Relaxation Techniques

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Relaxation in the presence of intercalators

Another way to think of the effect of intercalators is to consider relaxation of DNA in the presence of ethidium bromide. Consider a topoisomer of'relaxed' pBR322 DNA (Lk Lkm +415, Tw +415, Wr 0) addition of ethidium bromide causes an untwisting of the DNA by, for example, eight turns (Tw +407) (Figure 2.18). The molecule must hence adopt an equivalent positive writhe (Wr +8). Treatment of the sample with a topoisomerase leads to relaxation of the DNA under the changed conditions (added inter-calator, reduced twist), that is Wr 0, Lk +407, Tw +407.4 Subsequent removal of the ethidium bromide causes an increase in twist and the appearance of negative writhe that is, the molecule becomes negatively supercoiled under the original conditions (e.g. Lk +407, Wr -6, Tw +413). This procedure is commonly used for the preparation of negatively supercoiled DNA of any required average specific linking difference such as those in Figure 2.15 relaxation under conditions of increasing ethidium...

Fractons and Vibrational Relaxation in Proteins

In his book on random walks, Howard Berg makes the memorable statement Biology is wet and dynamic (Berg, 1983). Indeed, biochemical processes are inextricably linked to the solution chemistry of the aqueous milieu. One might anticipate a continuum description, as given in Chapter 5, as being the most appropriate for the diffusive processes of biochemistry. There is, nevertheless, considerable interest in discrete or jump transport processes. Such processes often provide a convenient mathematical limit for studying continuum events. However, discrete models are more than mathematical devices. The starting point for the formulation of vibrational relaxation in complex media are differential-difference equations. These equations have a rich phenomenology and can give rise to complex oscillatory and chaotic processes. The focus of the present chapter will be on vibrational processes in proteins. There are a number of other biological settings that are appropriately described by jump...

Relaxation And Tissue Contrast

The process wherein the magnetization returns to its equilibrium configuration parallel to B0 is known as nuclear spin relaxation. Typically, relaxation is conceptually separated into two separate processes (i) relaxation of the magnetization component that is parallel to B0 and (ii) relaxation of the magnetization component that is transverse to B0. The former is known as longitudinal or T1 relaxation, and the latter is known as transverse or T2 relaxation. Relaxation derives its energy from the random rotational and translational motion of the water (or lipid) molecules within the tissue. These motions are constrained by the tissue ultrastructure. It has not been possible to develop an exact theory of nuclear magnetic spin relaxation relevant to tissue due to the complex nature of the tissue ultrastructure. However, theories developed for simpler homogeneous materials can be extended to describe tissue nuclear spin relaxation. Moreover, tissue nuclear spin relaxation characteristics...

Theoretical Basis For Applied Relaxation

Since there are no studies regarding the mechanism of change for AR at this time one can only speculate concerning this issue. Personally, I believe that AR works through the patient having acquired the skill to rapidly achieve a state of relaxation, which counteracts the anxiety reactions both on a physiological and a cognitive level. Perhaps Bandura's self-efficacy theory can be used in this regard. There are at least three contributing factors which cannot be disregarded 3. Increased self-confidence. By using the relaxation skill in natural situations and noticing that it works, one can reduce or abort the anxiety altogether. The patient develops an increased confidence in their own ability to do something proactive. The patient is no longer a helpless victim of panic.

Instruction of Differential Relaxation

Continue to relax as much as possible in the entire body. While you do that open your eyes and look around in the room without moving your head. Look to your left . and to your right . up to the ceiling . and down to the floor. Concentrate on relaxing as much as possible in the rest of the body Now do the same thing but also turn your head in order to take in a larger field of vision. Look to the left and to the right up to the ceiling and down to the floor. Good Take the head back to a comfortable position and relax as much as possible. Let your arms rest against the elbow rests and now lift the right hand a bit from the support. Concentrate on the relaxation in the left hand and arm . now stretch the arm straight out . and straight up in the air . focus on the relaxation in the left arm . and now take the right arm back to a comfortable position on the armrest. Relax as much as possible in your right arm and do the same thing with the left arm. Lift the left hand a little bit from...

Cue Controlled Relaxation

The purpose of cue-controlled relaxation (CR) is for the patient to learn to associate the self-instruction relax with a relaxed state, and further reduce the time it takes to become relaxed. Cue-controlled relaxation may be introduced to patients as follows Most of us have probably been in situations where we or an acquaintance have been very nervous. In that situation we often get the advice to 'take it easy and relax.' This advice very seldom works since it is given when we are already mentally and physically at a high arousal level. In order to relax in these situations you must practice pairing the relax self-instruction with the relaxed state. Once you can successfully make yourself relaxed, you then need to start practicing this cued relaxation in increasingly more stressful settings. The session starts by the patient relaxing on their own with the help of the release-only version of PR, which the patient has been practicing for 1-2 weeks. When having achieved a deep degree of...

Introduction to Rapid Relaxation

The purposes of rapid relaxation (RR) are to teach the patient to relax in natural but not anxiety-arousing situations, and to further reduce the time it takes to become relaxed. The goal for this is 20-30 seconds. In order to reach these goals the patient should use rapid relaxation 15-20 times a day in natural situations. At this stage it is very important that the therapist spends some time to thoroughly go over the goals with the patient and to write down suitable situations that function as signals for RR training. The therapist asks the patient to describe what an ordinary day looks like to them and what they do between getting out of bed in the morning through going to bed at night. Among those activities that the patient does one can choose signal situations in such a way that it make up at least 15 practice occasions per day.

Relaxation Therapies

Since the late 1950s a host of formal relaxation therapies including progressive muscle relaxation training, autogenic training, imagery training, biofeedback, and hypnosis have all been used to treat insomnia. Common to these approaches is their focus on such factors as performance anxiety and bedtime arousal, which often perpetuate sleep difficulties. Regardless of the specific relaxation strategy employed, treatment entails teaching the insomnia sufferer a formal exercise or set of exercises designed to reduce anxiety and arousal at bedtime so that sleep initiation is facilitated. Typically multiple weekly or biweekly treatment sessions are required to teach relaxation skills that the patient is encouraged to practice at home in order to gain mastery and facility with self-relaxation. The goal of all such treatments is that of assisting the insomnia sufferer in achieving sufficient relaxation skills so that insomnia resulting from sleep-related performance anxiety and bedtime...

Instruction of Rapid Relaxation

When the patient is relaxing in natural situations during this phase of AR the relaxation has largely been reduced. The patient is instructed and the therapist models the following sequence If, after doing all the above, the patient still feels that they haven't achieved a deep enough degree of relaxation, one can take one more deep breath as described above. In some cases the entire sequence can be repeated for a third time. After this the patient should be content with the degree of relaxation achieved. Otherwise there is a risk that the patient will trigger symptoms of hyperventilation, which of course counteracts the purpose of RR.

Relaxation Enhancement

Biological tissues are associated with characteristic relaxation time constants T and T2, which reflect processes of longitudinal and transverse relaxation (often referred to as spin-lattice and spin-spin relaxation, respectively). These relaxation time-constants may indeed be directly interpreted as indicative of the nature of the microenvironment longitudinal relaxation is facilitated by (although not solely by) the presence of macromolecular or microstructural entities - hence water proton Tj may be short in white matter, and rather longer in cerebrospinal fluid in which such moieties are less prevalent. Similarly, spin-spin relaxation rates are facilitated by interactions between protons of water molecules. In the cerebrospinal fluid (CSF) environment, such interactions are brief in duration and so remain relatively ineffective (leading to a rather long T2 value). By comparison in more physically constrained biological tissues, in which interactions are more pronounced, the T2...

Releaseonly Relaxation

Below is an example of the instructions used in this phase Breathe with calm, regular breaths and feel how you relax more and more with each breath Just let go Relax your forehead eyebrows eyelids jaws . tongue and throat . lips . and your entire face Relax your neck . shoulders . arms . hands . and all the way out to your fingertips Breathe calmly and regularly . and let the relaxation spread to your stomach . waist and back Relax the lower part of your body, your buttocks . thighs . calves . feet . and all the way down to the tips of your toes Breathe calmly and regularly and feel how you relax more and more with each breath Continue to relax like that for a while Pause for about 1 minute. Now take a deep breath, hold it . and let the air out slowly . slowly . Notice how you relax more and more.

Differential Relaxation 1 Introduction to Differential Relaxation

In order for AR to be an effective coping skill it must be portable, The patient should be able to use it in practically any situation and not be constricted to a comfortable armchair in the home or in the therapist's office. The primary purpose of differential relaxation (DR) is to teach the patient to relax in other situations besides in the comfortable armchair. The secondary purpose of DR is to learn not to be tense in the muscle groups not being used for the activity at hand.

