• Title/Summary/Keyword: sensory threshold

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The quantitative sensory testing is an efficient objective method for assessment of nerve injury

  • Kim, Young-Kyun;Yun, Pil-Young;Kim, Jong-Hwa;Lee, Ji-Young;Lee, Won
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.37
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    • pp.13.1-13.7
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    • 2015
  • Background: This study evaluated Somatosensory evoked potentials (SEP), Quantitative sensory testing (QST), and thermography as diagnostic methods for nerve injury. Methods: From 2006 through 2011, 17 patients (mean age: 50.1 years) from ${\bigcirc}{\bigcirc}{\bigcirc}{\bigcirc}$ Hospital who sought care for altered sensation after dental implant treatment were identified. The mean time of objective assessment was 15.2 months after onset. Results: SEP of Inferior alveolar nerve(IAN) was $15.87{\pm}0.87ms$ on the normal side and $16.18{\pm}0.73ms$ on the abnormal side. There was delayed N20 latency on the abnormal side, but the difference was not statistically significant. In QST, the abnormal side showed significantly higher scores of the current perception threshold at 2 KHz, 250 Hz, and 5 Hz. The absolute temperature difference was $0.55^{\circ}C$ without statistically significance. Conclusion: These results indicate that QST is valuable as an objective method for assessment of nerve injury.

CHANGES OF SENSORY AND SOMATOSENSORY EVOKED POTENTIALS FOLLOWING A NEEDLE INJURY ON THE INFERIOR ALVEOLAR NERVE IN RATS (백서 하치조 신경 손상에 따른 감각 유발전위와 체성감각 유발전위의 변화에 관한 연구)

  • Woo, Seung-Chel;Kim, Soo-Nam;Lee, Dong-Keun;Cheun, Sang-Woo
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.18 no.4
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    • pp.652-672
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    • 1996
  • Dysfunction of the inferior alveolar nerve may result from trauma, diseases or iatrogenic injury. The development and refinement of an objective method to evaluate this clinical problem is highly desirable and needed, especially concerning for an increasing medico-legal issue. Evoked potential techniques have attracted considerable attention as a means of assessing the function and integrity of nerve pathways. The purpose of this study was to characterize the Sensory Evoked Potentials(SEPs) and Somatosensory Evoked Potentials(SSEPs) elicited by electrical stimulation of mental nerve. SEPs and SSEPs were measured and analyzed statistically before and after needle injury on the inferior alveolar nerve of Sprague-Dawalye rats. Measuring SEPs was more sensitive in evaluation of the recovery of sensory function from inferior alveolar nerve injury then measuring SSEPs but we measured SSEPs in the hope of providing a safe, simple and objective test to check oral and facial sensibility, which is acceptable to the patient. We stimulated mental nerve after needle injury on the inferior alveolar nerve and SEPS on the level of mandibular foramen and SSEPs on the level of cerebral cortex were recorded. Threshold, amplitude, and latency of both of SEPs and SSEPs were analyzed. The results were as follows ; 1. Threshold of SEPs and SSEPs were $184{\pm}14{\mu}A$ and $164{\pm}14{\mu}A$ respectively. 2 SEPs were composed of 2 waves, i.e., N1 N2 in which N1 was conducted by II fibers and N2 was conducted by III fibers. 3. SSEPS were composed of 5 waves, of which N1 and N2 shower statistically significant changes(p<0.01, unpaired t-test). 4. SEPs and SSEPs were observed to be abolished immediately after local anesthesia and recovered 30 minutes later. 5. SEPs were abolished immediately after injury. N1 of SSEPs was abolished immediately and amplitued of N2 was decreased($20.7{\pm}12.2%$) immediately after 23G needle injury, but N3, N4 and N5 did not change significantly. Recovery of waveform delayed 30 minutes in SEPs and 45 minutes in SSEPs. 6. The degree of decrease in amplitude of SEPs and SSEPs, after 30G needle injury was smaller than those with 23G. SEPs recorded on the level of mandibular foramen were though to be reliable and useful in the assessment of the function of the inferior alveolar nerve after injury. Amplitude of SSEPs reflected the function and integrity of nerve and measuring them provided a safe, simple and abjective test to check oral and facial sensibility. These results suggest that measuring SEPs and SSEPs are meaningful methods for objective assessment in the diagnosis of nerve injury. N1 and N2 of SSEPs can be useful parameters for the evaluation of the nerve function following a needle injury.

