compliance, however brought about, then the deceleration will occur more suddenly and the dissipation of energy will result in the production of an audible sound within the ventricle. The sound will obviously occur at the peak of the rapid filling wave, which is the S3. Intraventricular pressure and transmitral flow studies in dogs have demonstrated a small but consistent reverse transmitral gradient to always accompany this deceleration (81). In addition, the sounds accompanying the flow deceleration could be recorded inside the...

S3 in Ventricular Volume Overload

In volume overload states such as mitral and tricuspid regurgitations, the inflow volume during diastole into the ventricle is larger because the regurgitant blood into the atrium as well as the usual venous (systemic or pulmonary) return will enter the ventricle during diastole. The ventricle is also hyperdynamic in its contraction in these states because of the Starling effect caused by the large volume of diastolic filling. The relaxation following such stronger contraction will also be expected to be very rapid because of better restoring forces. In addition, the v wave peak pressure in the atrium will be higher because of the regurgitation (through the mitral and the tricuspid valves). For these reasons, the inflow into the ventricle not only will be large in volume but will also move with greater velocity, achieving greater energy. In fact, an apexcardiogram obtained in patients with volume-overloaded left ventricle will often show an exaggerated large rapid filling wave with an...

Ions and Autocorrelation Functions

One of the simplest examples of this type of calculation involves the study of a system of rare-gas atoms, as in, e.g., calculations carried out on liquid argon. The relaxation time after a collision was found to be on the order of 1013 s, which is about the same time as that for rather large ions (e.g., of 500 pm). Thus, much of what one learns from the MD study of molecular motion in liquid argon should be applicable to ionic diffusion.

Postjunctional Mechanisms of Transmitters

Decrease of excitability, presynaptic modulation of transmitter release. Smooth muscle Contraction, relaxation, alteration in the pattern of activity, Relaxation Relaxation cells. In the heart, the Ca2+ pump of the sarcoplasmic reticulum is regulated by an accessory protein, phospholamban, which on phosphorylation increases the affinity of the pump for Ca2+, and enhances Ca2+ uptake into the sarcoplasmic reticulum. In smooth muscle, the plasma membrane Ca2+ pump is similarly affected, enhancing transport of Ca2+ out of the cells. These processes can result in relaxation of smooth muscles. In the heart, the extra Ca2+ available for release from the sarcoplasmic reticulum results in an enhancement in the force of contraction (positive inotropic effect), with a shortening of the contraction mediated by the faster removal of Ca2+ by the sarcoplasmic reticulum pumps and the lower affinity of troponin for it.

Emotional Similarities

Emotion-relieving characteristics of humor. Unfortunately, these theories are typically not consistent in whether they refer to the humor producer, the humor appreciator, or both. But in any case, relaxation, emotional release or liberation' from the bounds of rational thinking are consistent themes in classic humor theories. Thus, the joy of discovery seems to be a fairly common emotional theme in both humor and creativity. The discovery can be tiny or grand, but is typically accompanied by some delight, surprise, and enjoyment.

Humor as a Producer of Creativity

Associated with humor should reduce tension and anxiety. In a state of relaxation, individuals would show less fixation and rigidity in their responses to problem solving situations. Second, beyond the reduced rigidity, there might also be a wider range of options that could be considered. The cognitive network could be expanded due to priming by the incongruous.

Clinical challenges

Neuromodulation, sympathectomy (sympathetic blocks), TENS and electrotherapy, nighttime resting splints (not recommended for daytime), counselling, biofeedback, relaxation techniques, group therapy and psychotherapy. Exercise and a graded desensitisation programme within perceived pain thresholds may be helpful to gradually habituate patients to stimuli perceived as noxious. However, there is little evidence to support the efficacy of these interventions (Pertoldi and di Benedetto, 2005) and referral to specialised pain clinics is recommended.

Cognitive Behavioral Treatment Studies

Cognitive-behavioral treatments for panic disorder have been subjected to extensive clinical trials and have been found to be efficacious treatments for treating this condition (Lydiard et al., 2001, APA, 1998). The cognitive-behavioral approach to panic disorder generally involves components of interoceptive exposure and cognitive restructuring. Therapy consists of restructuring of cognitions, exposure, and training in arousal reduction. Patients are educated about the cognitive-behavioral model as a means for helping them to understand their illness. Therapists also work with patients to reappraise catastrophic beliefs by examining them as hypotheses and noting the distortions of the risk of catastrophic outcome. Using interoceptive exposure, somatic sensations similar to panic are induced in patients with a variety of techniques. Repeated exposure to these cues in a safe setting reduces patients' catastrophic experience of them. Patients are also taught skills for coping with these...

Continuous Techniques

Continuous peripheral nerve blocks allow the maintenance of analgesia either by repeated injections or by continuous infusion of local anesthetics. Most of the studies on the use of this technique are in the postoperative setting rather than in the setting of trauma. The advantages of this technique in trauma, however, are quite obvious. With a catheter in place, the duration of the analgesia or anesthesia can be extended, and the concentration of the local anesthetic can be changed to provide sympathetic block, sensory block, or motor block with muscle relaxation, as desired.