Progressive Relaxation

The method involves learning to relax by first tensing and then relaxing different muscle groups in the body. Briefly tensing muscles makes it easier to experience the contrast between a tensed and a relaxed muscle, and to notice tension in various muscles during daily activities. The different muscle groups that are included can be conceived of as a menu from which patients can choose. There is absolutely nothing sacred about the constellation of muscle groups. The important thing is that as patients achieve a high degree of relaxation, they need not always follow the PR instructions to the letter. For some patients the tensing releasing of a certain muscle group can lead to an experience of increased tension in that muscle. If that is the case, that particular muscle group may be deleted from the relaxation training. Progressive relaxation training begins with demonstrating to patients exactly how the different muscle groups are to be tensed and relaxed. The therapist sits opposite...

Relaxation Techniques

Relaxation is different from leisure. Leisure activity is an important way to achieve balance. Physicians will find the stressors of leisure enjoyable in part because they are so different from the common stressors of professional life. Leisure activity will also usually involve family and friends. However, leisure activity frequently contains stressors of its own that tend to arouse and fatigue, rather then renew. Relaxation is different from doing nothing. Relaxation actually increases awareness and focuses the mind while resting the body. It is a time to be present, to reflect, and to process experiences and feelings. Systematic relaxation requires concentration and deliberate mental activity. It will lead to lower arousal and release of strain. It can be particularly helpful if the relaxation does not require physically leaving the home, e.g., pleasure reading, gardening, hobbies, and crafts. For those finding it difficult to achieve this level of relaxation, many techniques are...

Relaxation exercises

Anxiety increases when dyspnea increases. Previously this has been primarily a clinical observation with anxiety increasing with increasing shortness of breath in a synergistic spiral resulting in severe shortness of breath and panic. Recently anxiety has been associated with increasing or high dyspnea in a controlled trial of asthma patients in an emergency room,63 in COPD patients during treadmill exercise64 and in cancer patients.8 Since they are related, strategies that decrease this anxiety or modulate the level of distress might be expected to reduce dyspnea. Relaxation may have a physiological effect by reducing respiratory rate and increasing tidal volume, thus improving breathing efficiency and dyspnea.65 One investigator studied the effect of relaxation on dyspnea in 10 patients with COPD compared with a control group that was instructed to relax, but not given specific instructions. Although dyspnea was significantly reduced for the relaxation group during treatment...


First, the protons slowly (on the time scale of seconds for most brain tissue) realign with the main magnet. This is called longitudinal relaxation, and the time constant associated with this exponential process is called T1. Second, the signal generated by the collection of precessing protons is weakened by the

Perioperative Management

Position Arm Dependent Position

A basic requirement of anesthesia for hip arthroscopy is satisfactory muscle relaxation at the hip. This allows distraction of the joint and permits adequate arthroscopic visualization. Regional techniques such as spinal or epidural anesthesia will provide the required muscle relaxation, but often require intravenous adjuncts for patient comfort. Although hip arthroscopy may be accomplished with patients in the supine position on a fracture table,2 the preferred method at our institution is to place the patient in the lateral decubitus posi-tion.3 (See Chapter 9.) After surgical prep and draping, the patient is seldom able to watch the procedure on a video monitor due to obstructed vision. Thus, the advantages of regional anesthetics are lost on two counts The patient's position may be quite uncomfortable during extended cases, and can require substantial amounts of supplemental intravenous medications. Furthermore, patient expectations to remain awake General anesthesia utilizing an...

Dnabinding Cyanine Dyes

The fluorescence quantum yield of cyanine dyes increases when torsional motion around the methine bridge is restricted, which reduces the probability of nonradiative relaxation from the excited singlet state. 7,8 When the dyes bind DNA, internal rotation is likely to be strongly hindered, which causes the dramatic increase in fluorescence.

Determinants of Functional Residual Capacity

Lung volume is determined by the interaction of elastic and surface tension forces in the lung and by the elastic properties of the chest wall. This interaction is illustrated in a relaxation pressure-volume curve, obtained from a person breathing from a spirometer (Fig. 6). At specified volumes, the mouthpiece is closed, the person relaxes the respiratory muscles, and pressures are measured. Figure 6 shows pressure-volume curves plotted against the appropriate transmural pressure for the lung alone (Pl), the chest wall alone (Pcw), and intact respiratory system (Prs). The lung curve is a function of Ppl, estimated from esophageal pressure as described earlier, and equals the curve that would be measured using positive pressure inflation on an excised

Echo Pulmonary Vein Doppler

Pulmonary Venous Doppler Young

AR, pulmonary venous peak atrial contraction reversal velocity EDT, early left ventricular filling deceleration time IVRT, isovolumic relaxation time S D, systolic-to-diastolic pulmonary venous flow ratio. AR, pulmonary venous peak atrial contraction reversal velocity EDT, early left ventricular filling deceleration time IVRT, isovolumic relaxation time S D, systolic-to-diastolic pulmonary venous flow ratio. If elevated intracardiac filling pressures are superimposed upon impaired LV relaxation, the Doppler pattern of mitral inflow can again appear normal, with an E A ratio greater than 1 and decreased E-wave deceleration time (Fig. 7). This occurs because increased LA pressure re-establishes a higher gradient between the LA and the LV, providing a larger pressure head to drive LV filling in early diastole. The result is a higher peak E-wave velocity and more rapid filling (decreased E-wave deceleration time). The fact that this apparently normal pattern occurs in the presence of...

Ethidium bromide titration

We have seen that binding of ethidium bromide changes the conformation of closed-circular DNA, producing a reduction in twist and a corresponding increase in writhe. Since these changes have an energetic cost, the intrinsic binding affinity of ethidium bromide (EtBr) is modulated by the topological state of the DNA. In particular, EtBr will bind with higher affinity to a negatively supercoiled molecule (ALk < 0) than to an unconstrained molecule (e.g. nicked-circular), since binding results in a reduction in the energetically unfavourable (negative) writhing of the supercoiled molecule, as well as the reduction in twist that occurs in both closed-circular and nicked molecules. On the other hand, binding of ethidium bromide to relaxed or positively supercoiled DNA is less favourable than to nicked-circular, since this results in the introduction of (positive) writhing. This is the reason that the numbers used in the example in Section 2.5.6 are not strictly accurate Relaxation of the...

Case Illustrations

Because of the diverse areas of applications of clinical biofeedback, instead of case examples, two general clinical protocols will be presented. The two clinical protocols selected for presentation will be the protocol for biofeedback facilitated relaxation training (BFRT) and for QEEG feedback for ADD ADHD. These protocols reflect the two major strategies of clinical biofeedback applications biofeedback for relaxation purposes and a specific biofeedback training technique based on specific physiological levels that are related to the diagnostic category.

Gynaecological Surgery

Hysterectomy may be undertaken by abdominal or vaginal route. Abdominal hysterectomy equates to a laparotomy in its anaesthesia requirements although the use of a low transverse incision has encouraged the use of the laryngeal mask airway instead of endotracheal intubation (assuming no other contraindications, such as morbid obesity). Muscular relaxation and IPPV are usually required with volatile agent and opioid of choice. Post operative pain relief may be delivered by the use of epidural infusions or PCA. The combination of PCA with a rectally administered non steroidal anti-inflammatory drug (such as diclofenac 100 mg) is widespread. Rectal administration of non steroidal anti-inflammatory agents in gynaecological surgery is especially indicated as the high concentrations of the drug which are found in the pelvic venous plexus after absorption ensure delivery to the surgical field. Vaginal hysterectomy is less of an insult than abdominal hysterectomy but has broadly similar...

Theoretical Bases

Recently, however, reports from patients suffering panic attacks and reports of laboratory findings, especially the occurrence of adventitious panic attacks during physiological assessments, have shown (1) the occurrence of hyperventilation in panic attacks, (2) the relatively low resting level of CO2 in the arterial blood of patients who suffer panic disorder, and (3) the high incidence of complaints of severe dyspnea reported to occur in panic attacks. As a consequence of this connection between aberrant breathing and panic, programs for the treatment of panic disorder include breathing retraining in an attempt to reduce ventilation. Programs of treatment that do not directly address breathing either prescribe a drug, unwittingly or by inten tion, that reduces ventilation (e.g., benzodi-azepines) or a method (e.g., relaxation) that indirectly reduces ventilation thus preventing hyperventilation and concomitant panic or terminating an attack soon

Left Ventricular Pressure

The QRS complex of the ECG initiates ventricular contraction. As the pressures in the left ventricle increases during isovolumetric contraction, it comes to exceed the pressure in the aorta. At this point the aortic valve opens and ejection begins. The aortic valve opens at about 80 mmHg. Ejection continues as long as ventricular pressure exceeds aortic pressure. The total volume ejected into the aorta is the stroke volume (SV). The ventricular pressure increases initially during ejection, but then starts to decrease as the ventricle relaxes. The gradient between ventricle and aorta starts to reverse at this point, since LV pressure has started to fall but aortic pressure is maintained by the momentum of the last of the ejected blood. When the ventricular to aortic pressure gradient has reversed, the aortic valve closes and isovolumetric relaxation begins. The dicrotic notch on the aortic pressure curve (below) marks this point. The LV pressure normally reaches a systolic maximum of...

