Relaxation Techniques

Staying Relaxed

Staying Relaxed

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Brain Evolution System

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Brain Evolution System Summary

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Alternative therapies

Alternative therapies, such as yoga and t'ai chi, have also demonstrated positive improvements in health.36-38 Yoga involves various standing, seated, and supine postures and breathing and relaxation techniques designed to enhance functioning of the various physiological systems by supporting a natural posture. T'ai chi incorporates slow body movements, called forms, that concentrate on balance and body-weight transfers. Young and old men and women have performed yoga and t'ai chi for centuries in Eastern countries. Both have been purported to focus concentration and relax the body.

End Systolic Volume Stroke Volume

INTRAVENTRICULAR VOLUME-PRESSURE DIAGRAMS. Beats 2 & 3 of the previous Figure 2.11 were combined as orthogonal signals producing a Lissa-jous-like pattern, that is, two almost coincident PV-loops. The two isovolumetric phases (relaxation, on the left, and contraction, on the right) take place along the levels, respectively, of the end-systolic volume, and of the end-systolic volume plus stroke volume end-diastolic volume. Points A and C mark the beginning and end of the mechanical systole (subdivided in the isometric contraction and ejection phases). The vertical arrow on the right shows the counter-clockwise rotation of each beat. On its way back to A, the cycle enters into its diastolic portion (subdivided, in turn, into relaxation and mainly passive ventricular filling, the latter from D to A). The four corners correspond to the openings and closures of both left cardiac valves.

Role of protein kinase C in stimulusresponse coupling

The role of protein kinase C in stimulus-response coupling was first demonstrated for the release of serotonin from platelets. The enzyme has since been shown to be involved in the release of certain hormones and neurotransmitters, the secretion of certain enzymes, smooth muscle contraction and relaxation, activation of T and B lymphocytes, inhibition of gap junctions, modulation of ion conductance, interaction and down-regulation of receptors, cell proliferation, expression of certain genes, steroido-genesis, lipogenesis and glucose metabolism. When intracellular Ca2+ concentrations become too high, protein kinase C activates the Ca2+-transport ATPase (calcium pump) and the Na+ Ca2+ exchange protein, both of which remove Ca2+ from the cell (Nishizuka, 1986).

Sexual pain syndromes

The sensation of PC muscle relaxation after the squeeze. Recommending the use of mirrors to become comfortable looking at and touching her external genitalia can help her to become more comfortable with her body. Becoming Orgasmic36 is an excellent reference it includes illustrations of variation in the appearance of women's external genital anatomy.

Check Your Answers on Next Page

Leave work at work. Do not take unnecessary paperwork home every night and on weekends. Plan to take vacations away from your working area. Go to the mountains or the coast for a few days every couple of months. Take a break at specific intervals to recharge your batteries. You can also learn and practice relaxation techniques. This does not mean getting extra sleep. Yoga is one relaxation technique, but other approaches are available, simple, and beneficial.

Neurophysiology Of Micturition

Normal voiding is accomplished by activation of the micturition reflex. 'This is a coordinated event characterized by relaxation of the striated urethral sphincter, contraction of the detrusor, opening of the vesical neck and urethra and the onset of urine flow (20). The micturition reflex is integrated in the pontine micturition center, which is located in the rostral brain stem (20,21,22). Interruption of the neural pathways connecting the pontine micturition center to the sacral micturition center usually results in detrusor external sphincter dyssynergia (23,20,24). Detrusor external sphincter dyssynergia is characterized by simultaneous involuntary contractions of the detrusor and the external sphincter. The involuntary detrusor contractions cause incontinence the involuntary sphincter contractions result in bladder outlet obstruction. Detrasorexternal sphincter dyssynergia is commonly seen in patients with spinal cord involvement because of the demyelinating plaques, which are...

Management of HF Caused by Systolic vs Diastolic Dysfunction

Positive inotropic agents, such as digox-in, are contraindicated in pure diastolic dysfunction because they further increase cardiac contractility. However, negative inotropic agents (lusotropic agents), such as beta-blockers or the CCBs diltiazem (Cardizem) and verapamil (Calan, Isoptin), are treatments of choice in pure diastolic dysfunction, because they allow ventricular relaxation and improve filling.

Normal Venous Function

Saphenous vein (LSV) and short saphenous vein (SSV) and their tributaries. As there are numerous communications between the long and short saphenous systems, and between the superficial and deep systems through junctional and nonjunctional perforators, these three elements are highly interdependent, both anatomically and functionally, in health and in disease. Most of the blood draining into the superficial veins from skin and subcutaneous tissues immediately enters the deep venous system via perforators in the foot, calf, and thigh. In healthy subjects, less that 10 of the total venous return from the lower limb passes through the LSV and SSV to the saphenofemoral junction (SFJ) and saphenopopliteal junction (SPJ), respectively. Blood is forced back up the leg during leg muscle systole, and prevented from flowing back down the leg under the influence of gravity during diastole, through the actions of the muscle pumps and closure of venous valves, respectively. The act of walking...

