Objects: This study aimed to evaluate the role of somatic delusion on the pain perception in patients with schizophrenia. It was hypothesized that pressure pain thresholds would be rather higher in schizophrenic patients who had somatic delusion than patients with other delusion. Methods The subjects were consisted of 3 groups, 23 men with schizophrenia who had somatic delusion, 25 men with schizophrenia who had other delusion, and 22 normal healthy controls. By using Algometer, pressure pain thresholds were examined to subjects on three non-tender sites with 6 weeks interval. The severity of delusion was evaluated in both patient groups. Statistically, Chi-square test, One-way ANOVA, Multivariate ANOVA, and Scheffe's test were used. Results : 1) There was significant difference between somatic and other delusion groups and normal control group at initial stage. 6 weeks later even when severity of delusion was thought to be ameliorated, this finding were sustained. 2) The severity of the components of delusion, conviction and preoccupation, were significantly decreased in both somatic delusion group and other delusion group according to the time interval. The decrements of the severity of delusion seems to be related with changes in pressure pain thresholds in both patient groups. Conclusions : We re-confirmed that both schizophrenic patient groups showed higher pressure pain thresholds compared to normal healthy control. However we failed to find the role of somatic delusion on pain perception in schizophrenia. Delusion, including somatic delusion, as a whole, seems to affect the increased level of pressure pain threshold due to attention deficit and decreased motivation in patients with schizophrenia.
Objective : This study was performed to confirm the effects of acupuncture on myofascial pain syndrome(MPS) through the change of visual analogue scale(VAS) and pain pressure threshold(PPT) and the usefulness of pressure algometer on the evaluation of pain. Methods : We perfomed this study with 20 outpatients complaining of upper back pain. Before acupuncture therapy(AT), immediately after AT and 2-3 days after AT, we respectively checked visual analogue scale(VAS) and pain pressure threshold(PPT) through pressure algometer, with patients seated and relaxed. The PPT was checked at major trigger point of upper trapezius, levator scapulae, supraspinatus, infraspinatus, rhomboideus minor. and the patients were needled at the same points and maintained for 15 minutes. Results : VAS of immediately after AT was mild higher than that of before AT, but not significantly different. and VAS of 2-3 days after AT was significantly lower than before AT and immediately after AT. PPT of immediately after AT was lower than before PT, but not significantly different. PPT of 2-3 days after AT was significantly higher than that of before AT and immediately after AT. Also PPT was significantly correlated with VAS. Conclusion : PPT of omen was signicantly lower than that of men. and there was no significant difference by age. PPT was increased according to pain duration. Effectiveness of acupuncture on myofascial pain syndrome through PPT and VAS is showed at 2-3 days after AT rather than immediatly after AT. and pressure algometer is useful for the evaluation of Acupuncture therapy on myofascial pain syndrome.
Journal of The Korean Society of Integrative Medicine
/
v.11
no.3
/
pp.127-135
/
2023
Purpose : This study was performed to evaluate the effects of magnetic therapy (MT) on pain threshold, blood flow, and balance in patients with knee osteoarthritis. Methods : A single-blind, randomized controlled trial (RCT) was conducted with 30 patient with knee osteoarthritis. They were randomly allocated 2 groups; magnetic therapy group (MTG; n=15) and placebo magnetic therapy group (PG; n=15). The MTG group received 30 minutes magnetic therapy and 20 minute conservative physical therapy (Hotpack, ICT), magnetic therapy was conducted in magnetic therapy device (OM-100, NUGA, Korea). In the placebo magnetic group received 30 minutes placebo magnetic therapy and 20 minute conservative physical therapy. Each group performed 50 minutes a day 3 times a week for 8 weeks. The primary outcome pressure pain threshold test, blood flow, balance ability were measured by a pressure threshold meter (Commander algometer, JTECH medical, USA), laser dofler image (Moor LDI2-IR, Moor instruments, USA), balance measurement system (BioRescue, Marseille, France). The measurement were performed before and after the 8 weeks intervention period. Results : Both groups demonstrated significant improvement of outcome in pain threshold, blood flow, and balance ability during intervention period. magnetic therapy group revealed significant differences in pain threshold, blood flow, and balance as compared to the placebo magnetic therapy group groups (p<.05). Our results showed that magnetic therapy was more effective than placebo therapy on pain threshold, blood flow, and balance in patients with knee osteoarthritis. Conclusion : Our findings indicate that magnetic therapy can improve pain threshold, blood flow, and Balance, highlight the benefits of magnetic therapy. This study will be able to be used as an intervention data for recovering pain threshold, blood flow, and balance in patients with knee osteoarthritis.