Sedation Agents And Techniques

Sedate children and should not be forgotten in the midst of a busy emergency department. As previously discussed, parental involvement, verbal preparation, relaxation, tactile stimulation, and distraction techniques are all effective. Manual restraint (sheets or papoose boards) may be required as an adjunct to the nonpharmacologic and pharmacologic approach to procedures for infants and toddlers. Parent should not be requested to provide or be responsible for the restraint of the child, but rather should be encouraged to provide comfort.

Attainment of Adulthood

Boys become men when they have gone through their initiation into one of the fraternities. For girls, marriage results in a relaxation of the tension brought about by the pressures on her to bring a husband into the house. She hopes to become pregnant soon, thus contributing to the continuity of the household and clan. Her early years of marriage are regarded as a happy time for most women, since she has met her goal and relations with her mother once again become warm and close.

Nature And Effectiveness Of

Cognitive-behavioral treatments of GAD have differed in their nature and emphasis. Early approaches consisted of biofeedback, relaxation therapies, and anxiety management training with later combinations of cognitive and behavioral strategies. The cognitive therapy component has been based around self-instructional training or the cognitive methods of Beck and Emery (1985). Controlled trials with DSM-III-R-or DSM-IV-diagnosed GAD patients demonstrate that cognitive-behavioral treatments are associated with significant clinical improvement. Moreover, these studies show that treatment gains are maintained at 6 and 12 months following the end of therapy. In one study there was evidence of maintenance of gains at 2 years (Borkovec, Newman, Pincus, & Lytle, 2002). Cognitive-behavioral therapy (CBT) appears to be associated with the largest treatment effect when compared with anxiety management, nondirective psychotherapy, or psychoanalytic psychotherapy (Durham et al., 1994). Fisher and...

Secondsite Binding Using Paramagnetic Probes

In steps 3 and 4 of SAR by NMR, it was necessary to saturate the first binding site and then screen for second-site ligands. While the traditional SAR by NMR strategy does this using chemical shift perturbations, one can also use paramagnetic probes 83, 84 . In this strategy, a first ligand is labeled with an organic nitr-oxide radical probe like TEMPO The location of the second ligand, relative to the first, is established based on the distance-dependant relaxation effect of the probe on the second ligand. The significant advantage offered by this method is that protein does not need to be labeled and sensitivity is quite high. The latter is true because the relaxation effect is dependant upon the gyromagnetic ratio of the electron, which is 658 times larger than that for protons. The relaxation rate enhancement is given by tron and nuclear spin, p is the Bohr magneton, fflH is the proton Larmor frequency and r is the distance between the probe and the proton on the second-site...

Rapid Intraoperative Tissue Expansion

Sasaki (49) originally reported the technique of rapid intraoperative tissue expansion in 1987. The mechanisms involved include mechanical creep (described above) and stress relaxation. Stress relaxation refers to the finding that the load required to maintain the skin in a stretched position decreases with time. There is controversy as to whether there is an actual gain in tissue volume or simply an apparent gain secondary to recruitment of adjacent tissue (45).

Length of the DHA Chain

These observations indicate that whatever DHA's conformation is, it must be compact. A second model, based on the ROS membrane, predicts a much different structure for DHA. A molecular spring model predicts a helical structure where DHA lengthens and shortens to accommodate conformation changes in rhodopsin (Dratz & Holte, 1992). Conformational energy calculations suggest DHA can lengthen or shorten over a range of 3-4 A with a small input of energy (Dratz et al., 1985). NMR order parameters and spin lattice relaxation times support the idea that DHA performs rapid structural transitions between extended and looped conformations (Holte et al., 1998 Koenig et al., 1997 Mitchell et al., 1998). It is therefore likely that whatever DHA's structural role in membranes is, it does not support a thick membrane in fact, DHA's conformation is quite compact.

Nuclear magnetic resonance relaxometry and imaging

Nuclear magnetic resonance (NMR) relaxometry and imaging have been evaluated as a technique to measure mealiness. Barreiro and colleagues used magnetic resonance techniques to assess mealiness in apples (Barreiro et al., 1999) and peaches (Barreiro et al., 1998b). Magnetic resonance techniques rely on the magnetic properties that some atomic nuclei have. When placed in a magnetic field, the natural magnetic dipoles of the nuclei reorient themselves along the magnetic field. After excitation they return to their equilibrium position. The rate at which this happens can be expressed by two relaxation times (T1 and T2) and is a function of the texture of the material (Smith and Lange, 1998). Barreiro et al. (1999) found that the variability of the T2 values inside an apple was larger than that between apples. However, a difference between the average T2 value of fresh apples and that of apples stored in mealiness-enhancing conditions was noticed minimum T2 values were shown to be...

Characteristics Of Gastrointestinal Peptides

The GI peptides regulate many different functions water and electrolyte secretion from the stomach, pancreas, liver, and gut enzyme secretion of the stomach and pancreas and contraction and relaxation of the smooth muscle of the stomach, small and large bowel, various sphincters, and gall bladder. These peptides also regulate the release of GI peptides and some other endocrines, such as insulin, glucagon, and calcitonin. Some GI peptides have trophic effects, regulating the growth of the exocrine pancreas and the mucosa of the stomach, small and large intestine, and gall bladder. Many peptides have identical effects on an end organ. Others may produce opposite effects.

Epinephrine adrenaline

Dose range is 0 01-0-3 micrograms kg-1 per minute. Epinephrine is a potent 01, 02 and a agonist. The cardiovascular effects of epinephrine depend on dose. At lower doses (0 005-0 02 micrograms kg-1 per minute which is the equivalent of 1 ml h-1 of 5mg epinephrine in 50 ml saline), pi stimulation predominates, that is, increased contractility, heart rate, and hence cardiac output. There is some stimulation of 02 receptors causing bronchodilation and vasodilatation in certain vascular beds (skeletal muscle). Systemic vascular resistance may fall, which explains the reduction in diastolic blood pressure that is sometimes seen. However, blood pressure tends to rise because 01 effects predominate. Epinephrine also enhances the rate of myocardial relaxation, to allow increased diastolic filling time.

Chronic obstructive pulmonary disease COPD

Dyspnoea, particularly on exercise, is a characteristic feature of COPD. At rest the inspiratory muscles are at a disadvantage due to hyperinflation which leads to the universally accepted finding that such patients generate reduced inspira-tory pressures,32-34 although this reduction is appropriate35 when the degree of hyperinflation is considered. Earlier studies considered that diaphragm fatigue accompanied exercise in COPD36 but as noted this has proved impossible to replicate using phrenic nerve stimulation techniques. In fact available data suggest the diaphragm in COPD is fatigue-resistant both because of changes in fibre type37 and also because shortened muscle is less susceptible to fatigue.13'38 Patients with COPD do demonstrate excessive inspiratory muscle loading, manifest by slowing of the maximal relaxation rate, both during weaning from mechanical ventilation39 and during exercise.40,41 Therefore it is plausible that perception of this loading contributes to dyspnea

TABLE 1532 Clinical Presentation of Serotonin Syndrome

At present, there are no accepted guidelines for the use of serotonin antagonists in the treatment of serotonin syndrome. Isolated human case reports suggest that cyproheptadine, methysergide, and propranolol have the potential to be effective antiserotonergic agents. Benzodiazepines are nonspecific serotonin antagonists and can be used to decrease patient discomfort and promote muscle relaxation. Cyproheptadine (Periactin) appears to be the most effective antiserotonergic agent in humans.1 ,. .8 It should be on most hospital formularies. The initial dose is 4 to 8 mg PO. This dose can be repeated in 2 h if no response is noted to the initial dose. Cyproheptadine therapy should be discontinued if no response is noted after 16 mg has been administered. Patients who respond to cyproheptadine are usually given 4 mg every 6 h for 48 h to prevent recurrences. The use of dopamine agonists (e.g., bromocriptine) have no accepted role in managing patients with serotonin syndrome. Dantrolene...