Anandamide endocannabinoid and endovanilloid

Whereas anandamide has similar affinity for TRPV1 to that of capsaicin, it has significantly lower potency 14 . In high-expression recombinant cell lines using various methods, the potency (EC50) of anandamide has been measured in the range of 0.7-5 pM. In native systems, the potency of anandamide ranges from 0.3 to 0.8 M in blood vessels (relaxation), compared with 6-10 M in bronchus (contraction), dorsal root ganglion (DRG) neurons and trigeminal neurons (intracellular Ca2+ con-

Intracellular versus extracellular

It is important to give consideration to the location of the agonist-binding site on TRPV1, which is located intracellularly 23, 24 the apparent low intrinsic efficacy of anandamide may be due to limited access to this binding site. As a consequence, the potency of exogenously applied anandamide will be affected by its ability to enter the cell (see 16 ). Anandamide gains access to the intracellular environment either via the anandamide membrane transporter (AMT) or via accumulation sustained by a concentration gradient that is maintained through the rapid intracellular hydrolysis of anandamide by fatty acid amide hydrolase (FAAH see 25, 26 ). The finding of the enhanced potency of anandamide when administered intracellularly is in line with the demonstration that compounds that alter the function of the AMT modulate the potency of anandamide in HEK-293 cells expressing TRPV1 27-29 . A recent study by Andersson et al. 21 provides further evidence that primary afferent fibers express...

Inpatients Severe Depression

Bowers 117 compared NT alone, relaxation in combination with NT, or CBT and NT in 30 inpatients (combined with usual hospital milieu therapy consisted of 12 group sessions) to find, in this moderately-severely depressed group, that all groups improved, but patients receiving CBT or relaxation had significantly fewer depressive symptoms and negative cognitions than those on medication alone. Patients receiving CT were less likely to be judged depressed at discharge than any other treatment conditions. When recovery was defined (HAM-D score < 6), 8 of 10 patients in CT compared to 1 of 10 or 2 of 10 in relaxation or medication alone, respectively, were found.

The Catecholamine System Adrenal Medulla

The adrenal medulla, the inner part of the adrenal gland, is not essential to life, but helps a person in coping with physical and emotional stress. It consists of masses of neurons that are part of the sympathetic branch of the autonomic nervous system. Instead of releasing their neurotransmitters at a synapse, these neurons release them into the blood. Thus, although part of the nervous system, the adrenal medulla functions as an endocrine gland. It secretes epinephrine (also called adrenaline) and norepinephrine (also called noradrenaline). Both are derived from the amino acid tyrosine and are collectively called catecholamines, a group that includes other related substances with similar properties. The former hormone increases the heart rate and force of heart contractions, blood is shunted from the skin and viscera to the skeletal muscles, coronary arteries, liver, and brain, causes relaxation of smooth muscles, and helps with conversion of glycogen to glucose in the liver. Other...

Gammahydroxybutyric acid

Gamma-hydroxybutyric acid (GHB) occurs naturally in the central nervous system and was synthesized in the 1960s. It has been variously used or studied as an anaesthetic, an adjunct in alcohol or opiate withdrawal, a treatment for narcolepsy, an agent to reduce tissue oxygen demand in resuscitation and sepsis, and a stimulator of growth hormone (particularly for body builders). Because of its ability to impair consciousness and to provide associated relaxation, euphoria, disinhibition and increased sensuality, it has recently become a popular but illegal drug of abuse particularly at parties and has been labelled in the press as the 'date rape' drug.

How can you cope with stress

Relaxation techniques and regular exercise can be helpful parts of stressmanagement programmes. Also, by thinking more appropriate and positive thoughts, you can go a long way towards reducing stress as well. But be realistic and remember that while stress can be managed and controlled, it cannot be eliminated. Your focus, then, should be on using the following 'Helpful tips' to help you to deal better with both the physical and the emotional effects of the stress response. Relaxation benefits you in many ways. First, it can give your body a chance to rest and recuperate. Also, a stronger body can help you to deal better with stress and life in general. Relaxation will help you sleep better, is pleasurable and will increase your feeling of emotional well-being. It can also give you a powerful sense of re-establishing control over your life, despite the presence of a chronic medical problem like diabetes. There are many different types of clinical relaxation techniques, including...

Endothelial dysfunction Vasomotor control

Relaxation contraction of the vascular smooth muscle. The state of contraction of the vascular smooth muscle is referred to as vascular tone. The arteries are normally maintained in a partial state of contraction (vasomotor tone) by the continual firing of nervous impulses from the vasomotor centre. The vascular endothelium lining the lumen can modulate vascular tone by the synthesis and release of potent vasorelaxant and vasoconstrictor substances. Release of these substances is usually balanced in favour of vasodilators, notably epithelium-derived relaxing factor, prostacyclin and endothelium-derived hyperpolarizing factor. Epithelium-derived relaxing factor has been identified as the nitric oxide radical (NO*) (Palmer et al., 1987 Ignarro et al., 1987), which is formed within endothelial cells by the oxidative deamination of L-arginine (Palmer et al., 1988). The enzyme responsible, endothelial constitutive nitric oxide synthase, requires tetrahydrobiopterin as a co-factor and is...

Interactions between platelets and the vascular endothelium

At sites of injury, ADP released by aggregating platelets and thrombin formed during blood clotting stimulate the release of endothelial nitric oxide and prostacyclin, which act synergistically to cause relaxation of the vascular smooth muscle. Aggregating platelets also release vasoconstrictors such as serotonin, Shimokawa & Vanhoutte (1989) showed that endothelium-dependent relaxation in response to aggregating platelets is severely impaired in atherosclerosis and moderately impaired in hypercholes-terolaemia. Thus endothelial damage or dysfunction shifts the balance of vasoactive compounds toward vasoconstriction, a state conducive to vasospasm. Under clinical conditions, the spasms can be complicated by thrombosis leading to vessel occlusion and myocardial infarction.

