Relaxation Techniques

Relax Your Mind

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Spin Spin Relaxation Molecular Weight Limitations

Spin-spin relaxation exists because NMR spectrometers detect signals only when the magnetic moments of entire populations of nuclei are aligned, and moving in synchrony. This condition is met at the outset of the typical NMR experiment, but as time goes on, the motions of the magnetic moments of individual nuclei vary from the mean due to random, molecule-to-molecule differences in environments. As the variation in the population grows, the vector sum of their magnetic moments decays to zero. Since nuclear magnetic signals also lose intensity when individual nuclei return to their equilibrium orientations, all processes that contribute to spin-lattice relaxation contribute to spin-spin relaxation also. T2 is always shorter than T . RNA Ti s can be reduced by selective deuteration because the relaxation rates of protons are determined mainly by their interactions with neighboring protons. Thus when some protons in a molecule are replaced with deuterons (2H), which have much lower...

Principles in lowfield NMR relaxation

In 1H low-field nuclear magnetic resonance relaxation (proton NMR) the specimen is investigated in a low magnetic field (Ruan and Chen, 1998). In a magnetic field, the magnetic moments of the nuclei will align with the magnetic field (like small compass needles). Following the application of a radio frequency, the protons (hydrogen molecules) in the material are excitated and consequently perturbed from their equilibrium state, to which they will subsequently return by a process described as relaxation. Two types of processes are involved in the return to equilibrium state, longitudinal relaxation (J1) and transverse relaxation (T2). These can consequently be used to characterize the material. In common low-field NMR studies, only the contribution from protons of mobile compounds, i.e. water and fat (non-crystallized) is 'visualized'. Chemically, water is simple with its two protons but, more interestingly, water behaves differently in different environments. The individual water...

Classification of the Relaxation Phenomena 131 Relaxation States

The term relaxation state in the widest meaning denotes states characterized by a lowering of psychic tension. According to the model below (Fig. 6.1) and the above analysis, specific states of relaxation may be distinguished. only relaxation response state Figure 6.1. Model of the main relaxation states. The meditative techniques lead to differentiated waking states of consciousness (DWSC) through the reduction of the goal-oriented activity of imagination as well as of reception of both exteroceptive and interoceptive stimuli. Studies on meditation (Wallace et al., Wilson, 1971 Benson, 1975) enable the interpretation of the DWSC in terms of the trophotropic reaction (Hess, 1957) or the relaxation response (Benson, 1975). DWSC is more a general notion than the fourth state of consciousness (Wallace et al., 1971) however, taking into consideration the results of the Holmes (1984) studies, these changes seem not to be attributed to meditation practice, but simply to resting. Meditation...

Rationale for a Multileveled Model of Relaxation States

In the light of data indicating that the organization of mental processes is multi-leveled and that consciousness is fluctuating, states of relaxation may be understood also in three-dimensional space according to the evolutionary leveled model. The four main states of consciousness, including relaxing states and the relaxation response states (rrs) DWSC (on the model below), should be considered on each of the levels. Therefore, on the one hand, different mechanisms of regenerative processes may be considered according to the horizontal plane of the model on the other hand, evolutionary aspects should be taken into consideration. Diminishing of the amount of incoming stimuli, which takes place in most of relaxation techniques, enhances regression, at least within the currently dominating level of psychical organization. However, reparative processes may also occur. The depth of regression or evolution may vary among subjects. A classification of dreams (see Fig. 6.2) may be helpful...

Theory Of Spin Relaxation In Proteins

The relaxation rates of proteins are affected primarily by dipolar interactions and chemical shift anisotropy (CSA). For 2H labeled proteins, the 2H quadrupolar interaction also contributes to the relaxation rates. The overall relaxation rates are the linear combination of all rates of the interactions. The relaxation rates can be expressed in terms of the combination of spectral density functions (Abragam, 1961 Kay etal., 1989). For an isolated XH spin system, the relaxation rate constants of the X spin (15N or 13C) caused by the dipolar interaction of the X spin with the 1H spin and by the magnetic shielding arising from the CSA interaction of the X spin

Experiments For Measurements Of Relaxation Parameters

The measurement of spin relaxation rates is achieved by carrying out a series of two-dimensional heteronuclear HSQC- or HMQC-type experiments. The pulse sequences for T1 and T2 relaxation measurement include a relaxation period which is inserted either before or after the t1 evolution period, whereas for heteronuclear NOE measurement, the cross-relaxation period is incorporated into the preparation period in the two-dimensional steady-state NOE sequence.

Relaxation Data Analysis

The R1 and R2 values are obtained by fitting the intensities of individual cross-peaks with a series of values of relaxation times T using Equations (1.83b) and (8.42), respectively. The NOE values are extracted from the intensity ratios of individual cross-peaks in the NOE and NONOE experiments using Equation (8.47) for the data recorded at different static magnetic field strengths. Once the values of the relaxation rates and NOE are calculated, the overall correlation time Tm is usually determined from the 10 trimmed mean of the R2 R1 ratio (Mandel et al., 1995). In the next step, dynamic parameters (squared generalized order

Determination of texture by lowfield NMR relaxation

As mentioned above, NMR relaxation can be used to display different water compartmentalizations in food materials by measuring the relaxation rates of the water protons. Several researchers have stated that NMR relaxation is a rapid, non-invasive and non-destructive method of determining the distribution of water pools with different relaxation rates in foods (Cornillon, 1998 Ruan and Chen, 1998). Water distribution in foods is an important characteristic in relation to food texture quality. The number of relaxation studies focusing on water compartments has increased enormously during recent years. However, only in a minority of these studies have the results been correlated to actual texture attributes most are focussed on the potential of determining water distributions within a food product, its water-holding characteristics and the effects of processing conditions, e.g. heating, cooking and freezing, on water exudation and migration. Nevertheless, it has been shown that low-field...

Application of the Evolutionary Model in Relaxation

The model presents perspectives for reformulation of our understanding of the mechanism of some relaxation techniques through a discussion about meditation and hypnosis. Figure 6.2. Evolutionary leveled model of relaxation states (Kokoszka, 1994). Figure 6.2. Evolutionary leveled model of relaxation states (Kokoszka, 1994).

Rationale for a General Theory of Relaxation 11 Introduction

Relaxation is an important element of many psychological processes. It is applied by psychotherapists using different psychotherapeutic approaches and in counseling and stress management. However, in spite of the fact that relaxation techniques are commonly employed, altered states of consciousness in relaxation, as such, are hardly studied in psychology. What exists are mainly descriptions of techniques and changes in psychophysiological parameters during relaxation. Relaxation techniques are based on an assumption concerning reciprocal connections between three factors psychic tension, functional state of the vegetative nervous system and the muscle tension. As the tonus of the skeletal muscles may be voluntarily changed, it enables an application of muscle relaxation for the achievement of psychic relaxation as well as for an influence on the functions of organs controlled by the vegetative nervous system (Kratochvil, 1978, p. 253). The notion of relaxation is used fairly...

Hypotensive Ues With Complete Relaxation

Delayed relaxation Incomplete relaxation UES upper esophageal sphincter. Figure 16-4 These manometric tracings show the most frequently identified motility abnormality in patients with Zenker's diverticulum. On the left is a normal manometric sequence. Simultaneous recordings show that the cricopharyngeus (crico) relaxes at the same time as the pharyngeal contraction occurs. In contrast, the simultaneous pressure recordings on the right are from a patient with a Zenker's diverticulum. The abnormality is that the crico pharyngeal or upper esophageal sphincter relaxation is premature, so that this sphincter is beginning to contract just as the pharynx begins its own contraction. This results in functional resistance to pharyngeal clearance, which causes the sensation of dysphagia and results in increased hypo pharyngeal pressure that results in the formation of this pulsion diverticulum.

Ligand Docking Using NMR Constraints T Relaxation or NOE Data

While CF STD NMR can be used to identify which ligands bind to a protein, further functional insights can be obtained if there is structural information about the protein-ligand complex. Although NMR is a powerful tool for determining protein structures (see section 26.3.2) and is playing a prominent role in structural proteomics efforts,25 it can also provide the structural data needed to guide the docking of a ligand into a protein structure. Thus, it serves the chemical proteomic role of providing information about protein-ligand interactions in a manner that lends itself to high throughput and potentially highly parallel studies of many proteins. The distance data used to guide the docking of a ligand can come from either T1 relaxation data or NOE data. With regard to the former, one can measure the distance between a paramagnetic center such as the iron atom of a heme cofactor and the protons on a bound substrate or inhibitor. Roberts14 has used T1 relaxation effects induced by...