Clinical Features

Biliary tract disease is an important consideration in the evaluation of dyspepsia. 10 Biliary dyskinesia or increased resting pressure of the sphincter of Oddi, or incoordination between gallbladder contraction and relaxation of the sphincter of Oddi, has been proposed as a cause of biliary tract induced dyspepsia. 10

Large Intestinal Motility

The myenteric plexus in the large intestine is concentrated underneath the teniae, that is, between the layers of longitudinal and circular muscle. The myenteric plexus receives input from local receptors and from both the parasympathetic and sympathetic systems. Parasympathetic fibers from the vagus innervate the cecum and ascending and transverse colons, and the descending and sigmoid colons and the rectum and anus are innervated by the pelvic nerves from the sacral region of the spinal cord. The pelvic nerves enter the colon near the rectosigmoid junction and project anteriorly and posteriorly along the myenteric plexus innervating it as well. Sympathetic innervation is supplied to the proximal colon via the superior mesen-teric ganglion, whereas the inferior mesenteric ganglion provides fibers to the distal colon. The rectum and anal canal receive sympathetic innervation from the hypogastric plexus. Within the autonomic system acetylcho-line, substance P, and tachykinins mediate...

Cultural Construction of Gender

Males and females are distinguished according to their different genitalia, as penis ones (me my) and vagina ones (me ni). However, human growth is not automatic and the social qualities and physical abilities that allow one to act as an adult man or woman are built up slowly, although transition from one age gender category to another is abrupt. The formation of the fetus requires repeated intercourse and may involve different men. Different phases of the life cycle are signaled by passage to the next age grade. Each age grade carries distinct standards of proper food consumption, social behavior, including sexual behavior, and distinctive participation in economic and ritual activities. Toward the end of their lives, elderly men and women have acquired quite different knowledge but act in very similar ways and enjoy a similar relaxation of dietary rules and codes of etiquette. Attributes of gendered persons are also differentiated according to age. It is difficult to point to any...

M Tension and Migraine Headaches

There is a wealth of outcome research demonstrating that these two disorders can be effectively treated with biofeedback techniques. For tension headaches, BFRT, with placements of the EMG sensors in the frontal location, combined with general relaxation techniques, such as PMR has been shown to be effective. Utilization of specific muscle feedback of the muscles of the face, neck, and cervical area has also proven effective. This author recommends the combination of frontal EMG feedback, PMR, and specific muscle feedback of the face, neck, and cervical area. The muscles selected for the feedback are determined by a dynamic EMG assessment. For biofeedback treatment of migraines the treatment of choice is finger temperature feedback combined with a relaxation technique, such as autogenic training. For those clients unresponsive to the finger temperature feedback, usually frontal EMG feedback will be effective. Based on the outcome research, biofeedback should be the treatment of choice...

Normal Anatomy of the Cerebral Arterial Vasculature

Major Cerebral Arteries

Smooth muscle cells within the cerebral vessels vasoconstrict or vasodilate in response to wall stress and shear to maintain a constant blood flow over a wide range of blood pressures. Within the endothelial cell, a complex balance exists between calcium levels and phosphorylation states of myosin. Central to this balance are endothelium-derived relaxation factors (EDRFs) and endothelial-derived constricting factors (eDCFs). The EDRFs include nitric oxide (NO), prostacyclin, and endothelium-derived hyperpolariza-tion factor notable EDCFs are endothelin, angiotensin II, prostaglandin F2a, and the thromboxanes.

Psychological support and behavioral interventions

Dyspnea may have a significant affective component and thus it is not surprising that patients suffering from chronic lung disease may experience anxiety and reactive depression.14'15 These symptoms can improve as patients participate in exercise training in a supportive and secure environment.16 Although some patients with major psychological problems may require specific intervention by a psychologist or psychiatrist, this is usually not necessary for the majority of patients. Indeed, the usefulness of psychological therapy alone in patients with chronic lung disease remains uncertain. Lustig and colleagues observed that 15-20 rehabilitation sessions, which involved exercise, education and relaxation techniques, produced either comparable or Although the evidence supporting the use of psychotherapy in pulmonary rehabilitation remains equivocal, many programs do incorporate some form of relaxation training and behavioral counseling into their curriculum.

Neuromuscular Control

Electromyographic Olympic Snatch

Firing rate or rate coding is the repeated stimulation of a particular motor unit over time. To create the muscle forces for normal movements, the frequency (Hz) that motor units are usually rate coded is between 10 and 30 Hz, while FG motor units have a faster relaxation time and can be rate coded between 30 and 60 Hz (Sale, 1992). The re- peated stimulation of a motor unit increases the twitch force above the level of a single twitch (up to 10 times) because the tension in the fibers begins at a higher level, before the decay or relaxation in tension. Since recruitment tends to be asynchronous and firing rates vary with motor unit size, the twitches of the motor units in a whole muscle combine and fill in variations, resulting in smooth changes in tension. When muscle is artificially stimulated for research or training purposes to elicit maximal force, the frequency used is usually higher than 60 Hz to make sure that motor unit twitches fuse into a tetanus. A tetanus is the...

Movement of the Organelles in Mierogravity

It is well known that the nucleus is surrounded by a kind of basket of actin filaments, which is involved in the positioning of this organelle. It has been suggested that actin filaments are associated with both the nucleus and the plasma membrane and generated tension between them (Figure 6-12). The results obtained by Lorenzi and Perbal (1990) were in good agreement with this hypothesis since the displacement of the nucleus in mierogravity could be induced by a relaxation of the cytoskeleton.

Starch and derivatives aroma interaction

The change from the glassy state to the rubbery state, either induced by heat or because of plasticisation by water, favours the relaxation of polymer chains, which can consequently facilitate crystallisation under suitable conditions. Aroma and water molecules are then expelled from the crystalline regions towards the amorphous parts of the matrix and eventually towards the surface of the material (Roos and Karel 1991b, Whorton 1995). Total crystallisation of the carrier thus leads to a complete release of the compounds that were initially encapsulated.

Leadership in Public Arenas

Leadership in kin groups and the political arena demonstrates varying degrees of joint gender roles (Du, 2002 Wang & He, 1999, p. 292). The overlapping of gender roles in leadership is derived from the cosmological and social ideals of male-female coheadship, as expressed by the common saying, A pair of male-female masters rules together. At the beginning of the 21st century, most Lahu villagers in Lancang still adhere to the traditional institution of male-female masters of the household, focusing on the joint authority and responsibility of household coheads in making consensus decisions (Du, 2002 Lei & Liu, 1999, p. 246 Wang & He, 1999, p. 114). Whereas indigenous institutions of male-female coheadship at the village and village-cluster levels have been fundamentally disrupted or eliminated in most Lahu areas since the establishment of the P.R.C. in 1949, it has been revived in a few village clusters after the relaxation of state policy in China in the 1980s. For example,...

The descriptive core of the theories of Standard Analytic Epistemology

Part) of the story about how we can test the deliverances of those judgments under the heat of careful experimentation rather than in the relaxation of the philosophical salon. Perhaps our armchair judgments will survive those fires. But before offering the world recommendations about how we should reason or what we should believe about important matters, it seems prudent to check.

Treatment of Autonomic Dysfunction

Continuous epidural block with bupivacaine provides sympathetic nervous system blockade, muscular relaxation, and analgesia in generalized tetanus. 20 The central a-receptor agonist, clonidine, decreases central sympathetic and peripheral arteriolar tone 21 and has also been used to manage tetanus-induced cardiovascular instability. Finally, it has been suggested that overactivity of the parasympathetic nervous system may contribute to the autonomic instability in patients with tetanus, since many of the clinical manifestations of the disease mimic cholinergic crisis. Evidence supporting this concept is provided by a report that atropine provides cardiac stabilization in patients with severe tetanus.22

Septal Knuckle Hypertrophy Causing Lvot Obstruction

Valsalva Lvot

No clear relationship exists between the severity of hypertrophy and the severity of diastolic dysfunction. Asynchronous myocardial relaxation of the hypertrophied muscle can lead to complex patterns of intracavitary flow during diastole. Fig. 24. DUST discrete disproportionate upper septal hypertrophy in the elderly. Disproportionate upper septal hypertrophy is commonly seen in othewise normal elderly individuals. Note the relationship of the septal knuckle to the left ventricular outflow tract (A) with flow acceleration on color flow Doppler (B). Spectral Doppler envelope shows late-peaking velocities (C). The impaired relaxation pattern (E a ratio < 1) occurs in normal aging (D). Fig. 24. DUST discrete disproportionate upper septal hypertrophy in the elderly. Disproportionate upper septal hypertrophy is commonly seen in othewise normal elderly individuals. Note the relationship of the septal knuckle to the left ventricular outflow tract (A) with flow...