Structure Determination of

Vpu is a typical helical membrane protein. A major challenge in structural biology is the determination of the structures of membrane proteins. Despite substantial efforts, Vpu has not been crystallized and continues to remain outside the realm of X-ray crystallography. Thus, NMR is the only method that is applicable, since it does not require crystals, and is capable of determining the three-dimensional structures of proteins with atomic resolution. However, the conventional multidimensional solution NMR methods that work well with globular proteins, such as HIV protease, are problematic for membrane proteins, even relatively small ones like Vpu, because the slow reorientation rates that accompany solubilization in micelles result in broad resonance line widths, short relaxation times, and efficient spindiffusion, all of which contribute to the difficulty in observing and assigning long-range NOEs as distance constraints for determining the three-dimensional structures of these...

Gases Respiratory Care

The answer is d. (Schwartz, 7 e, pp 448, 499.) The cause of malignant hyperthermia is unknown, but it is associated with inhalational anesthetic agents and succinylcholine. It may develop in an otherwise healthy person who has tolerated previous surgery without incident. It should be suspected in the presence of a history of unexplained fever, muscle or connective tissue disorder, or a positive family history (evidence suggests an autosomal dominant inheritance pattern). In addition to fever during anesthesia, the syndrome includes tachycardia, increased O 2 consumption, increased CO2 production, increased serum K+, myoglobinuria, and acidosis. Rigidity rather than relaxation following succinylcholine injection may be the first clue to its presence. Treatment of malignant hyperthermia should include prompt conclusion of the operative procedure and cessation of anesthesia, hyperventilation with 100 oxygen, and administration of intravenous dantrolene. The urine should be...

Bioimpedancimetric Signals

Records obtained from the elbow and palm of the hand regions showing clearly voluntary contraction and relaxation of the muscles involved in the movements. Observe the smallness of its amplitude. By permission, after Cohen and Givler, 1972. Figure 3.9. MAGNETOMYOGRAM. Records obtained from the elbow and palm of the hand regions showing clearly voluntary contraction and relaxation of the muscles involved in the movements. Observe the smallness of its amplitude. By permission, after Cohen and Givler, 1972.

Principles Of Pain Management Pathophysiology of pain

Debate continues around the exact central areas that are involved in the conscious experience of pain, this may be the reason for the individual differences in pain perception. Strategies such as cognitive-behavioural strategies are used which reduce the sensory and affective aspects of pain. These strategies include distraction, relaxation and imagery, distracting from the pain and reducing the number of signals transmitted to the higher centres.

Attributes Of A Dental Specialist

The dental specialist's personal habits are reflected in the appearance of the office in which he works. All efforts resulting in orderliness and cleanliness of dental personnel and of surroundings contribute to the patient's comfort, security, and relaxation.

How Dreams Are Products Of Our Minds

While the idea that the psychological state and the personality of a person contribute to dream generation can be found in ancient through contemporary writings, there is only a small correlation between what personality tests reveal about persons and the nature of their dreams. Anxious persons report more anxious dreams, and relaxation training that reduces anxiety in these persons results in an increase in the reported pleasantness in their dreams. Also, people successfully treated for their phobias report experiencing a reduction in phobic objects in their dreams. The dreams of depressed people contain more masochism, dependency, helplessness, and hopelessness, which is like their waking thoughts (Weiss, 1986). Furthermore, age and gender have been shown to cause great individual differences in recalled dream content, but social class, structure of the family, and health also can have an influence.

Reflex innervation of skeletal muscle

A reflex is initiated by a stimulus of a sensory neuron, which in turn innervates a motoneuron and produces a motor response. In reflexes involving skeletal muscles, the sensory stimulus arises from receptors in the muscle, and the motor response is a contraction or relaxation of one or more skeletal muscles. In the spinal cord, lower motoneurons form the specific motor component of skeletal muscle reflexes. Upper motoneurons provide descending control over the reflexes.

Interventions For Childhood Worry

Unfortunately, there are (to this author's knowledge) no interventions that have been directed specifically at childhood worry. There are now a number of Cognitive Behaviour Therapy (CBT) based treatments that appear to have efficacy in treating childhood and adolescent anxiety in general (e.g. see Cartwright-Hatton, Roberts, Chitasabesan et al. (2004) for a review). However, these interventions have largely been targeted at the emotional (e.g. fear) and physiological aspects of anxiety. Very few treatment protocols have modules specifically for dealing with worry. Indeed, because of the developmental limitations on children's ability to use the more cognitive elements of CBT, most interventions focus heavily on behavioural elements, such as exposure and relaxation. If evidence from the adult literature is indicative, it seems unlikely that these elements will have a substantial impact on worry. Where cognitive elements are incorporated into treatment, these are usually limited to...

Studying the Mechanosensitivity of Voltage Gated Channels Using Oocyte Patches

Mechanosensitive (MS) channels, that is, channels sensitive to membrane stretch, are found in most channel families, including the voltage-gated (VG) channel super-family. The MS responses of VG channels are biophysically significant and putatively are of physiological and pathophysiological interest. When membrane stretch alters membranes, a new equilibrium distribution of channel conformations may result. The process of relaxation to that new equilibrium can loosely be termed MS gating of the VG channel. If stretch exerts an irreversible effect on gating, it is more appropriate to speak of the VG channel as mechanosusceptible.