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AN EXPERIMENTAL STUDY OF ELECTROPHYSIOLOGICAL AND HISTOLOGICAL ASSESSMENT ON THE INJURY TYPES IN RABBIT INFERIOR ALVEOLAR NERVE (가토의 하치조 신경 손상 형태에 따른 전기생리학적 및 조직학적 변화에 관한 실험적 연구)

  • Lee, Jae-Eun;Lee, Dong-Keun
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.18 no.4
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    • pp.679-700
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    • 1996
  • Inferior alveolar nerve dysfunction may be the result of trauma, disease, or iatrogenic injury. Inferior alveolar nerve injury is inherent risk in endodontic therapy, orthognathic surgery of the mandible, and extraction of mandibular teeth, particularly the third molars. The sensory disturbances of inferior alveolar nerve associated with such injury have been well documented clinical problem that is commonly evaluated by several clinical sensory test including Tinels sign, Von Frey test(static light touch detection), directional discrimination, two-point discrimination, pin pressure nociceptive discrimination, and thermal test. These methods used to detect and assess inferior alveolar nerve injury have been subjective in nature, relying on the cooperation of the patients. In addition, many of these techniques are sensitive to differences in the examiners experience and skill with the particular technique. Data obtained at different times or by different examiners are therefore difficult to compare. Prior experimental studies have used electro diagnostic methods(sensory evoked potential) to objectively evaluate inferior alveolar nerve after nerve injury. This study was designed with inferior alveolar nerve of rabbit. Several types of injury including mind, moderate, severe compression and perforation with 19 gauze, 21 gauze needle and 6mm, 10mm traction were applied for taking the sesory evoked ppterntial. Latency and amplitude of injury rabbit inferior alveolar nerve were investigated with sensory evoked potential using unpaired t-test. The results were as follows : 1. Intensity of threshold (T1) was $128{\pm}16{\mu}A$ : latency, $0.87{\pm}0.07$ microsecond : amplitude, $0.4{\pm}0.1{\mu}V$ : conduction velocity, 23.3 m/s in sensory evoked potential of uninjured rabbit inferior alveolar nerve. 2. Rabbit inferior alveolar nerve consists of type II and III sensory nerve fiber. 3. Latency was increased and amplitude was decreased in compression injury. The more injured, the more changed in latency and amplitude. 4. Findings in perforation injury was similar to compression injury. Waveform for sensory evoked potential improved by increasing postinjured time. 5. Increasing latency was prominent in traction injury rabbit inferior alveolar nerve. 6. In microscopic histopathological findings, significant degeneration and disorganization of the internal architecture were seen in nerve facicle of severe compression and 10mm traction group. From the above findings, electrophysiological assessment(sensory evoked potential) of rabbit injured inferior alveolar nerve is reliable technique in diagnosis and prognosis of nerve injury.

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Effect of Age-related Changes in Taste Perception on Dietary Intake in Korean Elderly (노인의 영양상태에 미각변화가 미치는 영향)