Metabonomics Data Acquisition Methods

Plasma and serum contain both low- and high-molecular weight components, and these give a wide range of signal line widths. Broad bands from protein and lipoprotein signals contribute strongly to the 1H NMR spectra, with sharp peaks from small molecules superimposed. Standard NMR pulse sequences can be used for spectral editing experiments. These are based on molecular diffusion coefficients or on NMR relaxation times and can be used to select only the contributions from macromolecules or the signals from the small molecule metabolites, respectively.

Scrotal Swelling and Scrotal Masses of Childhood

The safest and one of the more effective maneuvers for reducing incarcerated inguinal hernias involves relaxation of the abdominal wall, using sedation if necessary, and subsequent placement of the child in the Trendelenburg position. This results in successful reduction of the incarceration more than 70 percent of the time. Failure of this technique represents an indication for immediate surgical consultation and exploration.

The Focus The Bible

Desensitization for the Christian is not developed in specific hierarchy form in the Bible as it is with a therapist. However, the major component of desensitization, the training in relaxation under stressful situations, is evident in many passages So do not fear, for I am with you. (Isaiah 41 10) Do not be anxious about anything. (Philippians 4 6, 7) Let not your heart be troubled, neither let it be afraid. (John 14 27).

Motor Components of Vomiting

The early stages of vomiting usually start with a sensation of nausea, followed by signs of sympathetic activity including peripheral vasoconstriction, hyperventilation, sweating, pupillary dilatation, tachycardia and reduction in gastric secretion. Salivation occurs in response to parasympathetic activity. Vagal impulses arising from the dorsal motor vagal nucleus cause a profound relaxation of the proximal stomach followed by a retrograde giant contraction beginning in the mid-small intestine which propels small bowel contents proximally back into the stomach in preparation for ejection.

Esophageal Motility Disorders in Systemic Diseases Scleroderma

Fig. 3.55 Manometric findings in nutcracker esophagus. The traces show hypertonic propulsive contractions of prolonged duration in the tubular esophagus. The LES shows a normal resting pressure with adequate relaxation in response to swallowing (from Hahn and Riemann, Klinische Gastroenterologie. Vol. I, 3 rd ed. Stuttgart Thieme 1996) les lower esophageal sphincter sw swallow

Are Protein Dynamics Fractal

While it is easy to describe a picture of polymer dynamics, putting this picture into a mathematical model is not so simple. The energy transfer modes within the polymer will depend on the nature of the bonding and internal connectivity of the polymer. This makes proteins a particularly challenging problem. Most work involves sorting through the phenomenology of protein dynamics and experimentally exploring the multitude of relaxation processes that are occurring. In the next section, an introductory discussion of protein dynamics is presented. The time, length, and energy scales of an array of different processes are discussed. Considering the complexity and range of protein dynamical processes, it is not surprising that protein dynamical processes often have a nonexponential time dependence. In Section 6.2 we examine a number of physically plausible and simple models that generate nonexponential behavior. We see that these models can be classified within two general schemes...

Criticisms Of Biofeedback

Biofeedback by definition can involve a variety of physiological indicators, making its application highly variable. Thus, regardless of empirical findings, treatment using biofeedback is not well standardized. In some settings, biofeedback is equated with relaxation treatment and or variations occur in the specificity and sophistication of the physiological data provided to the individual (e.g., using computerized versus noncomputerized information real-time versus lag-time data).

Tranquilizer Withdrawal

The evaluation of the efficacy of a single-treatment mode presents some difficulty, for treatment trials usually combine a number of approaches in any condition and group. Caution must therefore be exercised when attempting to interpret the outcome of trials in terms of the effect of any single component of treatment. Some of the components are necessary to introduce or convey the techniques and have been found to be in themselves effective. Teaching the technique of slow abdominal breathing is usually embedded in progressive relaxation training, as tense abdominal muscles are likely to prevent slow and easy breathing. A further component is an extensive rationale as to why a particular technique will be helpful for a symptom. This necessitates discussion of the symptoms, including to a certain extent their reattribution. This strategy is the mainstay of cognitive restructuring, which is by itself highly effective in the treatment of panic disorder. Furthermore, in order to learn to...

Predisposing factors for anaphylaxis

Alcohol is a clear example of a drug that may work in several ways. In amounts that are consumed socially, it impairs judgement and encourages risk taking and may therefore impair the intellectual response to being exposed to a food known to potentially contain an allergen that is unsafe for the subject (the classic example being the Indian takeaway). Alcohol also works physiologically by causing relaxation of blood vessels, leading to a fall in blood pressure. A fall in blood pressure may be more precipitous if an allergen is consumed during a meal in which alcohol is also consumed.

Golgi Tendon Organ Reflex

Golgi Tendon Organ

Another reflex that modulates contraction and relaxation of skeletal muscles is mediated by the Golgi tendon organs. These are situated in the muscle tendon just adjacent to the muscle fibres. The Golgi tendon organs also respond to muscle stretch but supply a feed back signal (via Ib afferents) to inhibitory neurones in the spinal cord. These neurones synapse with the a motor neurones, inhibiting them and reducing skeletal muscle tone during contraction. The Golgi tendon feedback signal also stimulates antagonist muscles of opposing groups to the inhibited muscle (Figure MP.18). The result is to smooth rapid or jerky muscle contraction. If a muscle is subjected to an excessive stretching force the Golgi tendon organ reflex can cause virtual relaxation of the muscle, thus helping to protect it against mechanical rupture. The Golgi tendon organ reflex is thus an example of a positive feedback loop.

Systematic Desensitization

Systematic desensitization consists of gradual, imag-inal exposure to stimuli organized on a hierarchy constructed using SUDS ratings. The stimuli in Table 1, for example, could be used in systematic desensitization by having the patient imagine each stimulus. Typically, systematic desensitization is combined with some form of relaxation training. The patient is asked to sit back in a comfortable chair and practice a relaxation exercise. Once a state of deep relaxation is attained, the patient is asked to imagine the least upsetting stimulus on the hierarchy. Exposure duration might be only for a few minutes, alternating relaxation with imaginal exposure until the imagined stimulus no longer evokes fear or distress. The procedure is then repeated with the next stimulus on the hierarchy. The disadvantage of systematic desensitization is that it is slow, and that it is

Example of a BFRT Protocol

When using BFRT, it is first necessary to determine if the client would benefit from such therapy. General relaxation may be helpful in a variety of conditions and it may also be useful as an incompatible response during such procedures as systematic desensitization. BFRT normally takes between 8 and 20 sessions, depending on the acquisition skills and the distress level of the client before and during therapy. After determination of the need for BFRT, the therapist must explain the rationale for biofeedback therapy, outline the basic aspects of the physiological processes that will be trained, and discuss the potential benefits and risks of the training. This author recommends conducting the first BFRT session with frontal EMG feedback, while monitoring other modalities such as finger temperature, SCA, and or heart rate. The therapist may also find it beneficial to monitor additional physiological events that are connected to the specific conditions being treated. During the first...

Motor Theory Of Thinkingconsciousness See Whorfsapir Hypothesistheory

Diately after listening to the music of Wolfgang Amadeus Mozart. Spatial reasoning abilities are involved in any task that requires the actual or imagined (mental imagery) manipulation of objects in space (e.g., the mental rotation of objects such as the movement of pieces of a jigsaw puzzle, or the mental activity involved in reading a map). Recently, a team of researchers (Rauscher, Shaw, & Ky, 1993, 1995) found that three dozen college students increased their average spatial reasoning scores (with a supposed equivalency of about 8 to 9 IQ points) after listening to one of Mozart's sonatas (Sonata for Two Pianos in D Major). The increase in students' spatial reasoning ability, however, was only temporary (lasting fewer than 15 minutes). Moreover, when the same students sat in silence, or listened to a relaxation tape, the effect did not occur (i.e., there was no increase in their spatial reasoning abilities). Even though there have been numerous subsequent studies that have...

Anger Management Interventions

Patterns of anger loss and control, and to increase awareness of external triggers and internal physiological and cognitive reactions. Finally, several arousal management skills such as deep breathing, imagery, and relaxation are taught to help youths reduce the accumulated physical tension and to increase the probability that they will think through the interpersonal event in a more rational fashion.

Lung Mechanics and Volumes

Inspiration is mainly as a result of diaphragmatic movement since flaring of the ribs reduces chest wall movement. Bronchial smooth muscle relaxation decreases airway resistance but lung compliance remains unchanged. Factors contributing to airway dilatation include direct effects of progesterone, cortisone and relaxin.