B Administer Thirty Chest Compressions

(c) Allow the chest to return to its resting position after each thrust, but do not remove your heel from the compression site. If the compression site is lost, repeat the location procedures before administering more chest thrusts. The thrust and the relaxation parts of the compression should be of equal duration. (d) Compressions should be smooth, not jerky. Allow the chest to return to its resting position after each thrust, but do not remove your fingertips from the compression site. The thrust and the relaxation parts of the compression should be of equal duration.

Renal Tubular Acidosis

Discussion Duchenne's muscular dystrophy is an X-linked recessive disorder characterized by a deficiency in muscle dystrophin, a subsar-colemmal cytoskeletal protein that stabilizes the sarcolemma during contraction and relaxation. Its course is relentlessly progressive, ending in death from cardiac and respiratory muscle involvement.

Control of bladder pain and overactivity

Within the sacral spinal cord and initiated by activation of capsaicin-sensitive bladder C-fibers, but this pathway is usually inhibited in adult mammals unless there are pathologies such as inflammation or spinal transection 59 . Thus, under patho-physiological conditions, bladder contractions triggered by capsaicin-sensitive C-fibers and mediated by the sacral reflex are involuntary and can be triggered by small volumes of urine, characteristics that generate an urge to urinate, urinary incontinence and a high urinary frequency. Moreover, these C-fiber-initiated contractions lack coordination with urethral sphincter muscle relaxation and can lead to increased intravesicular pressure and potential harm to the upper urinary tract 58 . Interestingly, TRPV1 expression occurs not only in nociceptive fibers that form close contacts with bladder epithelial (uroepithelial) cells but also in uroepithelial cells themselves 60 this suggests that these cells may work in concert with underlying...

Measuring Aggression Aggression Questionnaire

Individuals with high scores on the VER scale are commonly aroused to anger by situations they perceive to be unfair. Persons with a preexisting antisocial personality will tend to obtain high scores on the VER scale. Low VER scores are obtained by individuals who do not perceive themselves as argumentative. The ANG subscale describes aspects of anger. Persons who score high on the ANG scale may benefit from relaxation training, as well as cognitive-behavioral and other arousal-reducing strategies or psychotherapy. Thus, this scale may be useful to predict those who might respond to treatment techniques aimed at reducing anger. The HOS subscale is most closely associated with pervasive social maladjustment, as well as severe psychopathology. It is probably wise to review this scale with elements on the MMPI-2. Predictors of violence from the MMPI-2 subtests are more fully explained in the forensic sections of this text. Persons with elevated HOS scores are more likely to demonstrate...

Generalized relative entropy finite dimensional systems

We begin with describing the General Entropy Inequality in the case of matrices and we deal with two theories where it applies to give an entropy based understanding of time relaxation. In the framework of the Perron-Frobenius eigenvalue theorem it explains why the associated dynamic converges to the first (positive) eigenvector (once correctly normalized). In the framework of Floquet's eigenvalue theorem it explains why the associated dynamic converges to the (positive) periodic solution (once correctly normalized).

Rationale for intravesical application of TRPV1 agonists

Clinical interest on TRPV1 agonists for the treatment of bladder diseases started with the observation that reflex bladder contractions triggered by bladder filling in intact or spinally transected cats had distinct sensibilities to systemic capsaicin. In spinally transected cats, but not in intact cats, reflex bladder contractions were completely suppressed by the neurotoxin 1 . The identification of two neuronal pathways involved in micturition control offered a solid explanation to this finding. A long pathway passing through the pontine micturition center and initiated in AS-, capsaicin-resistant, bladder sensory fibers controls reflex bladder contractions in mammals with intact spinal cord. A short neuronal pathway entirely lodged in the sacral spinal cord and initiated in type C, capsaicin-sensitive, bladder sensory fibers, usually inactive in adult mammals, is enhanced after spinalization and replaces the supra-spinal reflex 1 . Bladder contractions triggered by the sacral...

Tetanus see also Clostridial infections

Inoculated spores germinate at the site of injury and produce a potent neurotoxin (tetanospasmin). This migrates centrally along motor neurone axons to the spinal cord, where it suppresses the inhibition of the reflex arc by internuncial neurones. The reflex antagonist relaxation normally activated during contraction

Mechanics of Skin Penetration

The mechanical stress-strain relationships of skin complicate the practical manipulation of the stratum corneum, epidermis, and upper dermal layers. The mechanics of skin, and other soft tissue such as arteries, muscle, and ureter, do not display single-value relationships between stress and strain and are therefore classified as inelastic materials (3). When tissues in this group are held at constant strain, they display stress relaxation, and when held at constant stress they creep. Historically this relationship has required uniaxial application of mechanical

Problems That Occur During Sleep

Mark Twain called snoring sleeping out loud. Other wags have called snoring sound sleeping. Snoring, however, can indicate serious problems and may cause some of those problems. It occurs when there is less room for the air to travel through the upper airways during sleep. The air has to move faster through the space and causes vibrations of the soft tissue of the throat, like a flag flapping in a stiff breeze. Anything that constricts the upper airway passages or results in there being more flaccid tissue in the throat can contribute to snoring, including relaxation of the throat muscles that normally contract when inhaling, excess tissue, inflammation, interventions. These treatments include relaxation techniques, systematic desensiti-zation, and the counterconditioning of a relaxing response to the nightmares and bad dreams. Even more effective has been the recent use of imagery rehearsal that has sufferers write, talk, paint, or draw about their nightmares and bad dreams, then go...