The Stokes Einstein Relation

The existence of a charge on a moving body has the following effect on a polar solvent It tends to produce an orientation of solvent dipoles in the vicinity of the ion. Since, however, the charge is moving, once oriented, the dipoles take some finite relaxation time r to disorient. During this relaxation time, a relaxation force operates on the ion this relaxation force is equivalent to an additional frictional force on the ion and results in an expression for the drag force of the form

The Echocardiogram

Beds.207 Isovolumetric relaxation coincides with right-to-left flow. Two flow patterns have been identified during ventricular diastole.207 Transient right-to-left flow occurs at the time of mitral valve opening followed by left-to-right flow from mid-diastole to the time of mitral valve clo-

Renormalization Group Approaches

Dependence of the exchange coupling function, as well as all higher-order couplings are neglected. It may be generalized to out of equilibrium situations, if the self-energy (the imaginary part of which describes the relaxation rate of the local spin) and the energy dependence of the coupling are kept. It is actually even possible to extend the RG approach into the strong coupling regime, provided the effect of the self-energy in controlling the flow of the coupling is treated correctly. Finally, the FRG has been successfully used to treat another strong coupling problem, that of frustrated quantum spin systems on a lattice in pseudofermion representation. where 7K D0 exp( l 2g0) is the Kondo temperature. One observes that g(D) diverges at D TK. The divergence is removed by taking the pseudofermion self-energy into account, the imaginary part of which describes the relaxation rate for As first proposed in 107-110 , and later derived within a full functional RG treatment 111 , the poor...

Ejection Murmurs Normal Physiology ofVentricular Ejection

In addition to the inherent contractility of the ventricular myocardium and the heart rate at which the ventricle performs its pumping function, the major determinant of its stroke output is the end-diastolic volume, which is essentially the preload. The end-diastolic pressure achieved prior to the onset of systolic contraction will primarily depend on the diastolic function reflecting both ventricular relaxation and compliance. These have been discussed in relation to the heart sounds S3 and S4. Once systole is set in motion by electrical depolarization of the ventricular myocardium, the excitation-contraction coupling leads to actin-myosin bridge formation. As the ventricular contraction proceeds, more and more of the myofibrils are recruited into contraction, resulting in rise of the ventricular pressure. The force exerted by the contracting ventricle on the blood mass it contains imparts energy to it. Once the inertial resistance offered by the blood mass is overcome, the blood...

Cognitive Behavioral Therapies to Enhance Coping Skills

Behavioral interventions are important adjunct approaches to SCD treatment to address both pain and illness-related concerns. Many behavioral interventions have been developed based on the empirical finding that active coping strategies are associated with decreased pain and more positive psychosocial outcomes, whereas negative thinking and passive coping are associated with more pain and higher levels of psychological distress (Gil et al. 1989, 1991, 1993). Therefore, cognitive-behavioral therapy (CBT) interventions have been developed to target the thoughts and behaviors associated with an active, positive approach to coping. Many programs focus on teaching specific coping strategies, including relaxation techniques, imagery, problem-solving skills, and positive self-talk (Gil et al. 1997b Powers et al. 2002 Thomas et al. 1998).

Gastrointestinal Systems

There is little, if any, direct sympathetic innervation of the longitudinal smooth muscle cells in most areas of the gut wall, although there may be a sparse sympathetic input to the taeniae and the rectum. There is also only a sparse sympathetic innervation to the majority of circular smooth muscles, and to the smooth muscle in the stomach. Sympathetic relaxation is mediated by inhibition of the cholinergic motor neurones. The only gut smooth muscles that receive a dense sympathetic innervation are the sphincters, where the innervation is excitatory. These include the lower oesophageal sphincter, the pylorus of the stomach, the sphincter of Oddi, the ileocolic sphincter and the internal anal sphincter. The main role of the extrinsic sympathetic nerves is inhibition of the activity of the gut. Motility is inhibited by constriction of the sphincters and relaxation of the longitudinal elements of the gut, and secretion is inhibited (with Vagal input causes receptive relaxation of the...

Overview Of Management

Outpatient chronic pain management programs include a team that can carry out behavioral modification, relaxation, and cognitive, physical, and occupational therapies to increase activity and reduce pain behavior. In addition, the team may adjust medications, deal with mood disorders, and provide education. Claims about the efficacy of pain treatments that have not been subjected to a clinical trial must be considered in relation to the nonspecific placebo effects provided by the team's interest, attention, and overall approach to the patient. Hands-on therapies such as soft tissue manipulations and ultrasound are less likely to affect neuropathic compared with muscu-loskeletal sources of pain. However, nocicep-tive pain from muscles and joints commonly accompanies neurologic diseases, causes disability, and degrades quality of life, and can exacerbate neuropathic sources of pain.