Alternative types of exercise yoga

'Eastern' exercises, such as yoga or Tai-chi, may be alternatives to aerobic or endurance training for people who are limited by severe shortness of breath. These exercises may bring about relaxation, calmness, balance, and may promote changes in the pattern of breathing, including slow and deep breath

A T1 and Timeto Repeat

T1 relaxation may be visualized as follows At the conclusion of an excitation RF pulse, the magnetization is situated away from its equilibrium state. It takes a finite amount of time for the magnetization to recover to its equilibrium configuration. This recovery time is specified with a characteristic time constant that is known as T1. A series of image acquisitions produces signal intensity that is dependent on how rapidly the RF pulses are repeated relative to the rate at which the system is capable of relaxing. It is conventional in MRI to specify the rate of repetition with a parameter called time-to-repeat (TR). Figure 10 illustrates that repeated acquisitions done at short TR tend to produce a relatively weak signal (compared to longer TR) because the magnetization does not have sufficient time to reattain its equilibrium configuration. A series of measurements in which signal intensity is measured as TR is increased typically leads to results illustrated in Fig. 10....

Leisure Recreation and the Arts

Most adult leisure time is spent in relaxation and conversation with other persons of the same sex. Gender segregation is voluntary and not absolute. In the 1970s, the beer hall at the sublocation center, where traditional beer was brewed and sold, was a popular gathering place for older men and women (widows), and one of the few places where women and men were commonly seen socializing together. Beer parties in family compounds usually involved women brewing and tasting the beer in one area and men drinking it in another.

Developmental Issues

Treatment, such as through communication of CBT techniques (such as relaxation) through doll play and use of star charts to enhance the child's implementation of these techniques. Additionally, parents should be taught to understand developmental differences in the expression of trauma-related symptoms as well as methods of improving young children's functioning. School-age children, who are developing enhanced abstraction and reasoning abilities, view the world as orderly and lawful. They are likely to respond best to treatments that foster their sense of mastery and exploration of cause-and-effect relations through structured exercises, such as thought stopping, generation of alternative responses to events, and role-plays. Interventions with adolescents, who have solidly developed abstraction and reasoning abilities, may focus more on anxiety reduction through exposure-based techniques to decrease avoidance and enhance independence, emotional processing, cognitive restructuring,...

Summary And Future Directions

Overall, trauma-focused CBT should be considered the first line of treatment for childhood PTSD (AACAP, 1998). The combination of exposure-based behavioral techniques, including imaginal flooding and gradual exposures, with cognitive exercises, including relaxation, cognitive restructuring, emotional processing, and parental training, increases the therapeutic alliance to significantly reduce trauma-related symptoms in children. Further, cognitive-behavioral treatments work quickly, demonstrating change in 8 to 15 sessions, which bears important implications in this managed-care era. Despite the efficacy of this treatment modality for childhood PTSD, further research is needed to better understand the components of CBT that contribute to symptom improvement as well as to clarify which types of trauma, which populations, and which symptoms are most effectively targeted and improved by trauma-focused CBT. By doing this we can further develop and refine alternative interventions and...

Homebound with supported outings

In this phase attention and distraction strategies can be reinforced and practiced, so they will become a 'habit' before, but also as, shortness of breath increases. Attention strategies might include monitoring of the symptom, advanced planning of activities, energy conservation and appropriate rests, and the use of a fan. Distraction strategies might include music, TV, the Internet, walks, reading, relaxation, guided imagery, self-talk, acupressure, or massage. This phase may require a change or decrease in the exercise regimen, however, optional exercises can replace walking, such as, daily weights, breaking up the exercise to smaller intervals, or chair aerobics. Support groups either organized or within the community can also help patients to learn strategies to cope with increasing dyspnea. Vicarious learning from peers who have developed ways to manage dyspnea is a potent source of self-efficacy or confidence that will help them to control their dyspnea. In the hypoxic COPD...

Hospitalization phase

Patients with a severe exacerbation of COPD may require hospitalization. In qualitative interviews patients with shortness of breath in the hospitalization phase have described emotions of fear, anxiety, panic, helplessness and a feeling of urgency as if'each breath was the last'.96'145 Mechanically-ventilated patients have rated their dyspnea from mild to very severe, depending on different types ofprocedures, ventilator support, weaning periods, and the time in their illness trajectory.146-148 During hospitalization is an excellent time for teaching patients new strategies that may help their shortness of breath. This teaching needs to begin early in the hospital stay when the patient is comfortable or during rest periods on the medical unit.149 Hospitalized patients often have had previous experience with strategies that they have learned from others or developed themselves. The patient can be asked to describe or write down the strategies they typically use at home. Often a family...

Structures and mechanisms of topoisomerases

If we consider the DNA relaxation reaction in the light of our discussions about linking number changes in Chapter 2 (see Sections 2.2.1,2.3.1), it seems logical that topoisomerases should work by a swivel mechanism. This might involve breaking one (or both) strands of the DNA, allowing the free end (or ends) to rotate about the helix axis, and resealing the break. This would alter the linking number of the DNA as required by the relaxation reaction. However, if we consider the knotting unknotting and catenation decatenation reactions (Figures 5.1 and 5.2), it should be clear that a swivel mechanism cannot account for the full range of topoisomerase actions. In fact a different type of mechanism, called strand passage, can account for the ability of topoisomerases to catalyse all these interconversions. In its most general form, strand passage involves the cleavage of one or both strands of the DNA by the enzyme and the passing of a single- or double-stranded segment of DNA through...

Nucleoid Organization of Bacterial Chromosomes

The level of DNA supercoiling in the bacterial nucleoid is established and maintained largely by the action of specialist enzymes called topoisomerases (Table I). Bacterial DNA gyrase is a type II ATP-dependent topoisomerase that introduces negative supercoils into DNA, reducing its linking number in steps of two. It can also remove positive supercoils using the same enzymatic mechanism. The activity of gyrase is opposed in the cell by DNA topoisomerase I, a type I topoisomerase that removes supercoils from negatively supercoiled DNA by a swivelase mechanism, increasing the linking number of the molecule in steps of one. It acts independently of ATP, using the energy stored in the supercoiled DNA molecule to drive the reaction. E. coli has two other topoisomerases, III and IV (Table I) that can relax negatively supercoiled DNA, although their main role in vivo seems to be to act as decatenases. The promoters of the genes coding for gyrase (gyrA, gyrB) and topoisomerase I (topA) are...

Type II topoisomerases

Of a phosphodiester bond in ATP into the torsional stress of supercoiling. Although it must be assumed that this process involves conformational changes in the protein, little is known of the detailed mechanism of this energy-coupling process. It is interesting to note that other type II topoisomerases hydrolyse ATP but are able only to relax, not supercoil, DNA (Table 5.1). Gyrase can also relax supercoiled DNA, but this reaction does not require ATP. The requirement for ATP hydrolysis for the reactions of topoisomerase II, most of which are apparently energetically favourable, has been something of a puzzle. Experiments have suggested that it is likely that this energy requirement enables topo-isomerase II to catalyse reactions in which the products are a non-equilibrium distribution of topoisomers (29). For example, E. coli topoisomerase IV can relax supercoiled DNA to yield a distribution of relaxed topoisomers that is narrower than that obtained by relaxation by topoisomerase I...

Technical Aspects Of Rp

Marlatt and Gordon suggest that, in order for maintenance to be successful, and RP to be consistently achieved, the person must make lifestyle changes that support both new coping strategies and reduce the likelihood of encountering high-risk situations. For example, a person whose drinking is largely driven by the goal of relaxation and stress reduction associated with work might be encouraged either to change jobs, or to develop systematic stress-reducing activities that can be incorporated into the person's life outside of work.

Mineral Elements Macro

Only small fractions of the Ca, Mg, and P and most of the Na, K, and Cl are present as electrolytes in the body fluids and soft tissues. Electrolytes present in body fluids such as blood or cerebrospinal fluid serve important functions in maintaining acid base equilibrium, water balance, and osmotic pressure they regulate membrane permeability and affect the exitability of muscles and nerves. For example, a certain balance between Ca, Na, and K in the fluid that bathes the heart muscle is essential for the normal relaxation and contraction that constitute heart beats. Profound disturbances in neuromuscular function arise in animals when Ca and Mg in the blood plasma levels fall below threshold limits.