Biomechanics of the Achilles Tendon

If a tendon is stretched, it does not behave perfectly elastically, even if the force applied does not stretch the tendon beyond its toe region. Due to the time-dependent properties of the tendon collagen fibers and interfiber matrix,12,13 the entire tendon exhibits force-relaxation, creep, and mechanical hysteresis.1-5 Force-relaxation means that the force required to cause a given elongation decreases over time in a predictable

Role of Taurine Phospholipid Interaction in Altered Calcium Transport

In a related study Earm et al.7 suggested that taurine might also enhance flux through the Na+ Ca2+ exchanger, although this effect appears to be secondary2246 to a rise in Ca2+ '. The function of the Na+ Ca2+ exchanger is to extrude calcium from the cell. In the normal functioning myocyte, the amount of calcium entering the cell via the calcium channel is balanced b the amount of calcium that leaves the cell via the Na+ Ca2+ exchanger. Therefore, maintenance of normal calcium homeostasis requires an active Na+ Ca2+ exchange process. Taurine appears to regulate this efflux process by altering the amount of calcium available to be extruded. According to Hilgemann et al.16 the Kd of the Na+ Ca2+ exchanger for calcium is about 6 M. Yet, peak systolic Ca2+ usually approaches only 2 M, and that only for a short period of time. Therefore, a dilemma develops over the mode of calcium efflux. A resolution of this dilemma was proposed by Langer27, who felt that calcium must be compartmentalized...

Nuclear Overhauser Effect

Upon saturating transitions of spin S, the population of level 1 is equal to that of 2 and levels 3 and 4 have equal populations. As a result, levels 1 and 3 are less populated compared to the equilibrium whereas the populations at levels 2 and 4 are increased by saturation of the spin S resonance. After the irradiation, the system will try to restore equilibrium through all allowable relaxation processes. The normal spin-lattice relaxation (see section 1.10.2), labeled as w1, does not alter the population difference for spin S because the two transitions have the same relaxation rate, resulting in no change in population difference between the spin states. Therefore, the relaxation w1 cannot change the intensity of spin I. However, in addition to spin-lattice relaxation via the above single-quantum transition there exist two other relaxation processes w0 via a zero-quantum transition with Am 0 and w2 via a double-quantum transition with Am 2. Although these transitions are not...

Superficially Altered States of Consciousness

These states have never been intensively studied by psychologists of consciousness, who focus their interest on the most unusual states. States from the borderline of normal and altered consciousness are mentioned only by supporters of the continuum hypothesis (Benson, 1975 Fischer, 1986). They mainly include relaxation states. Paradoxically, the description of these states is more difficult than PASC. This issue was not investigated by psychologists, because they recognized it as the domain of psychopathology. On the other hand, psychiatrists do not consider transient changes of one's view of reality as a meaningful psychopathological symptom, especially when they are recognized as a deviation by the individual. The traditional line of division between psychology and psychopathology includes the possibilities for reality testing, rationality of experiences in reference to cultural norms, preserved feeling of reality, and an adequacy of emotional...

Behavioral Psychotherapy

Main techniques used in Behavior therapy include (1) focusing on changing clients' present behavior (2) actively and directively teaching clients how to change their dysfunctional behaviors and how to practice more functional ones (3) applying imaginal and in vivo systematic desensi-tization of anxieties and fears (4) showing clients how to use stimulus control in the situations that cause them problems (5) performing skill training (6) using contingencies of reinforcements for adaptive behavior and aversive conditioning for maladaptive behaviors and (7) teaching relaxation techniques.

Imprinting in Human Pluripotent Cells

Onyango et al.10 demonstrated that H19 is appropriately imprinted in human EG cell lines. Although H19 shows monoallelic expression in the differentiated cultures, other imprinted genes such as IGF2 showed a partial relaxation of imprinting, resulting in biallelic expression. To date, analysis of imprinted gene expression in human ES cells (hESCs) has unfortunately been limited. A recent study by Hwang et al.19 however, has demonstrated that both maternally (H19 and UBE3A) and paternally-expressed (SNRPN and ARH1) imprinted genes are detectable in cells of an ES cell line derived from a cloned human blastocyst via somatic cell nuclear transfer. While RT-PCR conducted in this study demonstrates that various imprinted genes are indeed expressed in the cell line, it does not address the question of whether the expression pattern is appropriate, i.e. monoallelic or biallelic. As use of hESCs becomes more accessible, and more information on the culture conditions required to maintain them...

Cardiomyocyte Dimensions and Contractile Function

Since myocardial tissue from trained humans is not easily available, data at the cellular level have to be derived from experimental models. Several animal models of endurance exercise have been shown to mimic important aspects of human physiology and could help determine the cellular and molecular mechanisms of training-induced improvements of cardiac function 40-44 . In a rat model of endurance training, increased dimensions and improved left ventricle contraction and relaxation can be observed in isolated cardiomyocytes. This demonstrates that improved intrinsic (i.e., without influence of the neuro-hormonal system) cardiomyocyte function can contribute to both the systolic and diastolic improvements that occur in the athlete's heart.

Intracellular Calcium Transients

In cardiac muscle, the force of contraction depends on the peak intracellular calcium (Ca2+) concentration during systole, the sarcomere length, and the responsiveness of the myofilaments to Ca2+ 55 . Impairment of Ca2+ handling is a major cause of both contractile dysfunction and arrhythmias in pathophysiological conditions 56 .A brief increase in cytoplasmic Ca2+ concentration allows Ca2+ to bind to the myofilament protein troponin C, which activates the myofilaments. This is often called the Ca2+ transient and this transduces the chemical signal and energy (ATP) into cardiomyocyte shortening in a Ca2+-dependent manner. During the action potential, Ca2+ enters the cell mainly via voltage-activated Ca2+ channels (dihydropyridine receptors or L-type Ca2+ channels) as an inward Ca2+ current (ICa2+). L-type Ca2+ channels are located primarily at sarcolemmal-sarcoplasmatic reticulum (SR) junctions where the SR Ca2+ release channels (the ryanodine receptors) reside. In addition, the...

Treatment of Spasticity

Drugs with systemic effects are now used primarily in patients who are confined to a wheelchair or bed. These drugs facilitate relaxation of muscles, allowing easier transfers from bed to chair and faciliating hygiene as well as alleviating painful flexor spasms. The drugs used are baclofen, diazepam, and tizanidine.

Escapeavoidance Learning

Conditioned, and the rat avoids by approaching a particular chamber that is consistently safe (i.e., where fear is clearly reduced or relaxation can occur). Some subjects in a oneway box learn to avoid in one trial, and learning to a 100 level in a mean of three or four trials is not unusual. Here the use of distinctive chambers and increasing the shock level up to a point facilitates learning. Presumably fear and safety are thereby segregated better, and reinforcement is enhanced (greater fear reduction), whereas the opposite is true in a shuttlebox, where conditioned fear (competition from freezing and the like) is enhanced by these manipulations. The same manipulations that facilitate or hinder avoidance learning have been shown to have parallel effects in pure escape learning by Franchina and associates. Mowrer's two-factor theory, or fear hypothesis, provides the main explanation of avoidance learning. Fear is conditioned to the shock area or warning signal, and escape from fear...

Cardiomyocyte Calcium Handling

Increased Ca2+ uptake capacity of the SR caused by increased SERCA2 expression could account for the increased rate of decay of the Ca2+ transient 43 . In line with this, we have unpublished observations of training-induced changes in cardiomyocyte contractility and relaxation that by far are abolished by selective protein kinase inhibition. This is consistent with the notion that activation of specific protein kinases enhances cardiomyocyte contractility and relaxation by phosphorylating proteins involved in Ca2+ handling 55 . Exactly how this happens has not been fully investigated, but compelling evidence suggests increased channel function by phosphoryla-tion, rather than merely changed myocardial protein levels of L-type Ca2+ channels or ryanodine receptors, respectively 93 .Another suggested mechanism may be related to protein kinase B Akt, as cardiac-specific overexpression of nuclear-targeted Akt increased Serine-16 phosphorylation of phospholamban, corresponding to a larger...

