| Co-Investigator(Kenkyū-buntansha) |
KAJIMOTO Yoshinaga Osaka Medical College, Dept.Neurosurgery, Associate Prof, 医学部, 講師 (30224413)
SASAKI Eun Osaka Medical College, 1^<st> Dept.Internal Med., 医学部, 非常勤講師 (60281507)
NAGAI Akira Osaka Medical College, Dept.Pediatrics, 医学部, 非常勤医師 (40411376)
MATSUSHIMA Reiko Osaka Medical College, Dept.Pediatrics, 医学部, 非常勤医師 (50411377)
|
|---|
| Budget Amount *help |
¥3,300,000 (Direct Cost: ¥3,300,000)
Fiscal Year 2005: ¥500,000 (Direct Cost: ¥500,000)
Fiscal Year 2004: ¥500,000 (Direct Cost: ¥500,000)
Fiscal Year 2003: ¥600,000 (Direct Cost: ¥600,000)
Fiscal Year 2002: ¥1,700,000 (Direct Cost: ¥1,700,000)
|
|---|
| Research Abstract |
We determined the criteria of four subsets or orthostatic dysregulation ; instantaneous orthostatic hypotension (INOH), postural tachycardia syndrome (POTS), delayed orthostatic hypotension and neurally-mediated syncope (NMS). INOH, sudden drop of blood pressure associated with active standing, is caused by blurred activation of sympathetic activation in the arteriolar vessels. This also involves the excessive pooling of blood in the lower part of the body, thus causing tachycardia during standing. POTS, showing tachycardia >= 115 during standing, is associated with augmentation of sympathetic activity of the heart. The loss of plasma volume or reduction of circulating blood during orthostatic stress is also involved in POTS. NMS is characterized with sudden reduction of blood pressure associated with loss of consciousness with or without cardioinhibitory mechanisms. This episode sometimes develops after severe increase in heart rate during standing in children with INOH and POTS. Thes
… More
e types of orthostatic intolerance were found to cause impairment of cerebral circulation only during upright posture in about half of the patients, resulting in various disabling symptoms, such as orthostatic dizziness, strong fatigue, fainting and lowering brain function including cognition and thinking. These disadvantages reduce quality of life in patients, thus causing psychological distress as well. There has been one report on the relation between orthostatic intolerance and gene mutation, although we did not find such a patient during the research period. New treatments have been also developed in this study from the biological and psychosocial aspect ; non-pharmacological treatments, medication and psychosocial support. The first alternative includes the repair of circadian rhythm, exercise training with adequate degree and sodium / water intake. We also invented an inflatable abdominal bandage which inhibits blood pooling in the lower part of the body. Regarding medication midodline was found as a most effective and a safe drug for INOH and POTS. We established the comprehensive support network system for patients with orthostatic dysregulation and school absenteeism from the bio-psycho-socio-ethical aspect. In this system, we incorporated a new occupational stuff, named "mental associates", who is usually an university postgraduate is expected to visit home of a child with school absenteeism and psychosomatic diseases for the purpose of metal support, tutoring and rehabilitation in society, under the control of medical specialists. A trained mental associate carried out his task according to the elaborated original program. We have experienced 17 cases. A mental associate performed a task once a week for 90 minutes including going out home and step-by-step tutoring, resulting recovery of emotional steadiness, decision-making and sociality. Less
|