Dynamic Histone Acetylation

Recently, more research has been carried out on histone acetylation. Histone acetyla-tion, discovered more than 40 years ago, is a reversible modification of lysine within the N-terminal domain of core histones. Histone acetylation is catalyzed by HATs, and deacetylation is catalyzed by HDs or HDACs. The N-terminal tails of the core histones are rich in lysines and are therefore positively charged under physiological conditions. It is assumed that this allows an intimate interaction either with the negatively charged backbone of the DNA and or with adjacent nucleosomes, leading to a tight nucleosome formation and higher-order chromatin folding. Acetylation on histone may weaken its interactions with the DNA, resulting in an open chromatin conformation (Hansen et al., 1998 Walia et al., 1998). Such a conformation facilitates the access for transcriptional regulators and the combination to transcription factor and promotes gene transcription. It is believed that localized relaxation of...

Reticuloendothelial System RES Contrast Agents

Kupffer cells in the normal liver will take up partic-ulate matter from the circulation and this property has been utilised to produce a group of RES-specific contrast agents. These consist of suspensions of superparamagnetic iron oxide particles (SPIO) or ultra-small superparamagnetic iron oxide particles (USPIO) (Fretz et al. 1989 Weissleder et al. 1989 Weissleder et al. 1990). These agents exhibit strong T1 relaxation properties, and due to susceptibility differences to their surroundings also produce a strongly varying local magnetic field, which enhances T2 relaxation. Pathological tissues which do not contain reticuloendothelial cells will maintain their normal signal intensity. Currently available agents include Endorem and Feridex Ferrumoxides. (USAN). SPIO. Ami-25, dextran-coated) , Resovist (Ferucarbotran, car-boxy-dextran coated iron oxide nanoparticles), Sinerem (USPIO) and Combidex (ferumoxtran-10, AMI-227) (for manufacturers' details see Table 14.1). There is...

General biological consequences of negative supercoiling

DNA breakage-reunion reactions are features of both recombinases and topoisomerases (see Chapter 5) in the former case the broken ends are rejoined to new partners, in the latter they are reunited with their original partner. Often, these reactions lead to changes in linking number of the DNA substrate. Clearly, if the reaction occurs on negatively supercoiled DNA, then processes leading to a positive linking difference (ALk), such as DNA relaxation by topoisomerases, will be favoured. The processes of binding, synapsis, and strand transfer are general phenomena found in many systems of DNAprotein interaction Section 6.6.2 discusses these processes in detail in relation to site-specific recombination.

Mechanism Of Action Of Pglycoprotein

Of ATP binding affinity showed only small changes upon drug binding.83 Senior et al. proposed that transport is driven by relaxation of a high-energy intermediate formed during ATP hydrolysis, which thus provides the power stroke.79 One molecule of ATP was proposed to drive the transport of one drug molecule. Sauna and Ambudkar have proposed an alternative model in which two molecules of ATP are hydrolyzed per cycle.185 In this model, drug and ATP binding do not influence each other hydrolysis of one ATP molecule drives drug transport, and hydrolysis of a second ATP molecule resets the transporter. This model is also unsatisfactory. There has been no independent verification of the proposed requirement for two rounds of ATP hydrolysis per drug molecule transported. Sauna et al. reported that Pgps with mutations in the Walker B Glu residues (E556Q and E1201Q) failed to undergo the second round of ATP hydrolysis required to reset the transport cycle.186 However, this was contradicted by...

Reliabilityvalidity Theory

RELIEF TENSION-RELEASE THEORIES OF HUMOR LAUGHTER. The relief tension-release class of humor theories places great weight on the relief from stress and on relaxation that derives from the sudden removal of a threat or discomfiture (cf., release theory of humor - states that humor tends first to raise one's level of anxiety and then, subsequently, to lower the individual's anxiety-level). For example, the French philosopher Rene Descartes (1596-1650) maintained that laughter results from the joy that comes when an indignation at some evil or malice has been mitigated by the realization that it does not cause personal harm the British associationist philosopher David Hartley (1705-1757) asserted that laughter is an expression of pleasure at the elimination of something alarming or painful and the English psychologist James Sully (1842-1923) indicated that laughter may be produced by relief from strain or by the sudden induction of a playful mood. Other features of the relief...

Physiology And Behaviour

Hence the high energetic costs of having and maintaining heavy muscles and their associated skeletal support no longer have to be met. Thus many of the elaborately developed sensory systems supported by large brains and a well developed central nervous system, typical of many species in the upper mesopelagic and epipelagic zones, become a liability rather than an asset (Marshall, 1971). As a result many bathypelagic species are physiologically more akin to jellyfish than they are to their evolutionary closest relatives (Childress and Thuesen, 1992). In the many bathypelagic fishes that have larval stages that live and feed near the surface, as the maturing larvae migrate down into deep water many of their sensory systems such as eyes regress. There are also reductions in those parts of the central nervous system which become redundant as the sensory systems they previously supported become non-functional. Visual receptors are often replaced by elaborations...

Applications And Exclusions

Exposure therapies should only be implemented by a suitably trained therapist. The therapist should not only be skilled in exposure therapy, but should have a good understanding of psychopathology and psychiatric diagnosis, and should be skilled in the psychotherapeutic interventions commonly used in conjunction with exposure therapy (e.g., cognitive therapy, social skills training, relaxation training). If the patient experiences intense anger or guilt during exposure, as sometimes happens when treating patients with posttraumatic stress disorder, it is often necessary to combine exposure with cognitive therapy The latter is used to address any dysfunctional beliefs associated with anger or guilt.

Replication elongation

As the replication fork proceeds along a DNA template, the unwinding of the strands causes positive supercoils to build up ahead of the fork (Chapter 2, Section 2.2.1). This is because the fork cannot rotate to follow the helix of the DNA, either through sheer size, or because it is tethered to organizing structures in the cell. In the case of E. coli, DNA gyrase is the obvious candidate topoisomerase to remove the positive supercoils (which would otherwise rapidly inhibit elongation) since it is efficient at relaxation of positive supercoils, whereas topoisomerase I will relax only negative supercoils (see Chapter 5, Section 5.3.1). However, it has been found that topoisomerase IV can also fulfil this function, at least in situations where gyrase is inhibited (33), suggesting that the two enzymes (gyrase and topo IV) may have overlapping functions. Additionally it has been found that in the absence of gyrase, E. coli topoisomerase III (see Chapter 5) is also capable of supporting...

Treatment For Children And Adolescents

One of the more widely investigated interventions for children with anxiety disorders is Kendall's (1992) Coping Cat program. In this 16-week program, children learn to recognize feelings of anxiety, identify negative and unrealistic thoughts, apply coping self-talk, and use self-reward as they undergo therapist-guided exposure exercises. Relaxation training is also utilized to enhance coping skills in feared situations. In the first controlled trial of this program, 64 of treated children (ages 9 to 13) were diagnosis-free at post-treatment by child and parent report. This was the case for only one child in the wait-list condition (Kendall, 1994). In a study replicating these findings, no differences were found in treatment outcome between diagnostic groups, suggesting

Cardiovascular System

In contrast, other effects of prenatal alcohol may be more subde, but permanent, and therefore more consistent with programming. For instance, adult rats exposed to alcohol as fetuses have shorter cardiomyocytes and impaired responsiveness to extracellular calcium or stimulating frequency.40 Impaired contractile responses of adult cardiomyocytes have also been observed in cells from rats born to dams that had been treated with 6 g alcohol per kg per day from e8 to e20 (maximum blood alcohol -0.26 ). Cells from alcohol-exposed rats in this study had decreased peak tension development and maximum contraction and relaxation velocities compared to controls. Furthermore, it has also been noted that the cardiomyocytes of adult rats exposed prenatally to alcohol have increased resting and peak intracellular calcium concentrations , and decreased calcium responses to caffeine. 1 Similarly, prenatal exposure to alcohol may alter vascular structure and or function. In vitro, rings cut from the...

Might There Be Deleterious Consequences of Introducing DNA Hypomethylation in the Genome As a Cancer Therapy

Sullivan MJ, Taniguchi T, Jhee A et al. Relaxation of IGF2 imprinting in Wilms tumours associated with specific changes in IGF2 methylation. Oncogene 1999 18(52) 7527-34. 63. Malik K, Salpekar A, Hancock A et al. Identification of differential methylation of the WT1 antisense regulatory region and relaxation of imprinting in Wilms' tumor. Cancer Res 2000 60(9) 2356-60.

Personality Differences by Gender

Stereotypic Tarahumara female behavior is quiet, soft-spoken, modest, and shy, particularly with strangers, while males can be more outgoing and vocal. In reality, diverse personalities are expressed by both sexes. Children up until the age of 5 or 6 are allowed relatively free expression of their emotions, but as they get older girls and young women are more firmly socialized to avoid unrelated members of the opposite sex, to be soft-spoken in the presence of others, to be nurturing, strong, cooperative, and responsible, and to avoid conflict. Boys are socialized similarly, but are allowed more freedom of movement and a wider circle of social interaction, which increases as they mature into men. Older women and men, especially past child-rearing age, enjoy relaxation of the social norms and often become more outspoken and interact more freely with both sexes. Many of these stereotyped personalities break down during tesguinadas (drinking parties). It is culturally expected and...

