Dr MK
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I see some familiar information
Common knowledge base from various common sources, but a little stealing here and there.<BLOCKQUOTE><font size="1" face="Verdana, Arial">quote
My understanding of this increases with time. To the extent that we can measure the former, we can indirectly infer the latter may have occurred. A nurse in the field with a stethoscope and a BP cuff could noninvasively perform these simple measurements. It could be a start... Simple is good. Simple and noninvasive is even better. Not proof but...compelling evidence if an effect was measured (e.g. if it's wet enough in the morning, I might conclude it was night rain rather than surface temperature plunging to the dew point).Of note, although most vasovagal reactions occur with a sudden drop in blood pressure, the most important part of a vasovagal faint is the corresponding cerebral vasoconstriction.
But your point is very well taken. <BLOCKQUOTE><font size="1" face="Verdana, Arial">quote
...which would shoot holes in what I suggested.I have come across some interesting reports of patients who have had syncopal events during cardiac electrophysiologic studies with minor changes in blood pressure and drastic changes in cerebral vasoconstriction.
Do share!
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Especially true given the reports you suggest.I think the test you suggest would only really work if one used an arterial line to monitor blood pressure fluctuations in real time.
We bench lab experimenters are spoiled though, no? I never fully appreciated how lucky I was to have had fully instrumented and conscious dogs to work with on my dissertation.
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If I may make a few comments from experience...At my hospital we are currently discussing a similar type of study using arterial lines.
I believe what you really want to measure is local tissue blood flow. As you may already know, radiolabled microspheres is the gold standard. I had quite a bit of experience with that in the cardiology dog lab. Unfortunately - as you know - it is terminally invasive.
We could always look for terrorists or misbehaving karateka to work with...
KIDDING, FOLKS!!!
Short of that... The second best method would be measuring blood flow of a peripheral artery that feeds the tissue bed. Think about the complexity of central vs. peripheral control mechanisms working simultaneously - sometimes in dynamic tension with each other. The whole hierarchy of controls was one of the major research focus points of my dissertation advisor. Measuring pressure alone - even at the periphery - isn't going to get you what you want.
My previous mentor was working on using albumin microbubbles and sonograms to measure tissue blood flow. But I know of nobody that uses something like this for the study of brain tissue blood flow.
You have something new up your sleeve?
Perhaps we could take this discussion offline, unless you (or others) think it germane to the present discussion.
Traveler (a.k.a. John)
Temerity is a wonderful western virtue.
What you suggest is both scientifically and intellectually interesting. I have considered it.
George and others are interested in illustrating the concept of a "set up point." I sometimes jokingly refer to it as "martial foreplay."
An experiment might go something like this.
Null Hypothesis - Hitting a specific leading point prior to hitting the target point has no effect on the response to being struck on the target point.
Control - Hit on some anatomically "uninteresting" point first (preferably in the same general region), and then hit on the target point.
Test - Hit on the set up point first, and then the target point.
Measurements - One or more simple physical exam tests before - in-between and after having struck the various points. Response to several questions (your name, what day it is, etc.) before and after having struck the two points.
Randomly assign individuals to either control or test groups.
That would be a randomized, controlled trial (RCT).
If we could use subjects that know nothing about kyusho, it would be a blinded RCT.
If we could have a kyusho person teach someone that knows nothing about kyusho to hit (presumably with the same intensity) either the control or test setup point in room one, and then go to room 2 where a second person (this individual can know something about kyusho) hits the second point (not knowing what had happened before), then we have a double-blinded RCT. (Presumably the kyusho person would want very much to hit with just enough force - and no more - to make the final result "interesting.")
What would that tell us?
IF the test group was (statistically)physiologically and/or psychologically more affected than the control group from the before to the after, then it would properly illustrate that the concept of a set up point exists. It also would add a little bit to the argument that there is something more than power of suggestion going on.
IF we were able to show some physiologic changes that went along with the changes in outcome (consciousness), then it would hint to the mechanism(s) involved.
Just a suggestion, since it was asked. I believe this hypothetical experiment illustrates how one would carefully and methodically go about improving the understanding of what's going on here.
My biggest concern for proceeding would be primarily issues of safety (and ethics). I would want an external review board of some sort to consider the sanity of such a proposal. I'd also want proper modern resuscitation techniques available (in addition to any "traditional" ones) to minimize the risk to the subjects. And finally I'd like a good lawyer and proper waivers signed. Participants would need to understand that they are taking a risk in the interest of advancing our knowledge.
Such a work, by the way, could be published in a reputable, peer-reviewed journal if it showed a positive finding. Even a negative finding though could be published - and advance our general knowledge - if properly framed.
- Bill