Magnetic Resonance Imaging

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

Preparation of Alignment Media for Residual Dipolar Coupling Measurement

Various media are available for moderately aligning macromolecules in solution in the magnetic field, of which two liquid crystalline media are most commonly used at the present time DMPC DHPC bicelles and filamentous phage. It is the interaction of the magnetic field with the anisotropic susceptibility of liquid crystalline media that aligns these particles in the magnetic field. When particles with a nonspherical shape, such as discs or rods dissolved in solution, are placed in the magnetic field, the anisotropic distribution of the electron density leads to an orientational dependence of this interaction. If the anisotropic interaction is large enough to overcome the thermal energy of the particles, the degree of orientation order of the media in the magnetic field becomes significant enough to be measurable, which is usually in the range of 0.5-0.85. As discussed previously (section 1.8.4 on Residual Dipolar Coupling), the order for macromolecules described by the magnitude of the...

Blood Volume Imaging Technique

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

Dyssynergy Synergy Syndromes

Although locomotor synergies, the basic patterns of muscle contraction and relaxation that produce coordinated rhythmic stepping, exist in the spinal cord, dyssynergies resulting from discrete spinal lesions are not recognized clinically. This is partly because spinal lesions that would disrupt the central pattern generators would probably affect

Effects of Axis II Diagnosis on Treatment Outcome

The work of Longabaugh and colleagues (39) suggests that pessimistic generalizations of negative outcomes for ASPD substance abusers may be due to a failure to account for the effects of treatment matching. These investigators assessed drinking outcomes for both antisocial and non-antisocial alcoholics receiving either extended cognitive-behavior therapy (CBT) for 16 sessions or relationship enhancement (RE) for up to 20 sessions, both delivered in a group format. The CBT sessions included functional analysis of drinking antecedents and consequences, and cognitive restructuring that focused on topics such as stimulus control, rearranging consequences, assertion training, problem solving, and dealing with slips and relapses. The RE treatment also included six sessions of functional analysis, but the remaining sessions focused on patients' relationships, with the participation of significant others in some of the sessions. No difference was found between the two treatment groups on...

Neuromuscular Junction Blocking Agents

There are two suggested mechanisms of blocking nerve impulse transmission. One group of drugs, the typical representative and progenitor of which is tubocurarine, are called antidepolarizing drugs. By competitively binding with corresponding H-cholinore-ceptor regions, they counteract action of acetylcholine on the postsynaptic membranes, thus preventing its depolarizing action and excluding the possibility of exciting muscle fibers. It should be noted that because of minor differences in dosage causing necessary muscle relaxation and facilitating the development of paralysis of skeletal muscle, a slight overdose of muscle relaxant compounds can lead to serious damage of respiratory function and a sharp decline in blood pressure. Overdose is reversed by introducing anti-cholinesterase agents, which block acetylcholinesterase and elevate the concentration of acetylcholine in the synaptic chain, using artificial respiration with oxygen, and when necessary, using drugs that elevate...

Texture of foods and demands for nondestructive measurements

Consequently, this unique technique has attracted increasing attention within food research over recent years, and interest in it is further reinforced by its non-destructive sampling nature. The NMR technique includes NMR spectroscopy, MR-imaging and NMR relaxometry. Low-field NMR relaxation and MR-imaging are especially relevant in the context of food science due to the relatively low cost of the instruments used. The present paper gives a state of the art overview of the potential of these techniques in texture analysis of foods.

Disorders of motor control

Present in only around 10 of those without cata-plexy. It is the inability to move while consciousness is retained, either at the onset of sleep or, less commonly, when waking up. The respiratory muscles, or more probably only the diaphragm, retain activity but speech is impossible. The episodes usually last for less than 2 min but can occasionally persist for up to 30 min. The intense relaxation may be pleasurable, but much more commonly it is perceived as frightening because of the inability to move, the loss of control, and the occasional association with vivid dreams.

Base Stacking Dynamics

Stacking of adjacent bases is a fundamental source of the free energy of stabilization of ordered structures in nucleic acids. To a first approximation the process in single stranded poly- and oligonucleotides can be analyzed with a localized two-state model, with each dinucleotide either stacked or unstacked. However, both states, especially the unstacked form, represent ensembles of conformations of the nucleotides. Since base stacking is accompanied by a reduction in absorbance in the UV, it has been possible to characterize the dynamics using optical methods. The stacking interaction is energetically favorable, with a negative AH of roughly 10 kcal mol1, so the temperature jump method can be used to induce unstacking. Porschke20 used a cable discharge technique to increase the temperature in a 0 ns interval, allowing study of the 25-100 ns dynamics of the stacking relaxation in CpC and poly C. The stacking rate constant in poly C (at 20 C) was about 1 x 107 s1, with a dissociation...

Bread and starchbased products

Hardness and water mobility in cooked rice were investigated by transverse NMR relaxation and correlated to texture measurement determined by TPA (Ruan et al., 1997). Furthermore, the change in firmness of the rice samples upon storage, which was due to retrogradation, was described by transverse NMR relaxation data. Seow and Teo (1996) showed that pulsed NMR could be used to monitor staling in different starch-based products e.g. cornstarch gel, bread and rice cup cake. With significant correlations (r 0.96-0.98) between NMR measurements and firmness determined by a compression test, it was concluded that NMR (solid phase signal) can be used to predict staling in starch gels and starch-based products. Moreover, staling and changes in firmness of sweet rolls were correlated with water characteristics determined by transverse NMR relaxation (r 0.87-0.98) (Ruan et al., 1996). The authors found that the change in the mobility of the water in the different water compartments was the basic...

Psychological Treatment Outcome of Headache

The three primary psychological approaches to headache are relaxation therapy, biofeedback, and cognitive-behavioral therapy. Because they are felt to have both psychological and physiological effects, the first two approaches are frequently called psychophysiological interventions. In practice, they are often combined with each other as well as cognitive-behavioral therapy. Please refer to the appropriate sections of this encyclopedia for more detail concerning these treatments.

Efferent Autonomic Pathways

Alpha-adrenergic receptors mediate sympathetically induced pupillary dilatation (mydriasis), vasoconstriction, and contraction of the vas deferens and bladder and rectal internal sphincters. Beta receptors mediate cardiac stimulation, vasodilation, bronchodilatation, relaxation of the bladder, and endocrine-metabolic effects. Muscarinic receptors mediate pupil constriction (miosis), salivary and lacrimal secretion, cardiac inhibition, bronchoconstriction, stimulation of motility and secretion in the gastrointestinal tract, evacuation of the bladder and rectum, and erection.

Tracheoesophageal Fistula

Spontaneous ventilation has strong advantages over controlled ventilation for the unsecured airway in TEF. The descending diaphragm draws gas into the lungs. All that is required is a patent airway above the lesion, which can be obtained with a standard jaw thrust, oral or nasal airways, or a laryngeal mask airway (LMA). Anesthetic induction methods that maintain spontaneous ventilation, like potent vapors, allow ventilation while the airway is assessed and secured. In contrast, controlled ventilation requires that the compliance of the lungs be lower than that of the GI tract. Even if a sufficient fraction of each delivered breath enters the lungs, there will be progressive abdominal distention since the esphagogastric junction acts as a one-way valve. Eventually, the distended abdomen will compromise ventilation. Despite the advantages of spontaneous ventilation, controlled ventilation and muscle relaxation is often employed in neonates, with subsequent occlusion of the TEF by a...

Pulsed Field Gradients

Experience different magnetic field strengths, which causes the spin to precess at different frequencies for chemically equivalent spins. This means that the transverse magnetization of the spins will have different precession frequencies for different physical locations along the z axis in the sample volume. Some will precess faster, and some slower than the resonance frequency. The transverse magnetization of the spins across the sample volume will be decreased with the duration of the gradient irradiation, because a portion of the magnetization will be canceled out due to dephasing of the magnetization. At some time during the gradient irradiation, the transverse magnetization becomes zero. Therefore, the field inhomogeneity created by the gradient eliminates the magnetization on the plane (xy plane) perpendicular to the gradient axis. The process may be reversed to recover the dephased magnetization by applying the gradient with an opposite direction, or negative to the previous...