Trachea And Esophagus

The trachea extends inferiorly from the cricoid cartilage in the midline (Figure 26-3A-C). At the level of the jugular notch of the manubrium the trachea is halfway between the sternum and the vertebral column. Sympathetic nerves from the T1 to T4 spinal nerve levels cause airway smooth muscle relaxation and thus dilation of the airways, whereas parasympathetic innervation from the recurrent laryngeal nerves (CN X) causes airway smooth muscle constriction and thus narrowing of the airways.

Oncology and Photosensitizers

The photophysical properties of the photosensitizers are usually monitored to determine the efficiency of the treatments. Parameters such as the lifetime of excited states, the intersystem crossing yield, and singlet oxygen O2 (*Ag) production yield are known only in solution form. As the PA and photothermal spectroscopic techniques are least sensitive to light scattering and are known to be sensitive to relaxation processes, several attempts have been made to use PAS to detect the photosensitizers in solution, in tissues, in excised organs, and in skin in situ and in vivo. Porphyrin derivatives are being actively investigated as photosensitizers for use in photodynamic therapy of tumors. The aggregation tendency of many porphyrins may be related to their selective retention in neoplastic tissues. Triplet state energy levels and intersystem crossing quantum yields of porphyrin derivatives have been obtained by measuring the phase angle difference between the PA signals of an...

Past Clinical Studies

In contrast to more recent studies, past clinical trials were often very defective in design and also outcomes. In a recent review, Cooke and Ernst (2000) included only those aromatherapy trials that were randomized and included human patients they excluded those with no control group or if only local effects (e.g., antiseptic effects of tea tree oil) or preclinical studies on healthy volunteers occurred. The six trials included massage with or without aromatherapy (Buckle, 1993 Stevenson, 1994 Corner et al., 1995 Dunn et al., 1995 Wilkinson, 1995 Wilkinson et al., 1999) and were based on their relaxation outcomes. The authors concluded that the effects of aromatherapy were probably not strong enough for it to be considered for the treatment of anxiety or for any other indication.

Neck Back and Myofascial Pain

Peutic exercise appears to be most useful.137,138 A randomized trial of strengthening, stretching, relaxation, and education about back care for 6 weeks was superior to usual primary care physician management with pain still comparatively reduced at 1 year.139 trolled trial.150 Too often, physical therapy is limited to ultrasound, hot packs, and a little massage, which are unlikely to help the patient with chronic neck pain or tension headache. Tricyclic antidepressants and stress management with cognitive coping and relaxation techniques improve the control of tension headaches and the combination is better than placebo or either treatment alone.151

Evidence Based Treatment Approaches

The treatment of CVS is complicated by a limited understanding of its pathophysiology and the lack of large systematic randomized, controlled trials. Given the absence of conclusive scientifically proven treatments, empirical guidelines have been developed (Li et al. 2008). Known precipitating factors such as chocolate, cheese, or MSG should be avoided when possible (Chow and Goldman 2007 Li and Misiewicz 2003). When anxiety or stress has been identified as a precipitant, the following may be preventive psychotherapeutic treatment, the use of relaxation training and related self-management strategies, and the use of anxiolytics (Chow and Goldman 2007). When attacks occur more than once per month, prophylactic medication is also rec

Characteristics of Regurgitant Systolic Murmurs

Since the pressure gradient often persists between the chambers well into the isovolumic relaxation phase and beyond, the murmur often will not end before the S2 and will often spill over into the very early part of diastole. Thus, there is generally no pause between the end of the murmur and the S2. The audibility of S2 with a regurgitant murmur, however, is mainly related to the relative loudness of the murmur and the S2. The S2 may be audible if the grade of the murmur is softer than the grade of the S2. If the murmur is louder than the S2, then the murmur lasting all the way to the S2 will engulf the S2. This will result in S2 not being heard separately.

D3D4 Lead Optimization and Drug Profiling

FIGURE 7.5 Disease phenotyping in rodent model of human embolic stroke. (a) Cerebral ischemia is induced by permanent transient occlusion of a brain artery, for example, the middle cerebral artery (MCA). The occlusion site is indicated by a cross. As a result, an infarct will develop that occupies large areas of the MCA irrigation territory. The MRI angiogram of a rat brain (top right) demonstrates the absence of blood flow in the left MCA of the animal (yellow arrow). Abbreviations indicate external (ECA) and internal carotid artery (ICA), basilar artery (BA), and Circle of Willis (CW). (b) The tissue damage is reflected by changes of various MRI parameters. The perfusion values (CBF) are dramatically decreased in the affected territory leading to oxidative stress, the apparent water diffusion coefficient (ADC) decreases due to cellular swelling caused by failing membrane pumps, and later the R2 relaxation rate decreases due to the formation of a vasogenic edema. All MRI images have...