Behavioral Voiding Dysfunction Pseudodyssynergia

Bladder outlet obstruction may also occur in the setting of an anatomically normal male patient owing to a dynamic obstruction caused by a lack of coordination between the detrusor and bladder neck smooth muscle (bladder neck dyssynergia) or striated muscle external sphincter (pseudodyssynergia). While psydodyssynergia generally implies a condition in a neurologically intact patient, similar conditions may be the result of a neurologic lesion (detrusor external sphincter dyssynergia, DESD) or in neurologically intact children (Hinman's bladder). Although the exact etiology of this condition is unknown, it is generally considered to be a learned behavior of failed pelvic relaxation. It has been postulated that the condition may arise as reaction to a negative response to micturition such as pain, and frequently is seen in younger male patients who have been treated for long periods for chronic prostatitis. Although not an absolute part of the syndrome, there is a preponderance of...

Two Mutually Coupled Cells

In this section, we consider a network consisting simply of two mutually coupled cells. By considering such a simple system, we are able to describe how we model networks of oscillators, the types of behavior that can arise in such systems and the mathematical techniques we use for the analysis of the behavior. For this discussion, we assume that each cell, without any coupling, is modeled as the relaxation oscillator System (29) can be viewed as a simple model for a bursting neuron in which the active phase corresponds to the envelope of a burst's rapid spikes. Of course, a two-dimensional model for a single cell cannot exhibit the more exotic dynamics described in the previous section for a bursting cell. However, by considering a simple relaxation-type oscillator for each cell, we will be able to discuss how network properties contribute to the emergent behavior of a population of cells. It is, of course, a very interesting issue to understand how this population behavior changes...

Overflow Incontinence After Lefort Surgery

The answer is b. (Scott, 8 e, pp 768-770.) Stress incontinence is the involuntary loss of urine when intravesical pressure exceeds the maximum urethral pressure in the absence of detrusor activity. The most common cause of urinary incontinence is incompetence of the urethral sphincter, termed genuine stress incontinence. The other major cause of incontinence is unstable bladder. An unstable bladder is the occurrence of involuntary, uninhibited detrusor contractions of greater than 15 cmH2O with simultaneous urethral relaxation. Up to approximately 60 of patients presenting with incontinence may have unstable bladder. Other causes of urinary incontinence are less common and include overflow secondary to urinary retention, congenital abnormalities, infections, fistulas, detrusor dyssyner-gia, and urethral diverticula. Detrusor dyssynergia implies that when the patient has an uninhibited detrusor contraction, there is simultaneous contraction of the urethral or periurethral striated...

Types of Stress Tests

Assessment of diastolic function by measuring the isovolumetric relaxation time, the deceleration time, the E A ratios, and the transmitral gradients can help determine the degree of diastolic impairment and serve as a baseline for therapeutic endeavors. These are defined as follows 1. The isovolumetric relaxation time is the time interval between closure of the aortic valve and the opening of the mitral valve.

Pathogenesis And Immunity

Once transported to the spinal cord, tetanospasmin affects the inhibitory neurons. These neurons use either glycine or Y-aminobutyric acid (GABA) and normally inhibit the alpha motor neurons. Without this inhibition, the motor neuron increases its firing rate, ultimately causing rigidity of the muscle innervated by this neuron. More clinically relevant is the fact that without this inhibition, the normal relaxation of antagonist muscles is impaired, and the characteristic tetanic spasm occurs, in response to movement or stimulation. The toxin is transported into the brainstem,59 but the clinical relevance of this is unclear.

Principle Paracrine Secretion Involved In Inhibition Of Gastric Secretions

The answer is b. (Berne, 4 e, pp 590-598.) Important inhibitory neurotransmitters in the gastrointestinal tract include vasoactive intestinal peptide and nitric oxide. Relaxation of gastrointestinal smooth muscle occurs following activation of nonadrenergic, noncholinergic (NANC) enteric nerve fibers. Acetylcholine, substance P, and dopamine are excitatory neurotransmitters. Somatostatin is a paracrine secretory product with multiple effects on gastrointestinal function. 172. The answer is d. (Berne, 4 e, pp 641-643.) Cholecystokinin is released from the upper small intestine in response to partially hydrolyzed dietary lipids and proteins and promotes gallbladder emptying. Gallbladder contraction and sphincter of Oddi relaxation are necessary for delivery of bile into the duodenum. These muscular actions are under both hormonal and neural control. Cholecystokinin contracts gallbladder smooth muscle by a direct action on the muscle and through activation of vagal afferent fibers...

Medications for Inflammatory Conditions of the Bladder Causing Storage Failure

Interstitial cystitis (IC) is a syndrome whose pathogenesis and etiology remain a mystery. Even the diagnosis of this entity is difficult and considered one of exclusion. There are four currently proposed etiologies for this syndrome inflammation, vascular insufficiency, epithelial leak, and deficiency of proteoglycans (i.e., glycosaminoglycans-GAG-). Dimethysulfoxide (DMSO), after being approved for use in 1977, has been shown to induce remission in 35-40 of the patients (128) and is a mainstay of treatment (129). However, no controlled clinical studies have been performed. DMSO is a derivative of lignin, which is a product of the wood-pulp industry. Its therapeutic properties include anti-inflammatory properties, analgesic properties, collagen dissolution, muscle relaxation, and mast-cell histamine release. The usual dose is a 50 solution instilled for 5-10 min. This therapy can be used as a one time dose, repeated weekly for 6-8 wk, or continued weekly for 4-6 mo. Some even...