Clinical Applications

Hypnosis is used to treat many medical, psychological, and behavioral problems. Claims of dramatic clinical results have not usually been well documented. Hypnosis can control pain in cancer and burn patients. It can modify chemotherapy-induced vomiting and nausea and ease discomfort of invasive procedures (e.g., debridement, bone marrow procedures) even with those of moderate hypnoti-zability. Hypnosis is especially useful in habit control where, for whatever reason, the patient is ready to give up a symptom and needs legitimization and a dramatic intervention to justify change. Hypnosis can establish whether patients have the resources to facilitate mind-body, self-control, and cognitive mastery over their symptoms. Hypnosis helps facilitate relaxation, allow ego strengthening, control anger and other negative emotions, uncover affect with age regression, develop imagery strategies, and facilitate symptom relief.

Hypnosis As A Psychotherapeutic Technique

Typically, an induction procedure is used to establish the context in which hypnotic suggestions are presented. Although hypnotic inductions vary, most involve suggestions for relaxation, calmness, and a sense of well-being. On the other hand, active-alert inductions that involve physical activity have also been shown to be effective in establishing responsiveness to suggestion.

Basic Principles and Techniques

The intrinsic high tissue contrast medium for MRI is one of the major strengths of this modality. Whereas CT uses differences in x-ray attenuation coefficients of two adjacent tissues, the MR signal is intrinsic and is generated by changing the proton spins in response to an external RF pulse. The different macromolecular characteristics of the intercellular and extracellular protons within the water molecules determines the intrinsic MR signal that is displayed for diagnostic interpretation. The macromolecular spin magnetization returns to its equilibrium state through a process defined by two relatively independent relaxation times, referred to as T1 and T2. After a 90-degree RF pulse the proton magnetization net vector rotates from the axis of the main magnet (z axis, longitudinal magnetization) to the transverse plane (x and y axes, transverse magnetization). When the RF pulse ends, the longitudinal magnetization recovers toward 100 percent in an exponential manner. The time it...

Twodimensional Experiments

Two-dimensional experiment and two-dimensional spectrum. The evolution time t1 is increased systematically for each of the FIDs. The FIDs acquired during t2 are Fourier transformed to obtain a set of 1D spectra. The second Fourier transformation is applied along t1, that is, each point of the spectra, resulting in a cross-peak coordinated by both frequencies on F2 and F1 . The F2 dimension has better digital resolution because t2 is always longer than t1. The parameter d1 is the relaxation delay (or predelay) and t2 is the acquisition time. Figure 4.17. Two-dimensional experiment and two-dimensional spectrum. The evolution time t1 is increased systematically for each of the FIDs. The FIDs acquired during t2 are Fourier transformed to obtain a set of 1D spectra. The second Fourier transformation is applied along t1, that is, each point of the spectra, resulting in a cross-peak coordinated by both frequencies on F2 and F1 . The F2 dimension has better digital resolution...

Anterior Tracheal Reconstruction Extended Resection

The cervical and cervicomediastinal approach is used for upper tracheal tumors, for limited tumors of the mid and even lower trachea, and for almost all benign strictures of the trachea at any level. Although more than half of the trachea may be removed through such an approach in young patients of appropriate body habitus, and approximation gained by cervical flexion alone, much less may be resected in the older, kyphotic, heavy-set patient, or in a patient who has undergone extensive prior tracheal surgery. Pretracheal mobilization and cervical flexion are key in this approach. Laryngeal release is the adjunctive procedure most easily added in this approach if further relaxation of anastomotic tension is needed.

Calcium Channel Blockers

In addition to being used as antianginal and antiarrhythmic agents, calcium channel blockers are used to treat weak and moderate hypertension. These drugs prevent calcium ions from entering into the smooth muscle cells of peripheral vessels, and they cause relaxation of peripheral vessels, which leads to lowering of arterial blood pressure. In clinically used doses, calcium channel blockers relax smooth musculature of arteries and have little effect on veins. In doses that relax smooth musculature, calcium channel blockers have relatively little effect on cardiac contractility.

Abnormal EMG Activity

With certain of the muscular dystrophies or inflammatory disorders of muscle, complex repetitive discharges are found. These have a high discharge frequency, but their amplitude and frequency remain constant (iiFig.i24-20 ). They appear to arise in the muscle itself and are probably initiated by a fibrillating muscle fiber that then depolarizes adjacent fibers by ephaptic transmission. y By contrast, in the myotonic discharges ( lllFig, l24-21 ) that characterize certain myotonic disorders with delayed relaxation after voluntary contraction, high-frequency trains of action potentials occur spontaneously, wax and wane in amplitude and frequency, and relate to a disorder of the muscle fiber membrane.

Stimulus time modulations

The option of interrupted pulses is mandatory in most neurorehabilitation clinical applications. Each stimulation program for different clinical applications is likely to require somewhat different contraction (on) and relaxation (off) times, also known as the duty cycle. The greater the duty cycle, the more profound the problem with muscle fatigue, since the time of rest is reduced.

Multidimensional Heteronuclear NMR Experiments

In order to study the structure and dynamics of proteins, the spectral resonances must be identified before the structural information and relaxation parameters can be utilized. This chapter addresses the general strategy and heteronuclear experiments required to achieve sequence-specific assignments of backbone and side-chain resonances. Practical aspects related to the experiments will also be discussed in detail.

Highresolution Magic Angle Spinning 1h Nmr Spectroscopy

Direct observation of metabolites within tissues is impaired by a number of physical processes that serve to broaden spectral resonances. Relaxation times are often short, giving rise to broader lines, and anisotropic NMR parameters are not averaged completely to zero, also causing line broadening. For 1H NMR spectroscopy, chemical shift anisotropies are small, quadrupolar couplings are not present, and J-coupling anisotropy is negligible. However, both dipolar coupling and dia-

Breathing assistance in high tetraplegia

Recent advances for respiratory pacing have been contributed by the work of DiMarco and colleagues, who have demonstrated the use of a minimally invasive approach for introducing electrodes into the diaphragm with a laparoscope. This technique significantly reduces the surgical procedure required. Electrodes are placed bilaterally near the motor points to activate the muscles simultaneously for inspiration expiration is due to passive relaxation. Of five subjects who have been entered into a clinical protocol and are through the exercise period, four have sufficient ventilation for breathing without other aids (e.g., respirator) for many hours per day. Subjects also report the return of smell as a result of the procedure (DiMarco, 2001).

Transthoracic Tracheal Resection

Right posterolateral thoracotomy in the fourth interspace or through the bed of the resected fifth rib provides wide access to the lower two-thirds of the trachea, the carina, the right hilum, and the esophagus (see Figure 23-8 in Chapter 23, Surgical Approaches). Options for this incision can be broadened if the right arm is kept free of arterial or venous lines and is prepared and draped into the field so that it may be swung backward and forward. The anterior chest wall, which may include the neck, can thus also be prepared and draped. However, since we learned that laryngeal release does not transmit relaxation for lower tracheal reconstruction, this is now rarely done.

Constanttime Multidimensional Enmr For Horizontal Sample Tubes

The gradient induced by the DC electric field, we developed a novel constant-time multidimensional (CT-ENMR) method (fig. 12.19a) 37 . A constant electric field (Edc) was applied to the xy-magnetization. The electrophoretic signal modulations were obtained by incrementing the duration of the electric field (tE) while simultaneously decrementing the flanking time delays (tv) between the gradient pulses and the electric field pulse. The diffusion time delay (T) between the two gradient pulses is constant (fig. 12.19a) therefore, the relaxation and diffusion decays of the ENMR signal in a conventional ENMR method (fig. 12.19b) were removed (fig. 12.19c). The electric current induced constant spectral phase modulations can be corrected by routine NMR signal processing procedures.