The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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v.29
no.3
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pp.73-84
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2023
Background: This study aimed to compare pressure pain thresholds (PPTs) in the vertebral segments between patients with chronic lower back pain (CLBP) and healthy participants without back pain and to determine the correlation between vertebral bone-segment PPT and pain level, lower back pain dysfunction, and psychological status in patients with CLBP. Methods: The subjects of this study were 23 healthy adults and 23 adults with CLBP. PPT was measured in 23 spinal bone segments using a PPT device, and the CLBP group was subjected to a pain level test (NRS) and a psychological test using the Korean version of the pain catastrophizing scale (KPCS). The functional level was assessed using the Korean version of the Oswestry disability index (KODI). Results: PPTs of the spinal sclerotomes were significantly lower in patients with CLBP than in healthy participants. In the CLBP group, the composite score of lumbar PPTs showed a high correlation with the composite scores for all segments, but not with the pain level (NRS), KPCS score, and spinal sclerotome PPT. Moreover, PPT in the sacral sclerotomes showed a significant negative correlation coefficient with function, with a KODI score of -.462 (p<.01). Conclusion: In this study, PPTs in all spinal segments in patients with CLBP was significantly lower than that in healthy subjects. The PPTs of the lumbar region was significantly correlated with the PPTs of other spinal regions. Through this study, it was found that there were changes in PPTs in CLBP patients not only in the lumbar region but also in other spinal regions. This information should be considered during clinical treatment of patients with low back pain.
Current Perception Threshold (CPT) using Neurometer($Neurometer^{(R)}$ CPT/C) is thought as one of easy and noninvasive QST(qunatitative sensory testing) tools for A${\beta}$, A${\delta}$ and C fibers within a relatively short time. However, conflicts about its reliability still exist. This study aimed to evaluate the reliability of CPTs evaluation and find a way to increase its reliability. Two examiners separately tested CPTs at each side of the mandibluar nerve areas for ten healthy male adults (average age of 22.4 years) three times with an intervals of a week during three weeks. Mean CPTs were compared between the right and left sides of the mandibular nerve area and between the three examinations on the each side. While CPTs at 2000 Hz(A${\beta}$ fiber) showed statistically significant side differences in all three examinations (p<0.05), significant side difference was found in only one examination at 250 Hz(A${\delta}$ fiber) and no difference at 5 Hz(C fiber). Comparing CPTs on the each side of the mandibular nerve area, all examinations at all sensory nerve fibers showed the least CPTs at the 1st examinations. CPTs at 250 Hz(A${\delta}$ fiber) and 5 Hz(C fiber) were significantly different between the first and the following examinations (p<0.05) and there was no significant difference between 2nd and 3rd examinations. The results of this study indicated that CPTs at 250 Hz(A${\delta}$ fiber) and 5 Hz(C fiber) are reliable but CPTs at 2000 Hz(A${\beta}$ fiber) is not appropriate for evaluation of side differences in the mandibular nerve area. In addition, it is suggested that repeated examination be helpful to increase reliability of the CPT evaluation.
Tobacco smoking is a major risk factor of systemic health and also impairs oral health, which is related to development of oral cancers, periodontitis, delayed wound healing, tooth loss, failure of implant, etc. Aside from smoking, many other risk factors can be related to oral health and long-term effects of smoking on salivary flow and taste threshold are still in controversy. Authors considered dental students to be an appropriate group with good oral hygiene for a long-term study to reveal effects of smoking on oral health. This study was performed to compare smoking patterns and current oral health conditions between smokers and nonsmokers in dental students prior to long-term evaluation. 192 volunteers (85.7%) of 224 male dental students in Dankook University were evaluated through questionnaires and clinical examination in 2010. Questionnaires included smoking pattern, alcohol use, nicotine dependence, preventive care, psychological profile and clinical examinations comprised assessment of teeth or periodontal status, nicotine pigmentation, salivary flow, electrical taste thresholds and halitosis. From the study, (current) smokers were older, and drank more frequently with more alcohol intake compared to former smokers and nonsmokers(p<0.05). There was no significant difference among them in salivary flow rate, halitosis and electrical taste threshold. However, there was significant difference in DMFT rate, periodontal treatment need, nicotinic pigmentation between smokers and nonsmokers(p<0.05), irrespective of their levels of preventive care. The smokers in this study, who are young dental students with relatively shorter duration of smoking, less use of cigarettes and low level of nicotine dependence, did not reveal significant impairment of oral health. However, their oral health was found to be relatively impaired compared to nonsmokers', which suggests negative effect of smoking on the oral health and a need of smoking cessation.