Selective Photothermolysis the Enabling Principle for Cosmetic Laser Surgery

Hemoglobin Laser Absorption

The era of cosmetic laser treatment of the skin began in the 1980s with the work of Harvard University dermatologists Rox Anderson and John Parrish, who used laser energy to selectively damage dermal blood vessels. They considered the physical properties of small blood vessels, including their depth, diameter, laser energy absorption of their chromophore (hemoglobin), and thermal relaxation time, a measure of how quickly a structure cools down after being heated to a certain temperature. They theorized that a laser with a high energy level (fluence), a short pulse duration, and a wavelength that was highly absorbed by hemoglobin (relative to other skin chromophores) could be used. Pulse duration had to be shorter than thermal relaxation time so that heat would not build up excessively within the blood vessel and then be conducted to surrounding dermal tissue, causing a burn injury (with resultant scarring).

Cholecystokinin

CCK exerts its effect via the CCK A and B receptors. Both are seven-domain transmembrane receptors from the G protein-coupled receptor superfamily. The CCK A receptor, primarily alimentary, mediates gallbladder contraction, relaxation of the sphincter of Oddi, pancreatic growth, and enzyme secretion. It delays gastric emptying, and inhibits gastric acid secretion by binding to sulfated CCK peptides. CCK A receptors have also been found in the pituitary, myenteric plexus, and areas of the midbrain. CCK B is the predominant receptor in the brain, but is also found in the stomach and pancreas. It is less restrictive, with a structure identical to the gastrin receptor, and binds nonsulfated CCK peptides (67).

Credit Awarded

He does not wander aimlessly through life but is in control of himself and his environment. Major plans may include renting an apartment and then buying a house in the future. More immediate plans may be to go to a movie this weekend with friends for entertainment and relaxation.

Urodynamics Studies

Electromyograms performed in the majority of poststroke patients reveal uninhibited relaxation of the external sphincter during or preceding detrusor contractions with resultant urinary incontinence (15). Interestingly, detrusor sphincter dyssynergia (DSD) is uncommon in the poststroke period (13,35). However, pseudodyssynergia, demonstrated by the voluntary contraction of the external sphincter during an involuntary detrusor contraction, may be more commonly observed in the recovery phase and should not be misinterpreted as DSD (36,37). Because of these confounding clinical possibilities, we recommend that there be close supervision of all urodynamic data and clinical symptoms by the urologist during a urodynamic study.

Mechanics

Historical tip Bayliss and Starling, in 1899-1901, formulated the Law of the Intestine (not to be confused with Alvarez Law) to provide an explanation for peristalsis. They found that the response of the small intestine to a local stimulus consisted of contraction of the muscularis externa layer immediately above, and relaxation immediately below the point of stimulation. It was attributed to a reflex that involved the myenteric plexus and was independent of the external innervations of the intestine. Cannon, in l911, called it a myenteric reflex, as referred to above the biphasic wave of relaxation and contraction was found to pass over the muscular layer in an aboral direction for short distances from the point of stimulation. Later workers, Alvarez among them, in l940, and Bozler, in l949, improved these studies. peristalsis are out of phase by 90 degrees, according to Davenport. On distension of the lumen the longitudinal muscle contracts, followed by progressive contraction of...

The Examination

On the day of CT colonography the patients remain sober until the examination is performed. Whenever necessary we advise the patients to take their regular medication shortly before CT colonography. CT colonography is preferably performed in the morning. Prior to the exam the patient is instructed to visit the restroom to empty the rectum. Smooth muscle relaxation is achieved using scopolamine butylbromide (Buscopan Boehringer Ingelheim) (Taylor et al. 2003a). After distending the colon with CO2 using an automated inflator, the patients are scanned in supine and prone position using an ultra-low dose. Using a 64-slice scanner enables an ultra-low dose of 140 kV and 10 mAs without distortion of the image quality (Fig. 4.3).

Lux Based Systems

Reacts with molecular oxygen to form 4a-hydroperoxy-FMNH (Intermediate II) (Fig. 5.1). In the absence of aldehyde, this decays to generate FMN and hydrogen peroxide with no light emission (dark decay). In the presence of aldehyde, Intermediate III (4a-peroxyhemiacetal-FMNH) is formed, which decays to yield the aliphatic acid and an excited emitter, proposed to be a 4a-hydroxy-FMNH species,3 which undergoes a radiative relaxation to emit light. After returning to the ground state, 4a-hydroxy-FMNH decays to generate water and oxidized FMN. Although the in vivo aldehyde substrate appears to be tetradecanal, other long chain aldehydes (e.g., nonanal or decanal) may elicit a bioluminescent response. Enzyme turnover rate is greatly affected by the nature of the aldehyde substrate used, and may differ significantly and characteristically with luciferases from different species.

The Lymphatic System

The distribution of fluid and protein between the vascular and ISF spaces depends on hydrostatic and oncotic pressures (Starling's forces), together with the relative impermeability of the blood capillary membrane to molecules over 70 kd. In healthy subjects there is net capillary filtration, which is removed by the lymphatic system. Small particles enter the initial lymphatics directly larger particles are phagocy-tosed by macrophages and transported through the lymphatic system intracellularly. Lymph flows against a small pressure gradient due to transient increases in interstitial pressure secondary to muscular contraction and external compression, the sequential contraction and relaxation of lymphangions, and the prevention of reflux due to valves. Lymphangions respond to increased lymph flow in much the same way as the heart responds to increased venous return in that they increase their contractility and stroke volume. Transport in the main lymph ducts also depends on...