Tracheal intubation and mechanical ventilation

Impending cardiorespiratory arrest is indicated by profound hypoxaemia on disconnection from oxygen or NIV, significant hypotension, or an altered mental state. Immediate intubation may then be required. As cardiovascular collapse is common after intubation, transfer of the spontaneously breathing patient to the ICU may, however, be safer. Collapse arises from a combination of reduced venous return secondary to positive intrathoracic pressure, and direct vasodilation and reduced sympathetic tone induced by sedative agents. Before intubation pre-oxygenation is essential. Intubation with the rapid sequence induction and cricoid pressure to reduce the risk of aspiration should ideally be performed by an experienced clinician. Suxamethonium is classically used for muscle relaxation as its short effect makes it safer in the event of a failure to intubate. Concerns about hyperkalaemic cardiac arrest31 have led to the increased use of short acting non-depolarising agents such as rocuronium....

Behavioral Coping Strategies

Havioral activity involves actively engaging in activities such as reading or visiting with friends to stay busy and unfocused on pain. Pacing activity involves taking regular, planned rest breaks to avoid overdoing and experiencing increases in pain. Isolation refers to withdrawing from social contact to cope with pain. Resting refers to reclining in bed or on the couch. Relaxation involves attempting to decrease physiological arousal by remaining calm and relaxing muscles. Relaxation also is sometimes referred to as a physiological coping strategy, because it may include direct physical benefits.

Stability and Change in Coping Strategies

The second approach to examining changes in pain coping strategies in chronic pain patients has been intervention studies. These studies have attempted to improve pain coping by training individuals in cognitive and behavioral pain coping skills. These studies have shown that with intervention, pain coping skills can be improved, and improvements in pain coping skills translate into improvements of psychosocial and functional adjustment. For example, in one study, Keefe and coworkers trained a group of patients with osteoarthritic knee pain to use relaxation, imagery, distraction, cognitive restructuring, and pacing activity. Compared with a control group, trained subjects had lower levels of pain and psychological disability. Furthermore, individuals in the pain coping skills group who had greatest positive change in their coping strategy use (i.e., increased perceived effectiveness) had the most improvements in physical abilities. Similar findings have been reported across several...

Mechanisms in CBF Control

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

Practical Conclusions

It should be emphasized that, in practice, there is no sharp border between the relaxing states and the relaxation response only. During meditation, according to rules described by Benson (1975), the reduction of interoceptive stimuli reception may not occur and eventually the relaxing state or sleepiness may appear. Similarly, during relaxing exercises it is possible to counteract the tendency to fall asleep by switching attention from interoceptive experiences to monotonous stimuli (i.e., observing or counting breaths). This may lead to the relaxation response by cutting off the reception of stimuli from the external sources of stimulation. 2. Both the relaxing exercises and meditative techniques may cause some people to experience states of consciousness previously unknown to them, or states that they avoid in everyday life. Such experiences may be stressful. Moreover, there are data that relaxation may sometimes induce anxiety (Heide and Borkowec, 1983). For this reason it is...

Drug therapy for intubation and mechanical ventilation

Ketamine is a general anaesthetic agent that has been used before, during, and after intubation in patients with acute severe asthma.61-63 It has sympathomimetic and bronchodilat-ing properties. The usual dose for intubation is 1-2 mg kg given intravenously over 2-4 minutes. It may increase blood pressure and heart rate, lower seizure threshold, alter mood, and cause delirium. Inhalational anaesthetics used for gas induction have the advantage of bronchodilation and may make muscle relaxation unnecessary. However, specialised anaesthetic equipment is required for this approach. avoided because of this possibility and vecuronium or pancuronium infusions used for longer term maintenance of muscle relaxation.

Mechanical Measurements

Extensor digitorum longus (EDL) muscles were removed from control and GES-supplemented animals, mounted on a force measuring system and immersed in continuously gassed (95 O2- 5 water-saturated CO2) Krebs solution (1 18 mM NaCl, 25 mM NaHCO3, 5mM KCl, 1 mM MgSO4, 2.5 mM CaCl2 and 5 mM glucose). Optimal muscle length for maximal force development was determined and the muscles were stimulated for 400 ms at a frequency of 100 Hz by capacitor discharges of alternating polarity. The force developed during the tetanus and the relaxation period was recorded. The time delay needed to observe a 20 force decrease after the end of the stimulation (t20 ) was calculated.

Zinc Supplementation

Ex vivo studies of frog skeletal muscle found that Zn added to the media increased muscle strength.60 This ergogenic effect was associated with increased tension without tetanus and prolonged contraction and relaxation periods of the muscle twitch. The effects of supplemental Zn on muscle function were examined in adult male rats fed a chow-based diet and supplemented with Zn (2 or 4 mg d) dissolved in water for 30 days.61 Rats supplemented with 4, as compared with 2 mg Zn, had a greater time to fatigue (19.8 1.0 vs. 16.2 0.8 s). These findings should be viewed with caution because there is no indication that the observed change in performance resulted from an improvement in Zn status or increased activity of Zn-dependent enzymes.

Ligandprotein Complexes

As NMR spectroscopy has been widely used to determine the structures and dynamics of molecules ranging from synthetic compounds to macro biomolecules, it has become a powerful approach for studying the interactions between proteins (and or nucleic acids) and ligands. The interactions can be studied by observing a change in NMR phenomena (signal) that is induced by the binding. For this purpose, a variety of pulse sequences has been implemented to observe changes in chemical shifts, mobility, relaxation properties, and NOEs, etc. Some of the methods make full use of the difference in mass between protein and ligands, such as methods measuring the diffusion and relaxation of ligands, whereas others observe binding-induced changes such as chemical shifts, NOE, and 1H exchange rate.

Structural modifications

As mentioned before, some fruits or vegetables tend to lose native liquid during processing at very low pressure, thus revealing cell structure damage due to mechanical strain. Thus, the deformation-relaxation phenomenon could induce irreversible effects, involving in some cases rigidity loss due to embrittlement or rupture in the cell walls junctions, as pointed out by several authors. From microscopic observations of kiwi fruit before and after vacuum treatment with glucose solutions, Muntada et al. (1998) noticed that the size of the cells in the infused plant tissue and their arrangement were preserved Vacuum infusion at 50 mbar of cylindrical apple samples with hypotonic or isotonic solution does not significantly change the maximum stress value, assessed by stress relaxation tests, compared with that obtained for fresh apple (Martinez-Monzo et al., 1998). Nevertheless, the use of an isotonic pectin solution produces a significant decay in the maximum force. The high viscosity of...

Assessment and Treatment of PTSD

A third psychotherapy approach is anxiety management, variously referred to as relaxation training, stress inoculation, or biofeedback training. This approach does not focus on the trauma itself, but is instead geared toward teaching an individual the requisite skills for coping with stress, often via the use of relaxation. For this reason, anxiety management is often an adjunctive treatment to trauma-focused treatments.

Temperaturedependent Ar2Res

An alternative mechanism for nonlinear behaviour of (Ar2)Expl involves a nonlinear increase with T of (Ar2 )Res due to motions becoming fast enough to be detected. In principle, this effect can lead to apparent dynamical transition behaviour in the absence of any change in (Ar2)Exp,. Figure 3 shows a fit of Equation 5 to the experimentally-determined (Ar2) from Daniel et al. (1998). The insert to Figure 3 shows the associated relaxation time, t(T) . T changes from the nanosecond to the picosecond timescale with increasing temperature, passing into the instrumental time resolution window of 100 ps. This figure demonstrates that dynamical transition behaviour can appear in a dynamic neutron scattering experiment without any change with T in the long-time, converged dynamics.

Saturation Transfer Difference

For large proteins, a cross-relaxation directly proportional to the correlation time tc dominates the relaxation process, causing extremely rapid magnetization transfer throughout the protein. Selective saturation of any protein resonances results in saturation of all protein protons as a consequence of the rapid magnetization transfer via the efficient cross-relaxation within the protein. Therefore, saturation can be achieved by a long irradiation on any resonance of the protein (i.e., any spectral region) in the 1D NOE difference experiment (Klein et al., 1999 Mayer and Meyer, 1999). When a ligand binds to a protein, the saturation of the protein resonances will also saturate ligand resonances owing to cross-relaxation. The 1D STD method consists of two experiments collected with interleaved acquisition. The first experiment is collected with on-resonance irradiation selective at an aliphatic resonance of the protein. The intensity of the bound ligand will decrease as a consequence...