  • 김화영
    • Journal of Nutrition and Health
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    • v.30 no.8
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    • pp.995-1008
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    • 1997
  • This study was performed to investigate the change in taste perception during aging and its effects on dietary intake in Korean elderly. The subjects were female aged 65 through 90 in the Anyang area, and college women were included as a comparison group . Dietary intake of the elderly(n=155) and young subjects (n=38) was measured by a 3 day diet record. The taste threshold and 'just right' concentrations(JRC) for sweet and salty tastes were assessed by sensory evaluation . Sucrose solution (0.0.,0.4,0.6,0.8,1.0, 1.2%) and salt solution(0, 0.02, 0.03,0.06,0.09,0.12,0.15%) were used to establish thresholds. for JRC assessment, four suprathreshold sucrose concentrations of 5, 8, 11 and 14% in orange-pineapple flavored juice and salt concentrations of 0.20, 0.34, 0.50and 0.75% in beef stock were prepared. Mean intakes of energy, protein , vitamin A, thiamin , riboflavin, niacin ,calcium and iron of the elderly were below the Korean Recommended Dietary allowances. The elderly showed higher taste thresholds than young subjects of both sweet and salty tastes consumed less calories. Needs to bespecified. The older subjects having high threshold or JRCs for sweet and salty tastes consumed fewer calories from protein and fat. Pearson correlation coefficients was between JRC for sweet and salty tastes 0.54(p<0.01). The correlation coefficients between tastes threshold and nutrient intakes were very low for both age groups. Unlike the college women, in the elderly the JRC of sweet taste of the orange-pineapple juice were negatively correlated with intakes of energy, protein, fats, thiamin , riboflavin , niacin ,vitamin C , iron and consumption of meat and egg food groups (p<0.01). In summation age-related alterations in sweet and salty taste perception were observed in the elderly and dietary intakes of the elderly see to be influenced by these taste perception changes.

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Long-term consistency of clinical sensory testing measures for pain assessment

  • Pablo Bellosta-Lopez;Victor Domenech-Garcia;Thorvaldur Skuli Palsson;Pablo Herrero;Steffan Wittrup Mcphee Christensen
    • The Korean Journal of Pain
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    • v.36 no.2
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    • pp.173-183
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    • 2023
  • Background: Understanding the stability of quantitative sensory tests (QSTs) over time is important to aid clinicians in selecting a battery of tests for assessing and monitoring patients. This study evaluated the short- and long-term reliability of selected QSTs. Methods: Twenty healthy women participated in three experimental sessions: Baseline, 2 weeks, and 6 months. Measurements included pressure pain thresholds (PPT) in the neck, upper back, and leg; Pressure-cuff pain tolerance around the upper-arm; conditioned pain modulation during a pressure-cuff stimulus; and referred pain following a suprathreshold pressure stimulation. Intraclass correlation coefficients (ICC) and minimum detectable change (MDC) were calculated. Results: Reliability for PPT was excellent for all sites at 2 weeks (ICC, 0.96-0.99; MDC, 22-55 kPa) and from good to excellent at 6 months (ICC, 0.88-0.95; MDC, 47-91 kPa). ICC for pressure-cuff pain tolerance indicated excellent reliability at both times (0.91-0.97). For conditioned pain modulation, reliability was moderate for all sites at 2 weeks (ICC, 0.57-0.74; MDC, 24%-35%), while it was moderate at the neck (ICC, 0.54; MDC, 27%) and poor at the upper back and leg at 6 months. ICC for referred pain areas was excellent at 2 weeks (0.90) and good at 6 months (0.86). Conclusions: PPT, pressure pain tolerance, and pressure-induced referred pain should be considered reliable procedures to assess the pain-sensory profile over time. In contrast, conditioned pain modulation was shown to be unstable. Future studies prospectively analyzing the pain-sensory profile will be able to better calculate appropriate sample sizes.

Reliability of Quantitative Sensory Testing Using Current Perception Thresholds in the Mandibular Nerve Area (하악신경영역에서 전류인지역치를 이용한 정량적 감각신경 검사의 재현성 조사)

  • Choi, Hee-Hun;Kim, Mee-Eun;Kim, Ki-Suk
    • Journal of Oral Medicine and Pain
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    • v.36 no.2
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    • pp.131-137
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    • 2011
  • 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.