Children Adolescents

In a controlled trial of 53 child and adolescent patients with either MDD or minor depression (8 ), Wood et al 128 compared CT to RT for 5-8 treatment sessions. Treatment consisted of a cognitive component based on Beck et al 4 , a social problem-solving component, and a symptom-focused component (e.g. sleep hygiene, activity scheduling). CT was more effective than relaxation on depression and overall outcome. Kahn et al 130 compared a CBT intervention, RT (progressive muscle relaxation), and self-monitoring intervention to WL in 68 moderately depressed middle school students. The CBT focused on acquisition of self-control, problem-solving, and social skills. The CBT and RT included 12 50-minute sessions over 6-8 weeks (group format with a single therapist). All treatments were effective at decreasing depression and increasing self-esteem at post-test and 1-month follow-up.

ANKTM1 channel

It is known that the plant-derived cannabinoid, A9-tetrahydrocannabinol (THC), has analgesic and anti-inflammatory properties, which may be mediated by CB1 receptors present on primary afferent sensory neurons. However, THC appears to retain an analgesic effect in CBj - - mice. In addition, cannabidiol is anti-inflammatory and analgesic and does not share the ability of THC to bind to and activate CBj receptors. These data raise the possibility of a non-CB1 receptor-mediated action of plant-derived cannabinoids 63 . Furthermore, THC and cannabidiol induce a concentration-related relaxation of arterial segment - an effect that is insensitive to antagonism by CBj receptor antagonists 64 . The relaxant effect is absent in cap-saicin-treated vessels, indicating a role for small-diameter sensory fibers, but is not antagonized by the TRPV1 receptor antagonist capsazepine. The relaxation is abolished by ruthenium red, which is a non-competitive antagonist of vanilloid receptors. This novel...

Cardiac output

The answers are 180 a 181 b 182 c 183 d. (Lilly, p 151.) A normal left ventricular volume loop is represented here. The mitral valve opens at point A. Diastolic filling ensues, represented by the line A-B, at which point ventricular contraction begins and the mitral valve closes at point B. Isometric contraction (the aortic valve is not yet open) is represented by the line B-C, indicating the increase in pressure in the left ventricle. As the left ventricular pressure maximizes, the aortic valve opens at point C. Line C-D thus corresponds with left ventricular ejection, and the aortic valve closes at point D. Line D-A thus represents isometric relaxation and subsequent reopening of the mitral valve at point A.

Too medical

However, the afferent signals entering the spinal cord initiate other effects that require an intact spinal cord. These include taking a deep breath (choice A), closing the glottis (choice B), and increasing abdominal pressure (choice D), all of which together move the fecal contents downward. Voluntary relaxation of the external anal sphincter then allows the feces to be expelled from the body. Loss of voluntary aid to the defecation process following spinal transection or injury can make defecation a difficult process however, excitation of the cord defecation reflex (either digitally or with an enema) can usually produce adequate defecation.

Treatment

GAD has typically included the elements of psychoeducation and recognition of anxiety symptoms, relaxation training, cognitive restructuring, and imaginal and in vivo exposure to worrisome thoughts and situations with prevention of overly cautious behaviors. Effect sizes (Cohen's d) immediately following treatment have typically been in the large range for those studies comparing CBT to wait list or usual care (Mohlman et al., 2003, .65 Stanley et al., 2003, .75 Stanley et al., 2003, 1.01 Wetherell, Gatz, & Craske, 2003, .85) and in the small to medium range for those studies comparing CBT to an alternative treatment or attention placebo (Gorenstein et al., 2005, .36 Stanley et al., 1996, .28 Wetherell, Gatz et al., 2003, .29). These results are generally less favorable than in comparable studies with younger adults. The first randomized, controlled trial of an SSRI for late-life GAD found a medium effect for citalopram over pill placebo (Lenze et al., 2005, d .54). A recent open...

Stress and emotions

Psychological treatments that have been designed to limit the severity of skin diseases (usually eczema and psoriasis) have included different but complementary aspects such as working on the reduction of scratching behaviours and the reduction of stress. Research has shown that patients with severe eczema who received instruction in relaxation, as well as in what are called techniques to reduce scratching, showed vastly diminished eczema severity and medication use. Interestingly, it has been shown that the use of a relaxation-type treatment has been successful with children whose eczema was considered to be resistant to the usual dermatological treatments. The children's treatment consisted of listening to tapes of 'magic music' to increase relaxation and reduce scratching at bedtime. Most children improved on scratching, itching and sleep disturbance and, importantly, a follow-up a few years later revealed that the majority of patients had maintained these gains. It is thought that...

Heat Production

Tissues are responsible, in part, for heat production. Skeletal muscle tissue contractions produce heat and are an important part of the homeostatic mechanism for maintaining normal body temperature. During a skeletal muscular contraction, only 20 or 30 percent of the total energy released is used for mechanical work. The rest of the energy is released as heat. Two types of heat energy are produced initial heat--produced by the contraction and relaxation of a muscle recovery heat--produced after relaxation of a muscle.

Histamine

Histamine induces relaxation of the smooth muscle walls of pre-capillary arterioles, causing the vessels to dilate and thereby increasing blood flow this produces the redness and heat. Histamine also causes retraction of endothelial cells in post-capillary venules, forming intracellular gaps the resultant increase in permeability leads to oedema (leakage of plasma into the interstitial space) and produces the swelling and, in part, pain. These effects on the blood vessels are mediated through stimulation of histamine type 1 (H1) receptors.