In order to evaluate the mechanism of transmission as well as processing of sensory information originating from low-threshold mechanoreceptor in oral and maxillofacial region at primary synaptic region of trigeminal nervous system, vibrissa afferent fibers of adult cat were labeled with intra-axonal HRP injection. Serial sections containing labeled boutons were obtained from the piece of trigeminal interpolar nucleus. Under electron microscope, total 30 labeled boutons were observed, and ultrastructural characteristics, frequency of occurence, synaptic organizations of vibrissa afferent terminals were analysed. The results were as follows: 1. Labeled boutons contained clear, spherical synaptic vesicles with diameter of 45$\sim$55nm. They formed asymmetrical synapse with dendrites showing definite postsynaptic density, larger synaptic cleft, multiple synaptic structures at various regions. With unlabeled axon terminals(p-ending) containing polymorphic synaptic vesicles, they formed symmetrical synapse showing indefinite postsynaptic density and narrower synaptic area. 2. Each labeled bouton formed 1 to 15 synapses, the average of 4.77$\pm$3.37 contacts per labeled bouton, with adjacent neuronal profiles. Relatively complex synaptic organization, which formed synapses with more than 5 neuronal profiles, was observed in a large number(46.7%, n=14) of labeled boutons. 3. Axo-somatic synapse was not observed. The number of axo-dendritic synapse was 1.83$\pm$1.37 per labeled bouton. Majority(85.0%) of axo-dendritic synapses were formed with dendritic shafts, nonprimary dendrites(n=47, 1.57$\pm$1.38/1 bouton), however, synapses formed with primary dendrites(n=6, 0.20$\pm$0.41/1 bouton) or dendritic spines(n=2, 0.07$\pm$0.25/1 bouton) were rare. 4. 76.7%(n=23) of labeled boutons formed axo-axonic synapse (2.93$\pm$2.36/1 bouton) with p-endings containing pleomorphic vesicles. Synaptic triad, in which p-endings formed synapses with labeled boutons and dendrites adjacent to the labeled boutons simultaneoulsy, were also observed in 60.0%(n=18) of labeled boutons. From the above results, vibrissa afferent terminals of adult cat showed distinctive synaptic organization in the trigeminal interpolar nucleus, thus, suggests their correlation with the function of the trigeminal interpolaris nucleus, which participates in processing of complex sensory information such as two-point discrimination and motivational-affective action. Further studies on physiologic functions such as quantitative analysis on ultrastructures of afferent terminals and nerve transmitters participating in presynaptic inhibition are required.
The purpose of this double-blind study was to evaluate clinical effects of botulinum toxin type A (BTX-A) injection on myofascial pain syndrome (MPS) involving upper trapezius and compare with those of lidocaine injection. 21 patients presenting with active TrP1 and/or TrP2 in the upper trapezius over 6 months were selected for this study. The subjects were randomly divided into two groups; one group injected with BTX-A (15 unit of $Botox^{(R)}$ / 0.3 ml per trigger point (TrP)) and the other group injected with 0.5% lidocaine (0.3 ml /TrP). The clinical effects were evaluated by VAS and PPT at baseline, 2, 4, 6 and 8 weeks after treatment. BTX-A group showed persistent decrease of VAS values and increase of PPT values following treatment. While there was no significant difference in VAS values between BTX-A and lidocaine groups (p=0.347), there was significant difference in PPT values after treatment between two groups (p=0.000). The subjects received BTX-A showed noticeable improvement in PPT values after treatment, suggesting more reliable effect of BTX-A injection compared with lidocaine injection. The results of this study support that the direct injection of BTX-A to a TrP is an effective and safe treatment for MPS involving upper trapezius.
The aim of the study was to investigate the effects of 904 nm GaAs laser irradiation for patients with hypersensitive teeth and to find the possibility of clinical use of this Low Level Laser Therapy (LLLT) for the control of hypersensitive teeth. Eleven patients visited Dept. of Oral Medicine, Dankook University participated in this study. Each patient contributed at least two or more contralateral pairs of hypersensitive teeth with exposed dentine at cervical surfaces. Total number of teeth used from subjects participated in this study was 50: 25 experimental and control teeth respectively. All participants were treated with 904 nm GaAs diode laser every week during 4 weeks. Tactile and cold (ice stick) tests were carried out before LLLT every week during 4 weeks and 1 week later after the last LLLT by measuring visual analogue scale (VAS) of patients and by measuring a score of electrical pulp tester (EPT) simultaneously. The VAS score in tactile test decreased significantly with time, but there was not statistically difference between those of groups. The score of EPT in the experimental group was significantly higher than that of control group, although there was no change with time. In cold test, there was significant difference between two groups and cold sensitivity of the experimental group significantly decreased with time after every LLL irradiation, compared with that of control group. Based on the results, it is suggested that the 904 nm GaAs laser irradiation could be positively used as an effective, reversible method in treating cervical dentine hypersensitivity.
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