A Study of Current Perception Threshold of Trigeminal Nerve after Tooth Implantation (치아임플란트 시술 후 삼차신경에서의 전류인지역치에 대한 연구)

  • Lim, Hyun-Dae;Lee, Jung-Hyun;Lee, You-Mee
    • Journal of Oral Medicine and Pain
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    • v.32 no.2
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    • pp.187-200
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    • 2007
  • This study attempted to contribute to the clinical application of implant operation by making a quantitative nerve examination using a neurometer for the evaluation of sensory disturbances that could be incurred after the implantation in the dental clinics, and it intended to establish an objective guideline in the evaluation of sensory nerve after the operation of implant. An inspection was performed with the frequencies of 2000Hz, 250 Hz and 5 Hz before and after the operations of tooth implant using $Neurometer^{(R)}$ CPT/C (Neurotron, Inc. Baltimore, Maryland, USA) for 44 patients who had performed an implant operation among the patients coming to Daejeon Sun Dental Hospital in 2006 and 30 people for control group. The measuring sites were maxillary nerve ending and mandibular nerve ending of trigeminal nerve according to the implant operating regions. The current perception threshold (CPT) by each nerve fiber was specifically responded under the electric stimulation of 2000 Hz in case of $A{\beta}$ fiber and of 250 Hz in case of $A{\delta}$ fiber and of 5Hz in case of C fiber. The CPT test could be performed to assess the damages of peripheral nerve in the trigeminal nerve area and it stimulated selective nerve fibers by generating the electricity of specific frequency in the peripheral nerve area. The nerve fibers with varied thickness were responsive selectively to the electric stimulation with different frequencies; accordingly, they applied the electric stimulation with different frequencies and the reaction threshold of $A{\beta},\;A{\delta}$ and C fibers selectively responsive to each electric current could be individually evaluated. In the assessment through the CPT, the increase and decrease of the CPT could be measured so that sensory disturbances such as hyperaesthesia or hypoaesthesia could be diagnosed. This study could obtain the following results after the assessment of the CPT before and after the implant operation. 1. In the assessment before and after the implant operation, the CPT in the frequencies of 2000 Hz, 250 Hz, 5 Hz for maxillary branch increased on the whole after the operation and the CPT for mandibular branch in the $A{\beta}$-fiber(2000 Hz) and C-fiber(5 Hz )after the operation increased statistically significantly. 2. For the groups of patients with medically compromised or its subsequent medicinal prescription, there were no significant differences before and after the implant operation and for the control groups, significantly high CPT was shown after the implant operation in the left $A{\beta}$-fiber(2000 Hz) and C-fiber(5 Hz). 3. In the comparison of the measured value of the CPT before the operation between the control group and the implant operation group, the latter group had a significantly high measured value of the CPT in the right $A{\beta}$-fiber(2000 Hz) and C-fiber(5 Hz) and there were significant differences in $A{\beta}$-fiber(2000 Hz) in the CPT assessment after the implant operation for the control group. 4. Male participants had higher CPT than female counterparts; however, there were no statistic significances. In the CPT evaluation before and after implant operation, there were no statistical differences in the male group while the right C-fiber(5 Hz) and left $A{\beta}$-fiber(2000Hz) were significantly high in the female group. 5. In the comparison between the group who complain sensory disturbance and the other group, the CPT increased on the whole in the former group, but there were no statistical significances. In the groups, whom there was an increase in VAS, the CPT after the implant operation in the right C-fiber(5 Hz) increased significantly; meanwhile, in case that the VAS mark was '0' before and after the operation, the CPT after the operation in the left $A{\beta}$-fiber(2000 Hz) increased significantly. This study suggested that the CPT measurements using $Neurometer^{(R)}$ CPT/C, provide useful information of objective and quantitative sensory disturbances for tooth implantation.

Studies on the Evaluation for the Quality of Food by Sensory Testing -I. Selection of Sensory Panel and Difference Testing for the Evaluation on the Sensory Quality of Milk- (관능검사법(官能檢査法)에 의한 식품(食品)의 품질(品質) 평가(評價)에 관(關)한 연구(硏究) -제(第) 1 보(報) : 우유의 관능(官能) 품질(品質)의 평가(平價)를 위한 파넬원 선발(選拔) 및 차이(差異) 식별(識別) 시험(試驗)-)