Pathophysiology

Normal bladder storage and emptying function depends on integration between detrusor and sphincter function. During filling, sphincteric closure provides continence. Bladder filling should occur at low pressures and these pressures should not substantially change (5 cm of water) during the storage cycle. No detrusor contractile activity should occur during this phase. At vesical capacity, detrusor contraction and sphincteric relaxation occur as essentially simultaneous events. Detrusor contraction should be of sufficient magnitude and adequately facilitated to empty the bladder.

Intravascular Sounds

Heart sounds should be distinguished from murmurs. The latter, sometimes called pronoises, are heard during a normally silent period of the cardiac cycle and mostly relate to pathological conditions. A murmur is like a prolonged whoosh. It could be due to a narrowing of the aortic or pulmonary valve or to a leak through the mitral or tricuspid valves (both due to acquired or congenital causes), during systole of the ventricles. Figure 3.18 well exemplifies a systolic murmur due to aortic stenosis. But heart murmurs may also be heard when there is signicant narrowing of the mitral or tricuspid valve during diastole (that is during relaxation, when the blood is flowing from the left or right atrium into the re-

Organ models

The example in Figure 8.2 illustrates a combination of 'only' two subsystems to study the effects of cardiac contraction on coronary tree architecture and function. Models like this allow one to determine changes in coronary blood pressure during the cardiac cycle of contraction and relaxation. Like in the real heart, the coronary tree moves with the cardiac tissue, into which it is embedded, and the pressure inside the vessels changes with the external compression by the contracting muscle. This external pressure is calculated and shown with the deforming coronary vessel tree in Figure 8.2. Thus, current electro-mechanical models of ventricular anatomy and function allow one to describe coronary perfusion during the cardiac cycle. By linking this to the models of cell metabolism

Biosensors

Biosensors have the potential to affect field application areas including medicine, physical therapy, music, and the video game industry. Although biosensors are not limited to any group of people, they are par-ticulary useful for the handicapped. Even completely paralyzed individuals have electrical activity in their bodies that can be detected. One biosensor application developed for the handicapped is an electronic instrument that produces music from bioelectric signals. Signal inputs such as eye movements, muscle tensions, and muscle relaxations are converted to MIDI (Musical Instrument Data Interface) and output to a synthesizer. Before being mapped to MIDI, the signals are analyzed for specific intensity and spectral characteristics for the particular individual. For dysfunctional or weak muscles the signals can be amplified according the level of tension and relaxation. These signal inputs are then interpreted to

Rd e C vcde no

The scattering kernel has been modified to take into account only the antisymmetric part of K in (5.38) because the main collision operator (zeroth order part of K) has been replaced by the mere relaxation to the equilibrium. Doing that, one can notice an important flaw in the model, that nonnegativity of fe is lost because the turning crosssection K1(v, v', c) Vc has no sign. This disqualifies the model but the mere relaxation is already an artefact. However it keeps the fundamental idea and motivation behind this model (i) scattering only describes interactions with an external medium (or long range interactions through the chemoattractant) and thus is fundamentally a linear operator for a given function c(t, x), (ii) but here we wish to model local self interactions of cells and this requires a nonlinear local operator (namely the relaxation to the equilibrium state). Additionally, we have used a hyperbolic scale for the rescaling of (5.38) rather than a parabolic scale as was done...

Stress management

Teaching people with diabetes methods for reducing stress and tension, including diaphragmatic breathing, muscle relaxation or meditation (see page 47 above). In addition, stress inoculation involves having people visualise stressful situations while practising their relaxation skills, therefore allowing them to practise managing stressors in a safe environment and improving their confidence in coping with stressful situations. These techniques are designed to reduce tension and associated changes that occur in your body in response to stressors and have been found to be very effective for numerous health-related problems, including diabetes.

Anatomic Obstructive

Uterine Mav

This entity initially was thought to be very common etiology for voiding dysfunction in women and has been termed Marion's disease (44). It is defined as incomplete relaxation of the bladder neck in association with adequate magnitude and amplitude detrusor contraction. Several large series now have reported the very rare nature of this disease. Both Farrar and Massey have shown that in large groups of unscreened patients reporting for urodynamic evaluation, this is a very unlikely cause of obstructive symptomatology (45,46). However it can be well-delineated in some patients and should be excluded with fluoroscopic evaluation. The underlying etiology may be representative of a learned voiding dysfunction, and or a true organic disease as some authors have reported increased fibrosis and collagenous deposition within the bladder neck in these patients (47). Whether or not these histologic findings are cause or result of any component of bladder neck...

NADA and TRVP1

In blood vessels, NADA shares the ability of anandamide to activate both TRPV1 and the novel non-CB1 endothelial receptor. O'Sullivan et al. 87 have identified that the compound effects relaxation of small mesenteric vessels via TRPV1 receptors and the novel endothelial CB receptor in the superior mesenteric vessels the compound interacts with TRPV1 and CB1 receptors. In the small mesenteric vessels, NADA is significantly more potent as a vasorelaxant than anandamide, the EC50 being 0.41 M, as compared to 1.7 M. In the superior mesenteric vessels, the compound is also more potent, but in the aorta the EC50 values of 1 M were obtained for both anandamide and NADA.

Heart Cardiac Scans

The multigated acquisition (MUGA) scan is a radionuclide study of heart function. MUGA scans are performed while the heart is in motion so that images of heart contraction and relaxation can be recorded. Heart wall motion, ejection fraction, stroke volumes, ventricular function, and cardiac output can be evaluated with this study. ECG signals, recorded during the MUGA scan, are coordinated with the imager and computer so that images can be taken in timed segments called gates.