• Journal of Dental Anesthesia and Pain Medicine
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• 제18권6호
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• pp.361-365
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• 2018

Background: Recently, we examined the effects of 2% lidocaine gel on the tactile sensory and pain thresholds of the face, tongue and hands of symptom-free individuals using quantitative sensory testing (QST); its effect was less on the skin of the face and hands than on the tongue. Consequently, instead of 2% lidocaine gel, we examined the effect of 8% lidocaine spray on the tactile sensory and pain thresholds of the skin of the face and hands of healthy volunteers. Methods: Using Semmes-Weinstein monofilaments, QST of the skin of the cheek and palm (thenar skin) was performed in 20 healthy volunteers. In each participant, two topical sprays were applied. On one side, 0.2 mL of 8% lidocaine pump spray was applied, and on the other side, 0.2 mL of saline pump spray was applied as control. In each participant, QST was performed before and 15 min after each application. Pain intensity was measured using a numeric rating scale (NRS). Results: Both the tactile detection threshold and filament-prick pain detection threshold of the cheek and thenar skin increased significantly after lidocaine application. A significant difference between the effect of lidocaine and saline applications was found on the filament-prick pain detection threshold only. NRS of the cheek skin and thenar skin decreased after application of lidocaine, and not after application of saline. Conclusion: The significant effect of applying an 8% lidocaine spray on the sensory and pain thresholds of the skin of the face and hands can be objectively scored using QST.

• 대한임상전기생리학회지
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• 제7권1호
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• pp.23-27
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• 2009

Purpose : The purpose of this study was to examine the effects of different medium frequency currents on afferent fibers. Methods : Thirty healthy volunteers who had no known history of neurological disorders were equally assigned to one of three groups; 2500Hz, 4000Hz, and control and each group was applied to the left wrist in palmer cutaneous branch of radial nerve by different medium frequency currents for 15 min. We measured the changes of thresholds for tactile, two-point discrimination, and thresholds for pain. Results : The results showed that the medium frequency currents stimulation increased thresholds for tactile, two-point discrimination, and thresholds for pain. However, there is no statistically significant difference between group 2500Hz and group 4000Hz. Conclusion : This may explain thresholds for tactile, two-point discrimination, and thresholds for pain plain medium frequency currents stimulation inhibits the excitability of afferent fibers, but the effect of the frequency difference within medium frequency currents is not demonstrated.

• Journal of Oral Medicine and Pain
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• 제40권3호
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• pp.96-101
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• 2015

Purpose: Thermal sensory test as an essential part of quantitative sensory testing (QST) has been recognized as a useful tool in the evaluation of the trigeminal nerve function. Normative data in the orofacial region have been reported but the data on differences in the test site, sex and ethnicity are still insufficient. Thus, this study aimed to investigate the normal range of orofacial thermal QST data in the healthy Korean women, and assess sex difference of thermal perception in the orofacial regions. Methods: Thermal QST was conducted on 20 healthy women participants (mean age, 26.4 years; range, 21 to 34 years). The thermal thresholds (cold detection threshold, CDT; warm detection threshold, WDT; cold pain threshold, CPT; and heat pain threshold, HPT) were measured bilaterally at the 5 trigeminal sites (the forehead, cheek, mentum, lower lip and tongue tip). The normative thermal thresholds of women in the orofacial region were evaluated using one-way ANOVA and compared with the previously reported data from age- and site-matched 30 healthy men (mean age, 26.1 years; range, 23 to 32 years) using two-way ANOVA. One experienced operator performed the tests of both sexes and all tests were done in the same condition except the time variability. Results: Women showed significant site differences for the CDT (p<0.001), WDT (p<0.001), and HPT (p=0.047) in the orofacial region. The CDT (p<0.001) and the CPT (p=0.007) presented significant sex difference unlike the WDT and the HPT. Conclusions: The thermal sensory evaluation in the orofacial region should be considered in the context of site and sex and the normative data in this study could be useful for assessment of the sensory abnormalities in the clinical setting.

• Journal of Oral Medicine and Pain
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• 제32권4호
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• pp.413-419
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• 2007

다양한 종류의 정량적 통각검사들의 연관성을 알아보기 위하여 56 명의 측두하악장애 환자를 대상으로 측두근, 교근, 측두하악관절 부위, 그리고 경골근의 냉통각역치 (Cold Pain Threshold, CPT), 열통각역치 (Heat Pain Threshold, HPT), 열통증인내역치 (Heat Pain Tolerance Threshold, PTT), 압력통각역치 (Pressure Pain Threshold, PPT)를 측정하였으며, 각기 다른 통각 역치 간의 상관관계와 측정 부위 별 통각 역치 간의 상관 관계를 분석하였다. CPT, HPT, PTT를 포함한 온도통각역치의 성별간 차이는 나타나지 않았다. 그러나 PPT는 여성이 남성에 비하여 모든 부위에서 유의하게 낮은 역치를 나타내었다. CPT, HPT, PTT를 포함한 세 가지의 온도통각역치들은 모든 측정 부위에서 약정도에서 강정도 (mild to high)의 상관관계를 나타내었다 (r= 0.324-0.754, p<0.05). PPT 값은 각각의 온도통각역치와 통계적으로 유의한 상관관계를 나타내지 않았다. 모든 측정 부위의 통각역치값들은 서로간에 약정도에서 강정도 (mild to high)의 상관관계를 나타내었다 (r= 0.284-0.878, p<0.05). 측두하악장애 환자의 온도통각역치와 열통각인내역치 사이에는 유의한 상관관계가 존재하나 온도통각역치와 압력통각역치 간에는 상관관계가 나타나지 않는 것이 관찰되었으며, 각기 다른 부위에서 측정된 통각역치 간에는 비교적 높은 상관관계가 나타났다.