Metabonomics Analytical Technologies

NMR spectroscopy is a nondestructive technique that provides detailed information on molecular structure for pure compounds and in complex mixtures. In addition and uniquely, NMR spectroscopic methods can also be used to probe metabolite molecular dynamics and mobility as well as substance concentrations through the interpretation of NMR spin relaxation times and by the determination of molecular diffusion coefficients. MS is considerably more sensitive than NMR Plasma and serum separated from whole blood contain 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 on them. Standard NMR pulse sequences, where the observed peak intensities are edited on the basis of molecular diffusion coefficients or on NMR relaxation times (T1, T1p, T2), can be used to select only the contributions from proteins and...

Isotope Editing Spectroscopy

Isotope enrichment has made it possible to observe different partners of a complex individually in a way such that only the magnetization originating from the desired part of the complex and then transferred to the other part of the complex via cross-relaxation is observed. Either the ligand or protein can be isotope labeled with 15N, 13C, and or 2H. Isotope-edited (also known as isotope-selected) experiments can be used to study a ligand protein complex with isotope enriched ligand. For ligands labeled with 13C, the 2D version of the 3D NOESY-1H, 13C-HMQC experiment (Figure 6.7a) can be applied to observe the intermolecular NOE

Upper airway compliance

The changes in dilator muscle contraction vary between the individual muscles. The genioglossus, which protrudes the tongue, and the geniohyoid, which pulls the hyoid forwards, are both upper airway dilators with mainly phasic inspiratory activity which is largely retained at the onset of NREM sleep. In contrast, the tensor palatini, which retracts the soft palate, has mainly tonic activity and this is lost in NREM sleep. The loss of this tonic muscle activity is largely responsible for the increase in upper airway resistance which is seen during normal sleep. Relaxation of the medial and lateral pterygoid muscles lessens the degree of mandibular protrusion, so that the base of the tongue becomes more posterior, the mouth falls open and the pharyngeal airway becomes smaller.

Isotope Filtering Spectroscopy

When isotope-labeled protein is available, structural information on the protein-ligand complex can be obtained by an 15N, 13C isotope-filtered experiment, in which only the intermolecular NOEs of the unlabeled ligand with the labeled protein are observed by suppressing the intramolecular NOEs among the protein resonances. The term 13C-filtered means that the signals from the 13C-attached protons are suppressed in the experiment, whereas 13C-edited or 13C-selected denotes that the signals from the 13C-attached protons are selected in the experiment (Breeze, 2000). The application of the heteronuclear filter on one dimension of the 2D experiment is also called half X-filter and, thus, a 2D NOESY-1H, 13C-HMQC pulse sequence may be termed as a 13C-half-filtered (w1) NOESY if the filter is on the t1 dimension, or as a 13C-half-filtered (rn2) NOESY if the filter is on the t2 dimension. Alternatively, the X-filtering can also be applied to both dimensions. However, additional half...

Exposure and Technique

Adequate exposure is extremely important to avoid complications from the use of the CO2 laser. We recommend the use of a subglottic laryngoscope with an attached Venturi Jet ventilation system when using a micromanipulator to deliver the CO2 laser energy. Ventilation is usually maintained with a Venturi apparatus and anesthesia is provided using intravenous compounds with muscle relaxation techniques. Since the use of intravenous anesthesia and muscle relaxation can severely compromise the patient's ventilation, spontaneous respiration with topical anesthesia is not recommended for cases with airway obstruction, until an adequate airway is established.

Prevention Of Hiv Associated With Substance Abuse

The use of inhaled nitrate drugs, most often reported in the homosexual population, is associated with increased prevalence of HIV-seropositive status in the male-to-male-sex group (167). These drugs can increase muscle relaxation and are reported to heighten sexual response. Questions about the use of these drugs, especially in the homosexual population, can be of significant

Psychotherapy Definition and Utilization

What is psychotherapy Although originally defined as one-on-one sessions between a patient and therapist with the intent of changing the inner workings of the patient's psychological life, over the last several decades psychotherapy has broadened in its formats, participants, procedures, and focus (there are now over 250 different forms of psychotherapy) so that any definition of psychotherapy must be far-ranging enough to encompass the full spectrum of different psychotherapies. What relaxation therapy, family therapy, cognitive therapy, group therapy, insight-oriented therapy, play therapy (with children), exposure therapy to name a few have in common is a set of psychological or behavioral procedures, delivered by one or more therapists, designed to change the thoughts, feelings, somatic symptoms, or behaviors of one or more participants who are seeking help.

Reading Disabilities Assessment

The evaluation should conclude with a feedback conference with parents at which results are carefully explained and recommendations made. Because the most important goal of an assessment for dyslexia is to provide guidance about appropriate interventions, the information from the evaluation should be summarized in a written report. Interventions can be thought of in terms of two broad categories remediation and compensation. Remediation refers to direct teaching to improve the child's weak skills, and there are numerous effective programs for this purpose. These share a focus on the child's poor phoneme awareness and mastery of the alphabetic code in highly structured and programmatic ways. Agood remedial program also includes considerable practice in contextual reading, using techniques such as guided oral repetitive reading to address the difficulties children with dyslexia have with achieving silent reading. Compensation refers to various procedures that teachers and others can use...

The Endothelium and Vasomotor Tone

CO on vessel wall dynamics (Beny and Burnet 1988 see below). Acetylcholine relaxes arterioles but causes endothelium-dependent contraction of human veins, possibly because arterial smooth muscle is more directly or markedly affected, or perhaps because venous smooth muscle is less sensitive to endothelium-derived relaxation factor (EDRF) (Rubanyi and Vanhoutte 1988). Angiotensin II, ATP, bradykinin, histamine, serotonin and thrombin also induce EDRF-mediated relaxation. Neuropeptide Y is another potent contractile agent found inter alia in the mesenteric, saphenous and uterine veins as well as arterioles (Fried and Samuelson 1991 Luu et al. 1992). NPY responds to nerve stimulation and is released from the sympathetic fibres along with noradrenalin, causing vasoconstriction it also exerts a negative feedback on the synapse (Daly et al. 1988).

The Role of Excipients

The glass transition temperature (Tg is considered to be a critical variable in estimating the molecular mobility of amorphous materials, and the addition of excipients with a high Ts is believed to increase the storage stability of lyophilized formulations. Stabilization by excipients that have high Tg values has been demonstrated with lyophilized bovine somatotropin and lysozyme865 and with lyophilized interleukin-2.866 The NMR relaxation-based critical mobility temperature ( Tmc), described above, can also be used as a measure of storage stability of lyophilized protein formulations. The TiC of a lyophilized bovine serum y-globu-lin formulation containing dextran increased with increasing molecular weight of the

Sexual Aversion Disorder

Defined as the avoidance of sexual genital contact with a partner, Sexual Aversion Disorder (SAD) has a high comor-bidity with history of sexual abuse, vaginismus, and dys-pareunia. Treatment for this condition often combines couples therapy and cognitive therapy and focuses on solving conflict areas within the couple, such as emotional differences and issues of control. Anxiety reduction techniques such as systematic desensitization are used when the aversion is accompanied by strong feelings of anxiety. Systematic desensitization consists of identifying a hierarchy of sexual activities that provoke anxiety and then pairing relaxation techniques with imagining the sexual activity. The goal is for the patient to feel relaxed while imagining each sexual activity and eventually while actually engaging in each sexual activity. Some therapists feel that, during treatment of sexual abuse survivors, trauma-related issues need to be resolved before SAD is addressed.

Sexual Pain Disorders Dyspareunia

Education and information about dyspareunia, training in progressive muscle relaxation and abdominal breathing, Kegel exercises to train the patient to identify vaginal tenseness and relaxation, use of vaginal dilators, distraction techniques to direct the patient's focus away from pain cues, communication training, and cognitive restructuring of negative thoughts. During biofeedback, the patient is instructed to contract and relax her vaginal muscles while a surface electromyographic sensor inserted in her vagina provides her with feedback on muscular tenseness.