  • Chae, Soo-Kyu;Chang, Kun-Hyung
    • Korean Journal of Food Science and Technology
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    • v.12 no.3
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    • pp.150-157
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    • 1980
  • In an attempt to evaluate the quality of food by sensory testing, the difference testing for commercial milk was conducted by selected members of a sensory panel. The results were summarized as follows: 1. Sensory panel of 40 persons were selected by the general basis of selection of panel members, by sensitivity test for primary taste, and by discriminatory ability test and trained to have normal abilities on the sensory testing for the quality of milk. 2. As a result of sensitivity test for 4 primary tastes by panel members, the solution concentration of salt, sour, bitter and sweet for which average recognition threshold was located were 0.0128 M sodium chloride, 0.0008 M citric acid, 0.0016 M caffeine and 0.0256 M sucrose, respectively. 3. As results of difference test of single stimuli, paired comparison test, duo-trio test and triangle test, a significant difference was recognized at higher level than the 1% among the samples of commercial milk produced by 5 companies.

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Narrative Review on the Mechanism of Whidam's Vibrator Sugi Therapy (휘담식 진동기 수기요법의 기전에 대한 서술적 고찰)

  • Hun Mo Ahn;Dae Sung Jung;Han Joo Kang
    • Journal of Korean Medical Ki-Gong Academy
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    • v.22 no.1
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    • pp.1-27
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    • 2023
  • Objective : This paper provides a narrative review of the research literature on the neurophysiological and neurochemical mechanisms of local vibration while studying the treatment principles and mechanisms of Whidam's vibrator Sugi therapy. Methods : Searches related to vibration therapy research were conducted in PUBMED using "Vibration", "Whole Body Vibration", "Localized Vibration", and "Focal Vibration". The Conditions were limited to review and systematic review. Results : Roberto Casale's paper was selected as an inquiry task and reviewed critically and narratively by referring to other papers. The stimulation process of local vibration (LV) was broadly classified into receptor transmission (pain reception phase), ascending sensory pathway to the spinal cord (segmental phase), and action of the cortex and subcortical structures (systemic control phase) according to the pain pathway. In addition, the role of C-tactile mechanoreceptors, changes in neurotransmitters and neurohormones, LV stimulation below perception threshold (lower threshold), pain control and kinesiologic illusions were specially addressed. In addition, the expression and function of Piezo Channels were added to supplement the human pain and tactile sensing mechanism. Conclusions : LV exerts pain control mechanisms through different interactions that can interfere with pain transmission and pain perception. Since LV provides sufficient neurophysiological reasons for clinical application, it is necessary to expand the use of Whidam's vibrator Sugi therapy to a wider range of clinical applications.

The study of difference between HIVD group and simple low back pain group by Current Perception Threshold test (요추추간판탈출증군과 단순요통군간의 Current Perception Threshold상의 차이에 관한 연구)

  • Kim Cheol-Hong;Lee Byung-Hoon;Kwon Hye-Yeon;Lim Chun-Woo;Seo Jung-Chul;Youn Hyoun-Min;Song Choon-Ho;Jang Kyung-Jeon;Ahn Chang-Beohm
    • Journal of Acupuncture Research
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    • v.18 no.6
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    • pp.59-69
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    • 2001
  • Objective : The aim of this study is to assess the ability of the CPT test to dignosis radiculopathy in Korean with NeuvalTM CPT database. Method : Electrical stimulation(at 2000, 250, and 5Hz) using Neurometer was applied to the 19 patients who felt back and sciatic pain with herniated intervertevral disc(HIVD) of L-spine, dignosisd by lumbar CT or MRI, and the 33 patients who felt only back or hip or leg pain without HIVD, stenosis, spondylolisthesis which causing radiculopathy. The test sites were toe1, toe3 and toe5 related to L4, L5 and S1 nerve roots. Results : The mean values of the CPT of HIVD group was stiatically lower than LBP group at toe1-250Hz, toe3-2000Hz, 250Hz and toe5-250Hz, 5Hz. The grading CPT score of HIVD group was stastically higher than LBP group at the toe3(L5). The VAS of HIVD group was stastically higher than LBP group. Conclusion : These results suggest that the CPT test can be a valuable testing for diagnosing radiculopathy in Korean. In using CPT test further study is needed for the diagnosis and evaluation of sensory nerve dysfunction in the musculoskeletal disease.

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