• The Korean Journal of Pain
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• 제14권1호
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• pp.7-11
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• 2001

Background: Although several mechanisms of causalgia, which results from a partial injury to the peripheral nerve trunk, have been proposed, whether or not antidromic impulses from the injured neurons contribute to the development of the mechanical hyperalgesia has not been studied. The purpose of this experiment is was to investigate the role of antidromic impulses to the peripheral sensory receptor site on the development of mechanical hyperalgesia in a rat model of peripheral neuropathy. Methods: Rats were prepared with tight ligation of by tightly ligating the left fifth and sixth lumbar spinal nerves. The effect of bupivacaine pretreatment on the development of mechanical hyperalgesia was evaluated by injecting 0.5% bupivacaine (0.3 ml) into the plantar surface of the left hind paw before the skin incision was made. For the control group, normal saline (0.3 ml) was injected instead of bupivacaine. To measure the mechanical hyperalgesia, paw withdrawal thresholds were measured using a series of von Frey hairs. Mechanical hyperalgesia was measured a the day before, and 1, 2, 3, 4, 7, and 14 days after the surgery. Results: The control group showed decreased withdrawal thresholds from the day after the surgery (the values were $14.0{\pm}0.5$, $8.9{\pm}1.3$, $8.4{\pm}1.6$, $6.9{\pm}1.2$, $8.8{\pm}1.5$, $10.5{\pm}1.3$, and $8.6{\pm}1.3$ g; at -1, 1, 2, 3, 4, 7, and 14 days after the surgery, respectively). However, withdrawal thresholds of the bupivacaine-pretreated group showed increased withdrawal thresholds for three days after the surgery ($14.5{\pm}0.3$, $12.6{\pm}1.4$, $12.7{\pm}1.1$, $10.5{\pm}1.3$ g; at 1, 1, 2, 3 days after the surgery). Conclusions: Our result suggests that antidromic impulses to the peripheral sensory receptors are at least partly responsible for the initial development of mechanical hyperalgesia in a rat model of peripheral neuropathy.

• Safety and Health at Work
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• 제2권4호
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• pp.355-364
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• 2011

Objectives: Though sulfur dioxide (SO2) is used widely at workplaces, itseffects on humans are not known. Thresholds are reportedwithout reference to gender or age and occupational exposure limits are basedon effects on lung functioning, although localized effects in the upper airways can be expected. This study's aim is to determine thresholds with respect to age and gender and suggests a new approach to risk assessment using breathing reflexes presumably triggered by trigeminal receptors in the upper airways. Methods: Odor thresholds were determined by the ascending method of limits in groups stratified by age and gender. Subjects rated intensities of different olfactory and trigeminal perceptions at different concentrations of $SO_2$. During the presentation of the concentrations, breathing movements were measured by respiratory inductive plethysmography. Results: Neither age nor gender effects were observed for odor threshold. Only ratings of nasal irritation were influenced bygender. A benchmark dose analysis on relative respiratory depth revealed a 10%-deviation from baseline at about 25.27 mg/$m^3$. Conclusion: The proposed new approach to risk assessment appearsto be sustainable. We discuss whether a 10%-deviation of breathingdepth is relevant.

• Journal of Oral Medicine and Pain
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• 제37권4호
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• pp.243-250
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• 2012

임플란트 수술이나 발치 같은 침습적인 치과치료로 인한 삼차신경 손상의 증가는 최근 치과계의 가장 민감한 문제의 하나로서 향후 법적인 문제로 까지 이어질 수 있다. 그러므로 신경손상에 대한 객관적이고 신뢰성 있는 평가 즉, 정량적 감각신경 검사(quantitative sensory testing)의 필요성이 강조되고 있으며, 온도역치 검사는 QST의 필수 항목으로 구강영역에서도 신뢰성이 입증되어 있다. 국내에서는 삼차신경손상과 관련한 온도역치 검사에 대한 보고가 아직 없기에, 본원에서 시행한 일부 증례의 온도역치 검사의 결과를 평가하고자 하였다. 2011년 5월부터 2012년 10월까지 단국대학교 치과대학 부속 치과병원 구강내과에 내원한 삼차신경손상이 의심되는 환자중 온도역치 검사를 시행한 18명의 환자 자료를 분석하였다. 환자들의 냉인지역치(cold detection threshold, CDT)는 이환측이 비이환측에 비해 유의하게 낮았으나 온인지역치(warm detection threshold, WDT), 냉통각역치(cold pain threshold, CPT), 열통각역치(heat pain threshold, HPT)는 통계적 차이를 보이지 않았다. 향후 더 많은 피검자를 대상으로 온도 자극과 관련하여 감각저하나 감각과민, 통각저하나 통각과민 같은 유형별 비교 연구가 필요하다.