Cognitive Behavioral Treatment Studies

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

Applications In Proteomics

The optimum measurement temperature depends on the type of paramagnetic material. The Boltzmann distribution, upon which the signal amplitude depends, increases as the inverse of temperature in Kelvin (equation 19.2). In addition, if the temperature is too high, the spectrum may broaden out due to fast relaxation if is too low, the signal may become saturated with microwave power. Therefore, it is necessary to explore variations in temperature and microwave power. Field modulation amplitude and field modulation frequency. These parameters result from the use of field modulation and phase-sensitive detection in EPR, which gives rise to the first-derivative line shape. Too low a modulation amplitude will produce a weak signal and too high will broaden and distort the spectrum. For modulation frequency, the higher the better, until electron-spin relaxation becomes limiting and the spectra are distorted. Generally, the modulation amplitude should be less than 1 3 of...

Size and the Cell Cycle

Arguments can be made in favor of either large or small vesicles as the most likely basis for early cellular life. The key challenge here is to come up with a plausible mechanism for cell growth and division, given that early primordial cells lacked all of the sophisticated internal machinery evolved by modern cells to control their growth and to mediate the physical process of division. Very small vesicles have an important property that may be relevant in this regard because of their small size and strong curvature, the membrane is highly strained. The growth of such strained vesicles is thermodynamically favored by the relaxation that occurs as size increases and curvature decreases. Growth can occur spontaneously, either slowly by incorporation of additional lipid molecules, or rapidly by fusion with other vesicles. Incorporation of additional lipid can occur by transfer through solution from micelles or other small vesicles, and transfer is faster into smaller vesicles (10)....

Squamous Cell Carcinoma

Motility disorders that delay oesophageal emptying increase the exposure of oesophageal squamous cells to ingested carcinogens. One such disorder, achalasia, results from impaired relaxation of the lower oesophageal sphincter and absent motility in the oesophageal wall. It is usually diagnosed after age 60 years. A population-based study showed that during the 24 years of follow-up, the risk increased more than 16-fold (Sandler et al., 1995). Fortunately, achalasia is uncommon.

Moisture profile in a rice grain during boiling

Takeuchi et al. (1997b) reported the moisture profile in a quenched rice grain after boiling in excess water using an NMR transverse relaxation time (T2 in milliseconds) imaging method at 200 MHz. The NMR image showed that the moisture content (g water g rice) after 6 min boiling reached 0.6 at the peripheries while the moisture content was less than 0.45 in the middle. The image after 12 min boiling indicated that swelling due to gelatinization was almost completed, although a core of low moisture content of less than 0.55 remained in the middle part. Sometimes a low moisture core was formed not in the middle but somewhat unsymmetrically shifted to the dorsal side. The thicker protein layer on the dorsal surface, which restricted water

Susan L Demeester Thomas H Magnuson

The finding of a lumbar or pelvic hernia is rare. Unlike inguinal or umbilical hernias, most lumbar and pelvic hernias are acquired secondary to trauma or postoperative change. Lumbar hernias have been described in children as well as adults. This type of hernia originates in an area of weakness in the parietal wall of the torso, namely, the superior triangle of Grynfeltt-Lesshaft and inferior triangle of Petit. In contrast, pelvic floor hernias are more common in elderly women primarily as a result of relaxation of the pelvic muscles with aging. The three types of pelvic floor hernias, in order of decreasing frequency, are obturator, perineal, and sciatic.

Regulatory guidelines

Other general guidelines such as CHMP (2005) 'Guideline on Clinical Trials in Small Populations' contain some statistical considerations. This particular guideline discusses the relaxation of statistical requirements in this setting including the possibility of a less stringent significance level at the trial level, use of surrogate endpoints, analysis of data incorporating baseline covariates and the use of meta-analysis as the primary evidence of efficacy.

Sportperformance Interventions

Athletes may use several strategies to manage their anxiety and arousal. Cognitive reappraisal approaches work on the assumption that excessive arousal is caused by problematic thought patterns. Changing particular cognitions or the situations that cause these cognitions can help moderate arousal levels, thus enhancing performance. Physiological anxiety-reduction interventions work by affecting physical parameters. For example, techniques such as diaphragmatic breathing and progressive relaxation have been shown to reduce physiological arousal. Hypnosis has also been used to help athletes regulate arousal and enhance performance. Imagery is the process by which stored sensory experiences are internally recalled and performed in the absence of external stimuli. Imagery can be used to build confidence, practice specific skills, control emotional reactions, improve concentration, practice strategy, and cope with pain and injury. When using imagery, athletes are typically advised to use...

Cognitive Behavioral Therapy

Cognitive-behavioral therapy for OCD encompasses three treatment types (1) exposure and response prevention (ERP), (2) cognitive therapy, and (3) relaxation training. Of the three, only ERP has been shown to be consistently effective in reducing OCD symptom severity (Shafron, 1998 Baer and Greist, 1997 Marks, 1997). Cognitive therapy is the changing of false beliefs regarding risk and responsibility, thereby challenging the reality of obsessions and the necessity for compulsions (Emmelkamp and Beens, 1991). It is generally viewed as ineffective if used as the sole treatment for OCD (Neziroglu et al., 2000) but may be helpful in facilitating participation in ERP (Shafron and Somers, 1998). Relaxation therapy is used mainly to manage anxiety during exposure but has not been shown to have direct benefits for the obsessive-compulsive symptoms (March, 1995).

An Application of the Information Metabolism Model to a Multiaxial Psychotherapeutic Diagnosis Case Study

During the period of three years he was actually followed by criminals three times. He has become habitually very vigilant, which resulted in persistent insomnia. Due to a necessity to constantly remain hidden, he cannot undergo a regular therapy, however, he is rather willing to get a psychological support in coping with the real danger than consider the PTSD symptoms as his disorder. He was resistant to insight psychodynamic therapy, idealizing his personal relationships. However, there are no signs of apparent pathology in his family relations. He successfully followed techniques of relaxation and behavioral desensitization of flashback scenes which led to a significant decrease of symptoms. Unfortunately,

Effect of Local Tissue Factors and Hormones to Cause Smooth Muscle Contraction Without Action Potentials

Skeletal Muscle Pump

Lack of oxygen in the local tissues causes smooth muscle relaxation and, therefore, vasodilatation. Smooth muscles have considerable diversity in how they initiate contraction or relaxation in response to different hormones, neurotransmitters, and other substances. In some instances, the same substance may cause either relaxation or contraction of smooth muscles in different locations. For example, norepi-nephrine inhibits contraction of smooth muscle in the intestine but stimulates contraction of smooth muscle in blood vessels. A Calcium Pump Is Required to Cause Smooth Muscle Relaxation. To cause relaxation of smooth muscle after it has contracted, the calcium ions must be removed from the intracellular fluids. This removal is achieved by a calcium pump that pumps calcium ions out Walker JS, Wingard CJ, Murphy RA Energetics of cross-bridge phosphorylation and contraction in vascular smooth muscle. Hypertension 23 1106,1994. Webb RC Smooth muscle contraction and relaxation. Adv...

Pectin constituents and related compounds

During fruit enlargement and ripening was intensively analyzed by the Kojima research group at Saga university, Japan (Sirisomboon et al., 2000b). Among the studied constituents, the alcohol insoluble solids in fresh weight (AIS in FW) appeared to have a significant effect on the textural properties of the fruit. The textural properties, which correlated differently with the pectin content in AIS and with that in FW, indicated the different effects of the fruit cell wall and fruit flesh (including skin) on the texture of the fruit during fruit enlargement. This study showed for the first time evidence for the close relationship of the pectin constituents in determining the fruit texture of the Japanese pear. Three textural properties from the plate compression test -namely, the deformation ratio, modulus of elasticity, and relaxation - and nine from the puncture test - rupture force, deformation at the rupture point, toughness, average firmness, initial firmness, apparent modulus of...

Aortic Pressure Curve

Pressure Recording Ventricle

Blood that remains in the ventricle after the previous heartbeat and is called the end-systolic volume. As venous blood flows into the ventricle from the left atrium, the ventricular volume normally increases to about 115 milliliters, called the end-diastolic volume, an increase of 70 milliliters. Therefore, the volume-pressure diagram during phase I extends along the line labeled I, with the volume increasing to 115 milliliters and the diastolic pressure rising to about 5 mm Hg. Phase II Period of isovolumic contraction. During isovolumic contraction, the volume of the ventricle does not change because all valves are closed. However, the pressure inside the ventricle increases to equal the pressure in the aorta, at a pressure value of about 80 mm Hg, as depicted by the arrow end of the line labeled II. Phase III Period of ejection. During ejection, the systolic pressure rises even higher because of still more contraction of the ventricle. At the same time, the volume of the ventricle...