Lateral Inhibition Theory

LATTA'S COGNITIVE-SHIFT THEORY OF HUMOR. Robert L. Latta (1998) proposed a cognitive-shift theory of humor (which he calls Theory L, named after himself) that is intended to be an argument against the traditional incongruity theories of humor. Latta's theory - expressed in logical and syllogistical terms - may be classified as a response-side theory, and states that the response aspect of the basic humor process demonstrates a particular pattern. Specifically, the person responds to stimuli in a way that entails unrelaxation that is, the individual makes a cognitive shift (which implies relaxation), and then responds to the situation the shift creates by relaxing again through the mechanism of laughter. Latta argues that his approach accomplishes the following it meets the challenges often raised against relief theories of humor it allows for the occurrence of a wide variety of humor processes it incorporates the genuine insights of other theories of humor it explains the...

The Golgi Tendon Organ

In summary, the muscle spindle and the Golgi tendon organ provide counterbalanced systems for setting overall muscle tone. Group Ia and II afferents from muscle spindles carry information about the static length of the muscle and its rate of change during contraction and relaxation. Because the muscle spindle is connected to the main muscle fibers in parallel, passive stretching or relaxation lengthens the spindle, excites the sensory end organ, and increases the firing rate of Ia and II fibers. Through a monosynaptic feedback pathway (the myotac-tic reflex), Ia fibers excite alpha motor neurons and cause muscles to contract after they are passively stretched.

Mitral Stenosis Murmurs Timing and Shape

ANS It begins just after the opening snap (OS). This means that there must be a pause between the A2 and the diastolic murmur, a pause due to isovolumic relaxation of the left ventricle (LV). Because of the pause that usually occurs after the S2, the MS murmur may be called an early delayed diastolic murmur.

Speech Perception Motor Theory Of See Speech Theories

Explain laughter on the basis of physiology and cerebral mechanisms. Spencer's theory of laughter (also called the overflow of nervous energy theory) states that laughter is analogous to the operation of a siphon or pump it is an overflow (along the most available and ready channels) of nervous energy from a reservoir that has been filled up too much. According to this mechanical, energy-release, or hydraulic theory, laughter occurs when we have prepared our minds for something large and meaningful, but what follows actually is something small and insignificant. Thus, Spencer advanced the notion that laughter is similar to nervous energy that is active within any part of the nervous system and that must escape through one or more channels that lead to other nerves not connected directly with motor nerves, motor nerves leading to muscular activity, or efferent nerves leading to the viscera. During laughter, the nervous energy escapes via habitual channels the speech apparatus and the...

Phosphodiesterase Inhibitors

Inhibition of PDE III causes an increase in intracellular cAMP and, to a lesser extent, cGMP in myocardial and vascular smooth muscle cells. The cAMP is responsible for phosphorylation of protein kinases in the cell. In the myocardium, this increases the influx of calcium through the slow calcium channels of the sarcolemma by increasing both the number of channels open and the duration of the open state. The sarcoplasmic reticulum is also affected facilitating faster calcium release. The net effect is an increase in calcium ion availability in the cell for contraction. The raised level of cAMP is also responsible for improved re-uptake of calcium into the sarcoplasmic reticulum so active myocardial relaxation is also improved leading to an overall improvement in myocardial function. In smooth muscle, the cAMP causes phosphorylation of the myosin light chain kinase which reduces the affinity for the calmodulin complex and dephosphorylates the myosin light chains. This results in...

Nuclear Magnetic Resonance Spectroscopy

Although for larger proteins magnetic relaxation becomes a limiting factor, the benefits of using uniform highlevel (> 96 ) deuteration was shown to inhibit relaxation processes (27). Complete deuteration provides significant signal-to-noise enhancement in heteronuclear NMR assignment and structure determination experiments, which uses the amide proton for detection. NMR pulse sequences lose sensitivity as the size of the protein under study increases above 25 kDa, mainly because of fast 13C transverse relaxation via the strong dipolar coupling between a 13C nucleus and its directly bonded protons. Since the gyro-magnetic ratio of 2H is 6.5 times smaller than that of *H, per deuteration dramatically reduces this relaxation. A recent news release stated that A technique called TROST (transverse relaxation-optimized spectroscopy) now greatly reduces NMR line broadening with increasing molecular size, permitting NMR analysis of molecules far beyond 100 kDa in size (28).

Posterior Glenohumeral Dislocations

Since severe pain and muscle spasms are the norm, muscle relaxation and analgesia are paramount. The reduction is performed with the patient supine. Traction is applied to the adducted arm in the long axis of the humerus. An assistant gently pushes the humeral head anteriorly into the glenoid fossa.

Gastric Motility and Emptying The Role of the Stomach as a Reservoir and a Churn

Motility of the stomach allows it to serve as a reservoir, act as a churn to fragment food and mix it with gastric secretions to aid digestion, and to empty gastric contents into the duodenum at a controlled rate. Gastric motility and storage are complex and subject to multiple regulatory mechanisms. The first aspect of gastric motility is gastric filling. Accommodation of large changes in volume when a meal is eaten is achieved by the plasticity of the stomach smooth musculature and by receptive relaxation. Plasticity means that smooth muscle can maintain constant tension over a wide range of lengths without changing tension. Mechanoreceptors in the proximal stomach signal the degree of distension and, beyond a certain level, a stretch-activated contraction is initiated and pacesetter cells are depolarized. These properties are augmented by receptive relaxation of the deep folds of the stomach (known as rugae), which is mediated by the vagus nerve and associated with eating, possibly...

Case Illustration

Respecting Briana's ability to assess her most immediate needs, subsequent sessions focused on helping her deal more effectively and assertively with interpersonal and academic tasks. Jean and Briana identified and practiced concrete strategies for negotiating conflicts with her boyfriend and parents, dealing with anxiety and concentration problems, and decreasing her use of alcohol. Briana developed new communication skills, cognitive behavioral tools, coping imagery, and relaxation to deal with the immediate problems. Although Briana became more confident about everyday coping, she admitted that she continued to have nightmares, did not enjoy physically intimate contact with her boyfriend, and still used alcohol or food to submerge depressed feelings.

Issues for Single Centre Trials

Be used as a reference for subsequent sequences (e.g. proton density sequences used as a reference for T1-weighted sequences, to allow rapid measurement of T1 relaxation times). Some manufacturers do not support this facility, and automatically reoptimise some or all of transmit amplifier attenuator settings, receiver amplifier attenuator settings, receive ADC set up and image scaling factors and filter factors each time a sequence is loaded.

Lee Hyer and Steve Sohnle

Posttraumatic stress disorder (PTSD) is a stress reaction characterized by symptoms of reexperiencing, avoidance numbing, and hyperarousal following exposure of 1 month or more to an extreme trauma. In recent years there has been a spate of studies and meta-analyses on the treatment of this disorder, involving the key curative components of exposure and assimilative techniques, as well as secondary factors of relaxation and rescripting. Generally, these studies have involved CBT, cognitive reprocessing, or eye movement desensitization and reprocessing (EMDR). Unfortunately, there have been no studies on the application of any of these methods to older people with PTSD. Additionally, there are few data with this group regarding the assessment of the client's mediating and moderating influences, implicit models of cause and treatment, the importance of education on change, the importance of the therapist, and a host of other client-treatment factors (Hyer & Sohnle, 2001).

Empirical Basis For Cbt For Somatization

While the aforementioned treatments have been categorized as CBT, a few variations in their content and format should be noted. All interventions were brief, lasting 6 to 16 sessions, and trained patients to alter dysfunctional cognitions and behaviors. One intervention emphasized relaxation training (Lidbeck, 1997) two others encouraged spousal participation in treatment (Allen et al., 2001 Sumathipala et al., 2000). Three studies examined the efficacy of group CBT (Hellman et al., 1990 Lidbeck, 1997 McLeod et al., 1997), whereas the other three investigated the efficacy of individual CBT (Allen et al., 2001 Speckens et al., 1995 Sumathipala et al., 2000). The setting in which treatment was implemented was either a psychiatry department (Allen et al., 2001) or a primary care clinic (Hellman et al., 1990 Lidbeck, 1997 McLeod et al., 1997 Speckens et al., 1995 Sumathipala et al., 2000).