• 한국엔터테인먼트산업학회논문지
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• 제14권8호
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• pp.237-244
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• 2020

감각장애는 뇌졸중에서 흔히 나타나며, 발에서 나오는 촉각의 감각정보는 균형을 위해 중추신경계에 중요한 정보를 제공한다. 본 연구의 목적은 뇌졸중 환자의 발바닥 감각역치와 균형의 상관관계를 연구하는 것이다. Semmes-Weinstein Monofilaments를 사용하여 발바닥의(엄지발가락과 뒤꿈치) 감각역치를 평가하였다. 균형은 버그균형척도와 MTD system을 이용하여 정적 선 자세와 앉은 자세에서 일어서기 동안의 마비쪽과 비마비쪽의 체중 분포 정도를 측정하였다. 정적 선 자세와 앉은 자세에서 일어서기 동안 체중 분포 정도는 비마비쪽보다 마비쪽에서 더 낮았다(P<0.05). 버그균형척도는 36.00±1.53이었다. 마비쪽의 엄지발가락 감각역치는 버그균형척도(r=-0.444, P<0.05), 정적 선 자세(r=-0.332, P<0.05), 앉은 자세에서 일어서기(r=-0.390, P<0.05)와 상관관계가 있었다. 마비쪽의 뒤꿈치 감각역치는 버그균형척도(r=-0.467, P<0.05), 정적 선 자세(r=-0.532, P<0.05), 앉은 자세에서 일어서기(r=-0.516, P<0.05)와 상관관계가 있었다. 이러한 결과는 발바닥의 높은 감각역치가 균형 능력 저하에 영향을 미칠 수 있음을 시사한다. 앞으로 뇌졸중 환자의 감각 역치에 대한 연구는 뇌졸중 환자의 재활과 감각 평가에 도움이 될 것이다.

• Annals of Clinical Neurophysiology
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• 제12권1호
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• pp.21-26
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• 2010

Background: Although quantitative sensory test (QST) is being used with increasing frequency for measuring sensory thresholds in clinical practice and epidemiologic studies, there has been no age-matched normative data in Korean adults. The objective of this study is to evaluate the value of QST in diabetic polyneuropathy with normal range in Korean adults. Methods: The Computer Aided Sensory Examination IV 4,2 (WR Medical Electronics Co., Stillwater, Minnesota, U.S.A.), with 4,2,1 stepping algorithm was used to determine vibration and cold perception threshold in 70 normal controls and 19 patients with diabetic polyneuropathy aged from 21 to 79 years. The data were used to define age-matched upper and lower normal limits and normal range of side to side difference. We also evaluated the duration of diabetes, serum HbA1C level, and findings of nerve conduction study (NCS) and QST in patients with diabetic polyneuropathy. Results: In normal adults, sensory thresholds slightly increased with age, and a slight side-to-side difference was observed. The diagnostic sensitivity of QST was not higher than NCS in patients with diabetic polyneuropathy (36.8% vs. 42.1%, p=0.716), especially among elderly patients. Conclusions: QST might be used as a complementary test for NCS in the diagnosis of diabetic polyneuropathy. Although the QST is a simple method for the evaluation of peripheral nerve function, there are some limitations. Most of all, because the QST measuring is dependent on the subjective response of patients, the degree of concentration and cooperation of the patients can significantly affect the result. And thus, attention should be paid during the interpretation of QST results in patients with peripheral neuropathy.

• 대한임상전기생리학회지
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• 제10권2호
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• pp.1-6
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• 2012

Purpose : This study is to investigate the modulatory effects to the ultraviolet induced erythema of pain processing system. Methods : Thirty six healthy volunteers were divided into none treatment group (n=6), indomethacine group (n=6), subsensory level electrical stimulation group (n=6), sensory level electrical stimulation group (n=6), motor level electrical stimulation group (n=6), noxious level electrical stimulation group (n=6). Subjects were induced erythema for three times minimal erythema dose (MED) at upper arm of dermatome C6 level. Each experimental group had mechanical pain threshold (MPT), electrical pain threshold (EPT), thermal pain threshold (TPT). Results : This study revealed that we observed that pain thresholds were significantly correlated with each other in pain processing system. The effect of electrical stimulation levels evaluates were shown to be significant differences pain control effect in electrical stimulation group (sensory, motor level electrical stimulation groups) more than indomethacine group, subsensory level and control group. Conclusion : In this study, it was found that the effect of ultraviolet induced erythema of pain control by modulatory electrical stimulation.