Drug combinations for selfinjection therapy

Penile Self Injections Demonstration

For instance, in vitro studies on human and rabbit cavernosal strips demonstrated that phentolamine significantly potentiated relaxation induced by sildenafil, VIP and PGE1. These vasodilators also significantly enhanced relaxation induced by phen-tolamine in the cavernosal tissue strips. The enhancement of VIP and PGE1-induced relaxation (cAMP-mediated) by phentolamine suggests a syn-ergistic interaction, while the interaction between phentolamine and sildenafil (cGMP-mediated) appears to be additive 47 . The same investigators were also able to show that sildenafil and PGE1 has additive and synergistic effects, respectively, with phentolamine-induced relaxation. Therefore, in combination therapy using phentolamine as an adjunct, the efficacy of vasodilators that initiate erection via independent relaxant pathways is increased due to a reduction in adrenergic tone, through the a-adrenoceptor blockade.

Prostaglandins From Euroform Healthcare

Contraction and relaxation induced by some prostanoids in isolated human penile erectile tissue and cavernous artery. J Urol 1985 134(6) 1245-1250. 30 Gupta S, Gallant C, Traish A, et al. Relaxation of corpus cavernosum smooth muscle by phentolamine via a non-adrenergic mechanism. Int J Impotence Res 1998 10 Suppl 3, S27.

Abdominal Muscle Contractions During Labor

In the early part of labor, the contractions might occur only once every 30 minutes. As labor progresses, the contractions finally appear as often as once every 1 to 3 minutes, and the intensity of contraction increases greatly, with only a short period of relaxation between contractions. The combined contractions of the uterine and abdominal musculature during delivery of the baby cause a downward force on the fetus of about 25 pounds during each strong contraction.

Lower Motor Neuron Pool

Changes in muscle tone, defined as resistance to passive stretch of muscle, are an important feature of diseases of the motor system. At one time, an important component of normal resting muscle tone was thought to be the result of low-level background alpha-gamma co-activation. However, more recent studies in fully relaxed individuals indicate that the viscoelastic properties of muscle and tendons account for normal resting tone. y Common experience indicates that resting muscle tone can vary considerably depending on the state of relaxation of the muscle as well as its viscoelastic properties. Some studies have shown that the passive viscoelastic properties of muscle may contribute to increased tone in patients with chronic spasticity and rigidity, but the most important determinants of pathological alterations in tone are the result of alterations in stretch reflexes. synergist muscles, causing contractions that oppose the lengthening (Fig. 15-9 (Figure Not Available) ). Branches...

Mehrabians PAD Pleasure ArousabilityDominance Temperamen t Model

Dominance is a characteristic feeling state be-haviorally expressed in postural relaxation. This feeling is a function of the extent to which an individual feels unrestricted or free to act in a variety of ways (Mehra-bian, 1980). At one extreme this dimension refers to feelings of lack of control or influence on the surroundings, and at the other, to feelings of being influential, powerful, and in control over the situation (Mehrabian, 1978b).

Human Chorionic Somatomammotropin

Relaxin is a polypeptide having a molecular weight of about 9000. This hormone, when injected, causes relaxation of the ligaments of the symphysis pubis in the estrous rat and guinea pig. This effect is weak or possibly even absent in pregnant women. Instead, this role is probably played mainly by the estrogens, which also cause relaxation of the pelvic ligaments. It has also been claimed that relaxin softens the cervix of the pregnant woman at the time of delivery.

Directional Movement of Peristaltic Waves Toward the Anus

Peristaltic Reflex and the Law of the Gut. When a segment of the intestinal tract is excited by distention and thereby initiates peristalsis, the contractile ring causing the peristalsis normally begins on the orad side of the distended segment and moves toward the distended segment, pushing the intestinal contents in the anal direction for 5 to 10 centimeters before dying out. At the same time, the gut sometimes relaxes several centimeters downstream toward the anus, which is called receptive relaxation, thus allowing the food to be propelled more easily anally than orad.

Rosenbach History Of Tetanus 1886

Ancient clinical descriptions have not been bettered. Therapy has changed, but it is possible that the number of survivors after the fourteenth day may not have improved markedly. William Osler, writing in 1892, found 80 percent mortality within 4 days. Therapy had improved The nasogastric tube enabled feeding and hydration morphine provided sedation, and chloroform provided muscle relaxation. Osler emphasized antiseptic care of the wound. It is fair to say that from Hippocrates to Osler - and to today - there have been no changes in diagnostic techniques, and there has been only a small reduction in mortality rates in established cases. Tetanus is a disease that must be prevented, and prevention had to begin with isolation of the organism and advances in immunology.

Alprostadil PGE1Caverject Edex Viridal

The effect of PGE1 on the human corpus cavernosum (CC) was first described in 1975 by Karim & Adaikan 3 . Of more than 30 prostaglandins tested in vitro on the human CC, PGE1 is the only compound that produced relaxation conducive for erection 4 . All other prostaglandins produced either a dual effect (contraction and relaxation) or contraction only. The relaxant effect of PGE1 on the human CC has been further demonstrated in vitro 5,6 . Initial studies on the effectiveness and mechanism by which IC administration of PGE1 produced erection were very encouraging 7-10 . Several investigators have assessed, in large groups of patients, the effectiveness of PGE1 for the treatment of erectile failure in man. PGE1 -induced relaxation of CC muscle is mediated through the activation of EP prostaglandin receptors and subsequent activation of the membrane bound adenylate cyclase, resulting in an increase in intracellular concentrations of cAMP in the cavernous tissue 11 . Further...

Physiologic Anatomy of Biliary Secretion

Liver And Biliary System

Relaxation of sphincter of Oddi Emptying of the Gallbladder Stimulatory Role of Cholecys-tokinin. When food begins to be digested in the upper gastrointestinal tract, the gallbladder begins to empty, especially when fatty foods reach the duodenum about 30 minutes after a meal. The mechanism of gallbladder emptying is rhythmical contractions of the wall of the gallbladder, but effective emptying also requires simultaneous relaxation of the sphincter of Oddi, which guards the exit of the common bile duct into the duodenum.

Pressure Control Mechanisms That Act After Many Minutes

Several pressure control mechanisms exhibit significant responses only after a few minutes following acute arterial pressure change. Three of these, shown in Figure 19-15, are (1) the renin-angiotensin vasoconstrictor mechanism, (2) stress-relaxation of the vasculature, and (3) shift of fluid through the tissue capillary walls in and out of the circulation to readjust the blood volume as needed. We have already described at length the role of the renin-angiotensin vasoconstrictor system to provide a semi-acute means for increasing the arterial pressure when this is needed. The stress-relaxation mechanism is demonstrated by the following example When the pressure in the blood vessels becomes too high, they become stretched and keep on stretching more and more for minutes or hours as a result, the pressure in the vessels falls toward normal. This continuing stretch of the vessels, called stress-relaxation, can serve as an intermediate-term pressure buffer.

Normal Pharyngeal Pressure

Manometry And Short Esophagus

Figure 6-23 Manometric record showing absence of oropharyngeal (upper esophageal) sphincter relaxation in response to pharyngeal contraction. (From Waters, P.E., and DeMeester, T.R. Foregut motor disorders and their surgical management. Med. Clin. North Am., 65 l259, 1981, with permission.) Figure 6-25 Manometric record showing absence of a pharyngeal pressure wave. Oropharyngeal (upper esophageal) sphincter relaxation is normal and initiates cervical esophageal pressure waves. (From Bonavina, L., Khan, N.A., and DeMeester, T.R. Pharyngoesophageal dysfunction. Arch. Surg., 20 546, 1985, with permission.) Figure 6-25 Manometric record showing absence of a pharyngeal pressure wave. Oropharyngeal (upper esophageal) sphincter relaxation is normal and initiates cervical esophageal pressure waves. (From Bonavina, L., Khan, N.A., and DeMeester, T.R. Pharyngoesophageal dysfunction. Arch. Surg., 20 546, 1985, with permission.)

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